Evidence map›Paper›PMID 40783888›Full record

ReviewDigestive diseases and sciences2026

Ubiquitous Environmental Exposures and Risk of Hepatocellular Carcinoma: A Narrative Review.

Hiwot Mulugeta Abate, Daniel Bujnowski, Ashley Jowell, Cynthia A Moylan, Cathrine Hoyo, Kara Wegermann

Abstract readReview
PubMed Publisher
In one paragraph

Review in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

6 authors.

Hiwot Mulugeta AbateDepartment of Medicine, Duke University Health System, Durham, NC, USA.
Daniel BujnowskiDepartment of Medicine, Duke University Health System, Durham, NC, USA.
Ashley JowellDepartment of Medicine, Duke University Health System, Durham, NC, USA.
Cynthia A MoylanDivision of Gastroenterology, Department of Medicine, Duke University Health System, Durham, NC, USA.
Cathrine HoyoDepartment of Biological Sciences, North Carolina State University, Raleigh, NC, USA.
Kara WegermannDivision of Gastroenterology, Department of Medicine, Duke University Health System, 40 Duke Medicine Circle, Durham, NC, DUMC 392327710, USA. kara.wegermann@duke.edu.

Funding

Southern Liver Health CohortUG3CA265842 · NCI · NORTH CAROLINA STATE UNIVERSITY RALEIGH · PI HOYO, CATHRINE, MOYLAN, CYNTHIA A · 2021 to 2022
$2.2M
NCI NIH HHS UG3 CA265842
6 · The paper itself

Abstract

backgroundHepatocellular carcinoma (HCC) is among the most prevalent and deadly cancers worldwide. Chronic liver disease is the most established risk factor for HCC, but environmental exposures are increasingly recognized as contributor. In this narrative review, we sought to analyze data linking three substances to HCC: polycyclic aromatic hydrocarbons (PAHs), per- and polyfluoroalkyl substances (PFAS), and cadmium.

methodsWe performed a literature search of MEDLINE for this narrative review. Two reviewers screened titles and abstracts for relevance. We focused on articles published within the last three years.

resultsPAH, PFAS, and cadmium have been linked to chronic liver disease, liver injury, and to a lesser extent, HCC. Major limitations in existing data are small sample sizes, lack of longitudinal follow up (most studies are cross-sectional), and heterogeneity in the species assayed and the methods of assay.

conclusionsFurther studies in large, prospective cohorts with longitudinal follow up are needed. Given existing evidence linking these substances to liver injury and HCC, a multi-faceted prevention and intervention strategy is needed, incorporating research, public education and engagement, legal frameworks, decontamination and medical interventions to mitigate deleterious effects of these substances.

Indexed as

Carcinoma, HepatocellularEnvironmental ExposureLiver NeoplasmsPolycyclic Aromatic HydrocarbonsCadmiumFluorocarbonsHumansRisk FactorsCadmiumFluorocarbonsPolycyclic Aromatic HydrocarbonsDNA damageOxidative stressPFASPolycyclic aromatic hydrocarbonsToxins

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.