Population attributable risk of aflatoxin-related liver cancer: systematic review and meta-analysis.

Population attributable risk of aflatoxin-related liver cancer: systematic review and meta-analysis.
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DOI:
10.1016/j.ejca.2012.02.009
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发表时间:
2012-09
影响因子:
8.4
通讯作者:
Wu, Felicia
Wu, Felicia
中科院分区:
医学1区
文献类型:
--
作者:
Liu, Yan;Chang, Chung-Chou H.;Marsh, Gary M.;Wu, Felicia

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Over 4 billion people worldwide are exposed to dietary aflatoxins, which cause liver cancer (hepatocellular carcinoma, HCC) in humans. However, the population attributable risk (PAR) of aflatoxin-related HCC remains unclear. In our systematic review and meta-analysis of epidemiological studies, summary odds ratios (ORs) of aflatoxin-related HCC with 95% confidence intervals were calculated in HBV+ and HBV− individuals, as well as the general population. We calculated the PAR of aflatoxin-related HCC for each study as well as the combined studies, accounting for HBV status. 17 studies with 1680 HCC cases and 3052 controls were identified from 479 articles. All eligible studies were conducted in China, Taiwan, or sub-Saharan Africa. The PAR of aflatoxin-related HCC was estimated at 17% (14–19%) overall, and higher in HBV+ (21%) than HBV− (8.8%) populations. If the one study that contributed most to heterogeneity in the analysis is excluded, the summarized OR of HCC with 95% CI is 73.0 (36.0–148.3) from the combined effects of aflatoxin and HBV, 11.3 (6.75–18.9) from HBV only, and 6.37 (3.74–10.86) from aflatoxin only. The PAR of aflatoxin-related HCC increases to 23% (21–24%). The PAR has decreased over time in certain Taiwanese and Chinese populations. In high exposure areas, aflatoxin multiplicatively interacts with HBV to induce HCC; reducing aflatoxin exposure to non-detectable levels could reduce HCC cases in high-risk areas by about 23%. The decreasing PAR of aflatoxin-related HCC reflects the benefits of public health interventions to reduce aflatoxin and HBV.
工作组报告:减少发展中国家黄曲霉毒素暴露的公共卫生策略。
DOI: 10.1289/ehp.9302
发表时间: 2006-12
影响因子: 10.4
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Strosnider, Heather;Azziz-Baumgartner, Eduardo;Banziger, Marianne;Bhat, Ramesh V;Breiman, Robert;Brune, Marie-Noel;DeCock, Kevin;Dilley, Abby;Groopman, John;Hell, Kerstin;Henry, Sara H;Jeffers, Daniel;Jolly, Curtis;Jolly, Pauline;Kibata, Gilbert N;Lewis, Lauren;Liu, Xiumei;Luber, George;McCoy, Leslie;Mensah, Patience;Miraglia, Marina;Misore, Ambrose;Njapau, Henry;Ong, Choon-Nam;Onsongo, Mary T K;Page, Samuel W;Park, Douglas;Patel, Manish;Phillips, Timothy;Pineiro, Maya;Pronczuk, Jenny;Rogers, Helen Schurz;Rubin, Carol;Sabino, Myrna;Schaafsma, Arthur;Shephard, Gordon;Stroka, Joerg;Wild, Christopher;Williams, Jonathan T;Wilson, David
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发表时间: 2003-04-01
影响因子: 4.3
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发表时间: 2005-09-01
期刊: ONCOGENE
影响因子: 8
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