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Primary Liver Cancer Rate and Mlatoxin Intake in a High Cancer Area
Abstract
Data have been accumulating in various parts of the world which suggest that there might be some relationship be~een the level of aflatoxin intake by certain populations and their primary liver cancer rate. The object of this work was to examine this relationship in the highest known liver cancer incidence area in the world, namely the Inhambane district of Mozambique. It was therefore necessary to obtain an estimate of the primary liver cancer rate for the total population which wc:s more reliable than existing data, and to sample prepared meals throughout the district for aflatoxin analysis. The age and sex distribution of the disease was obtained by means of a hospital registration programme and data on the absolute occurrence of the disease extracted from the health records of gold-miners originating from the study area. Tile two sets of data were used to calculate the specific cancer rates according to age and sex, in addition to' the over-all cancer rate for the population. Values for the 1964 to 1968 and lS69 to 1971 periods were 35,5 and 25,4 per 100000 per year, the disease occurring more than twice as commonly in males than in females. The extent of aflatoxin contamination of prepared food consumed by the population was ascertained by means of the chemical assay of 880 meals collected at random. The mycotoxin was found in 9,3% of all samples, resulting in a mean contamination of all prepared food of 7,8 p.g/ kg wet food, and a mean daily per capita consumption of 222,4 ng/kg bodyweight (15 p.g/adult/day). The pooling of these data with similar studies in lower incidence areas elsewhere revealed a significant correlation between the level of aflatoxin consumption and the liver cancer rate. The results obtained represent both the highest primary liver cancer rate reported and the highest known aflatoxin intake.
