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World J Gastroenterol. Mar 14, 2013; 19(10): 1508-1512
Published online Mar 14, 2013. doi: 10.3748/wjg.v19.i10.1508
Aflatoxins, hepatocellular carcinoma and public health
Arvin Magnussen, Mansour A Parsi
Arvin Magnussen, Sandefjord High School, 3228 Sandefjord, Norway
Mansour A Parsi, Section for Therapeutic and Pancreatobiliary Endoscopy, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Magnussen A searched pubmed for relevant articles, gathered and interpreted the data, and wrote the draft manuscript; Parsi MA co-authored and critically revised the manuscript.
Correspondence to: Mansour A Parsi, MD, MPH, Section Head, Section for Therapeutic and Pancreatobiliary Endoscopy, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States. parsim@ccf.org
Telephone: +1-216-4454880 Fax: +1-216-4446284
Received: September 6, 2012
Revised: November 2, 2012
Accepted: November 14, 2012
Published online: March 14, 2013

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer deaths worldwide, primarily affecting populations in the developing countries. Aflatoxin, a food contaminant produced by the fungi Aspergillus flavus and Aspergillus parasiticus, is a known human carcinogen that has been shown to be a causative agent in the pathogenesis of HCC. Aflatoxin can affect a wide range of food commodities including corns, oilseeds, spices, and tree nuts as well as milk, meat, and dried fruit. Many factors affect the growth of Aspergillus fungi and the level of aflatoxin contamination in food. Drought stress is one of the factors that increase susceptibility of plants to Aspergillus and thus aflatoxin contamination. A recent drought is thought to be responsible for finding of trace amounts of aflatoxin in some of the corn harvested in the United States. Although it’s too soon to know whether aflatoxin will be a significant problem, since United States is the world’s largest corn producer and exporter, this has raised alarm bells. Strict regulations and testing of finished foods and feeds in the United States should prevent a major health scare, and prevent human exposure to deleterious levels of aflatoxin. Unfortunately, such regulations and testing are not in place in many countries. The purpose of this editorial is to summarize the current knowledge on association of aflatoxin and HCC, encourage future research and draw attention to this global public health issue.

Keywords: Aflatoxins, Hepatocellular carcinoma, Environmental health, Food safety, Public health