IARC MONOGRAPHS ON THE EVALUATION OF CARCINOGENIC ...

Table 12 (contd)
Reference Area Study base Cases Controls Exposure measures Covariate Results Comments
Mandishona
et al. (1998)
Omer et al.
(2001)
South Africa Two
hospitals in
one province
of South
Africa
Sudan Residents of
two regions
of Sudan
HCC; n = 24 Two control series:
one hospital-based
(trauma or infection
patients),
n = 48; family-based
(including related
and unrelated family
members),
n = 75
Cases of
HCC
diagnosed in
5 out of 6
hospitals in
Khartoum;
n = 150
Community-based,
selected from ‘sugar
shop’ registries in
same regions as
cases; n = 205
Measured AFB1–
albumin adducts
Detailed diet history
for peanut butter,
and for storage of
peanuts
Several
measured, but
not used in
analysis of
aflatoxin
HBsAg, anti-
HCV, smoking
alcohol, GSTM1
genotype
Median levels of AFB1–albumin adducts were lower
among cases than among both sets of controls
Cases OR 95% CI
Highest quartile 63 3.0 1.6–5.5
of peanut butter
intake*
Humid storage 99 1.6 1.1–2.5
Highest quartile of NR 17 2.7–105
peanut butter intake
+ GSTM1-null
genotype**
High risks of HCC
found for HBsAgpositive
subjects,
alcohol, and iron
overload. Questionable
comparability of
hospital control series,
and possible overmatching
with family
control series
Questionable comparability
of cases and
controls
*Test for trend
statistically significant
**Test for trend among
GSTM1-null genotype
subjects statistically
significant
AFB1, aflatoxin B1; AFM1, aflatoxin M1; CI, confidence interval; GST, glutathione S-transferase; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; NR, not
reported; OR, odds ratio; PLC, primary liver cancer; RR, relative risk
AFLATOXINS 207