{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:49:30Z","timestamp":1792223370633,"version":"4.4.0"},"reference-count":124,"publisher":"American Chemical Society (ACS)","issue":"6","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":2870,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatocellular carcinoma (HCC), or liver cancer, is the third leading cause of cancer deaths worldwide, with prevalence 16\u201332 times higher in developing countries than in developed countries. Aflatoxin, a contaminant produced by the fungi Aspergillus flavus and Aspergillus parasiticus in maize and nuts, is a known human liver carcinogen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We sought to determine the global burden of HCC attributable to aflatoxin exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a quantitative cancer risk assessment, for which we collected global data on food-borne aflatoxin levels, consumption of aflatoxin-contaminated foods, and hepatitis B virus (HBV) prevalence. We calculated the cancer potency of aflatoxin for HBV-postive and HBV-negative individuals, as well as the uncertainty in all variables, to estimate the global burden of aflatoxin-related HCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 550,000\u2013600,000 new HCC cases worldwide each year, about 25,200\u2013155,000 may be attributable to aflatoxin exposure. Most cases occur in sub-Saharan Africa, Southeast Asia, and China where populations suffer from both high HBV prevalence and largely uncontrolled aflatoxin exposure in food.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Aflatoxin may play a causative role in 4.6\u201328.2% of all global HCC cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1289\/ehp.0901388","type":"journal-article","created":{"date-parts":[[2010,2,19]],"date-time":"2010-02-19T11:03:33Z","timestamp":1266577413000},"page":"818-824","source":"Crossref","is-referenced-by-count":1022,"title":["Global Burden of Aflatoxin-Induced Hepatocellular Carcinoma: A Risk Assessment"],"prefix":"10.1021","volume":"118","author":[{"given":"Yan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2010,2,19]]},"reference":[{"issue":"1","key":"2026080504090385300_micit1","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1017\/S0950268803008574","article-title":"Seroepidemiology of hepatitis B virus in Addis Ababa, Ethiopia: transmission patterns and vaccine control","volume":"131","author":"Abebe","year":"2003","journal-title":"Epidemiol Infect"},{"key":"2026080504090385300_micit2","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/1743-422X-6-146","article-title":"Seroprevalence of hepatitis B virus and hepatitis C virus among blood donors in Nyala, South Dar Fur, 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