Over the past 30 years there have been extensive efforts to investigate the association between
aflatoxin exposure and human
liver cancer. These studies have been hindered by the lack of adequate dosimetry data on
aflatoxin intake, excretion, and metabolism in people, as well as by the general poor quality of worldwide
cancer morbidity and mortality statistics. These realities have spurred the efforts to develop new technologies to assess exposure status and risk for
aflatoxins, and these agents are among the few
environmental carcinogens for which quantitative risk assessments have been attempted. One of the goals of these risk assessments has been the development of primary and secondary preventive intervention methods to lower the human health impact from
aflatoxin exposures. The long-term goal of the research described herein is the application of
biomarkers to the development of preventive interventions for use in human populations at high risk for
cancer. Several of the
aflatoxin-specific
biomarkers have been validated in epidemiologic studies and are now available for use as intermediate
biomarkers in prevention trials. The development of these
aflatoxin biomarkers has been based upon the knowledge of the biochemistry and toxicology of
aflatoxins gleaned from both experimental and human studies. These
biomarkers have been utilized subsequently in experimental models to provide data on the modulation of the markers under different situations of disease risk. This systematic approach provides encouragement for preventive interventions and should serve as a template for the development for the development and validation of other chemical-specific
biomarkers and their application to
cancer or other
chronic diseases.