In an initial study in high-risk and low-risk regions of Transkei (South Africa) for esophageal cancer, cancer rates were correlated with the proportion of maize samples infected by F. moniliforme. In a follow-up study, the mean proportions of maize kernel infected with F. moniliforme in both healthy and moldy maize samples from households in the high-incidence esophageal cancer area were significantly higher than those in the low incidence area. FB1 and FB2 levels in healthy maize samples from the low-risk area were approximately 20 times lower than those in healthy samples from high-risk areas. One study estimated that naturally poisoned horses consumed levels of fuminisins equivalent to those shown to be toxic experimentally, and that humans in high esophageal cancer risk areas can potentially consume levels higher than those shown to be carcinogenic in rats.
A number of surveys have been conducted in Henan Province in northern China. Fungal strains from samples of wheat, corn, dried sweet potato, rice, and soya beans were cultured and isolated in five counties with a high incidence of esophageal cancer and three with a low incidence. The frequency of contamination by F. moniliforme was significantly higher in food samples from high-risk areas, although the frequency of contamination by all other fungi analyzed was also significantly higher in samples from the high-risk counties. Although these studies, as well as those conducted in South Africa, demonstrate correlations between high esophageal cancer rates and contamination of foods, primarily corn, with F. moniliforme, the specific role of the fumonisins or other related toxins in the etiology of this cancer remains to be firmly established.
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