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

BACKGROUND: Fumonisins are mycotoxins produced by Fusarium spp. They are classified as Group 2B carcinogens by the International Agency for Research on Cancer. AIM: We aimed to investigated the association between gastric cancer (GC) and urinary fumonisins levels. METHODS: 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. RESULTS: 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. CONCLUSIONS: This study has demonstrated that urinary fumonisins levels are associated with low socio-economic status but not to GC.