A follow-up study of urinary markers of aflatoxin exposure and liver cancer

A cohort of 1 8,244 mostly middle-aged (45-64 years) men residing in four small geographically defined areas of Shanghai was accrued between January 1 986 and September 1 989. In addition to an in-person interview regarding dietary and other past exposures, each subjed donated a single void urine sample at recruitment so that the presence of aflatoxins in urine could be assessed. In addition, a 1-year survey of market foods in Shanghai was conduded to quantitatively estimate the extent of aflatoxin exposure in the study population. After close to 70,000 person-years of follow-up, 55 incident cases of hepatocellular carcinoma (HCC) had been identified. Levels of urinary aflatoxin B, and the oxidative metabolites, including the major aflatoxin nucleic acid addud, aflatoxin-N7-guanine, wer