Association between Gastric Cancer and Urinary Fumonisins: A Case-control Study

Fumonisins are mycotoxins produced by Fusarium spp. They are classified as Group 2B carcinogens by the International Agency for Research on Cancer.

We aimed to investigated the association between gastric cancer (GC) and urinary fumonisins levels.

We conducted this age- and sex-matched case-control study in Lusaka, Zambia. Cases were patients with histologically confirmed GC while controls did not have cancer. We tested the urine samples for fumonisins using high-performance liquid chromatography, collected information on risk factors using interviewer-administered questionnaires and analysed the reults in Stata version 15.

A total of 52 participants were included in the study, 26 GC cases and 26 controls. In each group, 15 (58%) were females. The median age was 54 years; interquartile range (IQR) 46-66. Fumonisins was detected in 10 (19%) of the samples. Quantitatively, levels of fumonisins were higher in cases (73 µg/ml; IQR 40-109) than in controls (21 µg/ml (IQR 5-47), but this difference was not statistically significant, P = 0.25. Qualitatively, there was no association between GC and presence of fumonisins in urine (odds ratio 1.0, 95% confidence interval [CI] 0.2-5.1, P = 1.00). Lack of formal education and low socio-economic status were associated with urinary fumonisins P = 0.04 and 0.02, respectively. However, on regression analysis, only low socio-economic status remained statistically significant with a regression coefficient of 50, (95% CI 29-70); P < 0.001.

This study has demonstrated that urinary fumonisins levels are associated with low socio-economic status but not to GC.