Aflatoxins From Food May Increase Risk Of Gallbladder Cancer Interview with:
Catterina Ferreccio, MD, MPH
School of Medicine
Pontificia Universidad Católica de Chile
Santiago, Chile

Medical Research: What is the background for this study? What are the main findings?

Dr. Ferreccio: In Chile, gallbladder cancer (GBC) is the 2nd highest cause of cancer death in women.  Other than gallstones no other causal factors have been identified. We conducted a pilot case-control study of gallbladder cancer to evaluate its association with aflatoxin B1 (AFB1) exposure. Aflatoxins are toxics products of the fungis Aspergillus flavus and Aspergillus parasiticus and are contaminants of food; AFB1 is carcinogenic. Usually they are found in areas closer to the Equator than Chile.

Main findings were the high proportion (35%) of study subjects carrying aflatoxins adducts and the particularly high exposure among the Gallbladder cancer (GBC) cases (64%) compared with gallstones controls (18%) or with population controls (23%).

Difference of gallbladder cancer vs controls were statistically significant and suggests aflatoxins may be a significant risk factor for gallbladder cancer; hypothesis never tested before.

Medical Research: What should clinicians and patients take away from your report?

Dr. Ferreccio: Aflatoxins, a recognized carcinogen for hepatocellular carcinoma, could also be a risk factor for gallbladder cancer.

Patients carrying gallstones should avoid exposure to aflatoxins; be aware of the food items at risk of contamination: cereals (like maize), oilseeds, spices, tree nuts and peanuts, but also milk, meat, and dried fruit.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Ferreccio: It is necessary to determine the magnitude and distribution of aflatoxin exposure in the population. To identify the food items responsible of the population burden. To confirm aflatoxin-GBC association.  To identify other health effects of chronic aflatoxin exposure, including other digestive cancers. To study biomarkers of aflatoxin exposure and effect. To study the mechanism by which aflatoxins cause cancer.


Nogueira L, Foerster C, Groopman J, et al. Association of Aflatoxin With Gallbladder Cancer in Chile. JAMA. 2015;313(20):2075-2077. doi:10.1001/jama.2015.4559.

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&nbsp Interview with: Catterina Ferreccio, MD, MPH, School of Medicine, Pontificia Universidad Católica de Chile, & Santiago, Chile (2015). Aflatoxins From Food May Increase Risk Of Gallbladder Cancer

Last Updated on May 26, 2015 by Marie Benz MD FAAD