title: Application of Probabilistic Modeling to Quantify the Reduction Levels of Hepatocellular Carcinoma Risk Attributable to Chronic Aflatoxins Exposure.
abstract: Epidemiological studies show a definite connection between areas of high aflatoxin content and a high occurrence of human hepatocellular carcinoma (HCC). Hepatitis B virus in individuals further increases the risk of HCC. The two risk factors are prevalent in rural Kenya and continuously predispose the rural populations to HCC. A quantitative cancer risk assessment therefore quantified the levels at which potential pre- and postharvest interventions reduce the HCC risk attributable to consumption of contaminated maize and groundnuts. The assessment applied a probabilistic model to derive probability distributions of HCC cases and percentage reductions levels of the risk from secondary data. Contaminated maize and groundnuts contributed to 1,847 ± 514 and 158 ± 52 HCC cases per annum, respectively. The total contribution of both foods to the risk was additive as it resulted in 2,000 ± 518 cases per annum. Consumption and contamination levels contributed significantly to the risk whereby lower age groups were most affected. Nonetheless, pre- and postharvest interventions might reduce the risk by 23.0-83.4% and 4.8-95.1%, respectively. Therefore, chronic exposure to aflatoxins increases the HCC risk in rural Kenya, but a significant reduction of the risk can be achieved by applying specific pre- and postharvest interventions.
authors.affiliation: a Department of Food Science , Nutrition and Technology, University of Nairobi , Nairobi , Kenya.|b Kenya Nutritionists and Dieticians Institute , Nairobi , Kenya.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Wambui
authors.affiliation: a Department of Food Science , Nutrition and Technology, University of Nairobi , Nairobi , Kenya.|b Kenya Nutritionists and Dieticians Institute , Nairobi , Kenya.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Karuri
authors.affiliation: b Kenya Nutritionists and Dieticians Institute , Nairobi , Kenya.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Ojiambo
authors.affiliation: a Department of Food Science , Nutrition and Technology, University of Nairobi , Nairobi , Kenya.|c Division for Epidemiology and Microbial Genomics , National Food Institute, Technical University of Denmark , Kongens Lyngby , Denmark.
authors.forename: Patrick M K
authors.initials: PM
authors.lastname: Njage
mesh_terms: D000348:Aflatoxins / Q000633:toxicity*; D006528:Carcinoma, Hepatocellular / Q000139:chemically induced / Q000453:epidemiology*; D004781:Environmental Exposure / Q000009:adverse effects; D005506:Food Contamination; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008113:Liver Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D015233:Models, Statistical; D018570:Risk Assessment / Q000379:methods; D012424:Rural Population; D003313:Zea mays
chemical_list: D000348:Aflatoxins