Aflatoxin and liver cancer in Sudan

Abstract

This study investigated whether aflatoxin contamination of peanut products may contribute to the incidence of hepatocellular carcinoma (HCC) in Sudan. Thirty‐seven peanut butter and peanut samples were collected from local markets. Aflatoxin concentrations were significantly higher in West Sudan [87.4 ± 197.3 (SD) μg/kg], a high‐risk area, than in Central Sudan (8.5 ± 6.8 μg/kg), a low‐risk area. In West Sudan, humid local storage conditions of peanut products were related to high aflatoxin concentrations. In a small case‐control study of HCC patients (n = 24) and controls (n = 34), an odds ratio of 7.5 (95% confidence interval = 1.4–40.2) was observed for humid vs. dry local storage conditions. Development of an index of individual HCC exposure was less successful, probably because of year‐to‐year variability in aflatoxins in food. These preliminary findings justify further research into the role of aflatoxins and hepatitis in HCC incidence in Sudan.