P A R T 2 • E V I D E N C E A N D J U D G E M E N T S
ulates the body’s inflammatory response, which may con-
tribute to the initiation and progression of several cancers
(see chapter 220.127.116.11).
The epidemiological evidence shows some
inconsistencies and the mechanistic evidence is
speculative. There is limited evidence suggesting that
greater body fatness is a cause of liver cancer.
The Panel is aware that since the conclusion of the SLR, two
cohort studies58 136 have been published. This new information
does not change the Panel judgement. Also see box 3.8.
18.104.22.168 Other exposures
Other exposures were evaluated. However, the data were
either of too low quality, too inconsistent, or the number of
studies too few to allow conclusions to be reached. These
were as follows: cereals (grains) and their products; non-
starchy vegetables; peanuts; fish; salted fish; water source;
coffee; and tea.
In cases of cereals (grains) and peanuts, there are data con-
necting these foods to liver cancer, but the Panel judges that
any causative factor is likely to be aflatoxins.
7.8.6 Comparison with previous report
See 22.214.171.124, and box 3.8 in chapter 3.
Since publication of the previous report, the evidence that
aflatoxin contamination of food is a cause of liver cancer is
stronger and now justifies a judgement of ‘convincing’.
The Panel concludes:
The evidence is convincing that aflatoxins, which contami-
nate mostly cereals (grains) and pulses (legumes), usually
as a result of long storage in hot, wet conditions, are a cause
of liver cancer.
Alcoholic drinks are probably a cause of liver cancer.
There is limited evidence suggesting that fruits are pro-
tective, and that body fatness is a cause of this cancer.
7.9 Colon and
Cancers of the colon and rectum are the third most
common type worldwide. Around 1 million cases were
recorded in 2002, accounting for around 9 per cent
overall. Rates of this cancer increase with industrialisation
and urbanisation. I