Evidence map›Paper›PMID 26804596›Full record

ArticleMedical hypotheses2016

The case for aflatoxins in the causal chain of gallbladder cancer.

Claudia Foerster, Jill Koshiol, Ariel R Guerrero, Marcelo J Kogan, Catterina Ferreccio

Open access · greenAbstract read
In one paragraph

Article in Medical hypotheses, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.1field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Claudia FoersterPublic Health Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Advanced Center for Chronic Diseases (ACCDiS), FONDAP, Santiago, Chile.
Jill KoshiolInfections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, MD, USA.
Ariel R GuerreroAdvanced Center for Chronic Diseases (ACCDiS), FONDAP, Santiago, Chile; Department of Pharmacological and Toxicological Chemistry, Pharmaceutical and Chemical Sciences Faculty, Universidad de Chile, Santiago, Chile.
Marcelo J KoganAdvanced Center for Chronic Diseases (ACCDiS), FONDAP, Santiago, Chile; Department of Pharmacological and Toxicological Chemistry, Pharmaceutical and Chemical Sciences Faculty, Universidad de Chile, Santiago, Chile.
Catterina FerreccioPublic Health Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Advanced Center for Chronic Diseases (ACCDiS), FONDAP, Santiago, Chile. Electronic address: cferrec@med.puc.cl.
Advanced Center for Chronic Diseases · CLPontificia Universidad Católica de Chile · CLNational Cancer Institute · US

Funding

Etiology of Biliary Tract CancerZIACP010218 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI KOSHIOL, JILL · 2011 to 2025
$30.4M
Intramural NIH HHS Z99 CA999999Intramural NIH HHS ZIA CP010218
6 · The paper itself

Abstract

Chronic aflatoxin exposure has long been related to hepatocellular carcinoma (HCC). Recently, its association with gallbladder cancer (GBC) was postulated. Here we present the data supporting this hypothesis in Chile, the country with the highest GBC mortality worldwide with age-standardized mortality rates (ASMR) of 10.3 in women and 5.04 in men. The highest GBC rates occur in Southern Chile (ASMR=18), characterized by: high Amerindian ancestry, associated with high bile acid synthesis and gallstones; high poverty and high cereal agriculture, both associated with aflatoxin exposure. Aflatoxins have been detected in imported and locally grown foods items. We estimated population dietary exposure ranging from 0.25 to 35.0 ng/kg-body weight/day. The only report on human exposure in Chile found significantly more aflatoxin biomarkers in GBC than in controls (Odds Ratio=13.0). The hypothesis of aflatoxin-GBC causal link in the Chilean population is supported by: genetically-determined rapid cholesterol excretion and high gallstones prevalence (49.4%); low prevalence of HCC (ASMR=4.9) and low HBV infection (0.15%) the main co-factor of aflatoxins in HCC risk. If the association between aflatoxins and GBC were confirmed, public health interventions based on food regulation could have a substantial public health impact.

Indexed as

Aflatoxin PoisoningModels, BiologicalDisease ProgressionEvidence-Based MedicineFemaleFood ContaminationGallbladder NeoplasmsHumansIncidenceMaleRisk FactorsSurvival Rate

Identifiers

PMID26804596
PMCPMC12315795
OpenAlexW2182470940

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.