Impact Of Chronic Multi-Mycotoxin Exposure In Europe On Cancer Incidence: A Basis To Develop Future Public Health Strategies

ZAVADIL J. ² , DE BOEVRE M. ¹ , HUYBRECHTS I. ² , DE SAEGER S. ¹

Mycotoxins are fungal toxins, estimated by the Food and Agricultural Organization (FAO) to contaminate 25% of the world’s most frequently consumed foods and feeds. Several fungi may co-occur on crops, resulting in co-occurrence of multiple mycotoxins. Given the ubiquity of many fungi worldwide, an urgent need exists for a coordinated international response to the problem of dietary mycotoxins.

In terms of chronic toxicity, mycotoxins are estimated to be the most hazardous food contaminants. The International Agency for Research on Cancer (IARC) identifies aflatoxins B1, G1, and M1 as sufficiently evident carcinogens, while other mycotoxins are possibly or probably carcinogenic (e.g. ochratoxin A and fumonisins).

Consumed with food, mycotoxins most commonly affect the liver, where they are metabolized, though not always inactivated. Further down the gastro-intestinal tract, mycotoxins and their active metabolites may interact with colon cancer cells.

Utilizing the European Food Safety Authority (EFSA) database of mycotoxin occurrences in foods, together with the European Prospective Investigation into Cancer and Nutrition (EPIC) study data on food consumption, the applicant will estimate dietary mycotoxin exposures in 23 regional European populations, associating chronic multi-mycotoxin exposure with carcinogenesis.

Preliminary analyses of combined data from EFSA and the European Food Consumption Validation (EFCOVAL) Project reported unexpectedly high exposures, some above upper tolerance levels (unpublished data). This dataset will have been validated through UHPLC-MS/MS quantification of mycotoxin ‘exposure biomarkers’ in blood and urine, by the time of this conference.

Ultimately, the applicant will determine how chronic multi-mycotoxin exposure influences carcinogenic incidence in Europe. Environmental mutagenic factors will be statistically controlled, to elucidate clear relationships between specific multi-mycotoxin profiles and relative cancer risk.

This is the first large-scale cohort study investigating the effect of multi-mycotoxin intakes on hepatocellular and colorectal cancers. The resulting mycotoxin databases will be instrumental for further characterizing the health effects of real exposure.