Hepatoma and groundnuts in the West Nile district of Uganda.

Primary carcinoma of the liver or hepatoma, is a disease with a striking geographic distribution. It appears to be most uncommon in the United States' and Scandinavia,2 while its incidence reported to date is greatest in Africa south of the Sahara.23 Of particular interest is the fact that Negroes in the United States have an incidence of hepatoma almost identical to the white population, and therefore significantly less than their African counterparts."6 Interest in hepatoma has been heightened by the recent observations regarding groundnut (peanut) contamination with Aspergillus flavus.7 This fungus elaborates a toxin (aflatoxin) which has been shown to produce hepatomas in rats.8 Groundnut meals containing aflatoxin also are capable of inducing hepatomas in ducks9 and rainbow trout,10 as well as in rats."' Since the groundnut is a widely cultivated staple in many parts of Africa, the possible significance of these observations is obvious. Hutt and Burkitt,' in reporting the differences in tumor incidence in the 16 administrative districts of Uganda, stressed the value of inter-territorial and intra-territorial studies of tumor distribution in Africa. The present study reports the observed distribution of hepatoma in the West Nile district of Uganda, and compares this with the reported distribution of groundnut cultivation in the same district.