[' ', 'provinces', '(and', 'all', 'of', 'China)', 'are', 'associated', 'with', 'chronic', 'infection', 'with', 'hepatitis', 'B', 'virus', '(HBV),', 'but', 'the', 'unequal', 'distribution', 'of', 'PHC', 'incidence', 'xatea', 'within', 'these', 'high', 'risk', 'provinces', 'correlates', 'only', 'weakly', 'with', 'the', 'prevalences', 'ef', 'chronic', 'carriers', 'of', 'HBV.', 'Other', 'factors', 'that', 'act', 'independently', 'of,', 'or', 'synergistically', 'with,', 'HBV', 'must', 'be', 'involved,', 'but', 'are', 'poorly', 'understood.', 'The', 'overall', 'goal', 'of', 'this', 'project', 'is', 'to', 'identify,', 'within', 'the', 'context', 'of', 'a', '5', 'year', 'prospective,', 'nested', 'case-control', 'study', 'of', '46,350', 'men', 'in', 'Haimen', 'County,', 'Jiangsu', 'Province,', 'China,', 'factora', '(in', 'addition', 'to', 'BBV', 'infection)', 'that', 'contribute', 'to', 'the', 'high', 'risk', 'of', 'PHC.', 'About', '255', 'cases', 'of', 'PHC', 'are', 'expected', 'to', 'ocenr', 'in', 'this', 'population', 'in', '5', 'years.', 'The', 'method', 'for', 'accomplishing', 'this', 'goal', 'is', 'to', 'test', 'hypotheses', 'of', 'azsociation', 'of', 'specific', 'variables', 'with', 'risk', 'of', 'PHC,', 'by', 'collecting', 'biological', 'samples', 'and', 'expoaure', 'information', 'by', 'questionnaire,', 'at', 'the', 'beginning', 'of', 'the', 'etudy,', 'and', 'making', 'laboratory', 'measures', 'of', 'person-specific', 'exposures', 'in', 'these', 'biological', 'samples', 'from', 'each', 'PHC', 'case', 'and', 'two', 'controls', 'at', 'the', 'time', 'of', 'occurrence', 'of', 'each', 'case.', 'The', 'Specific', 'Aims', 'consist', 'of', 'teating', 'the', 'following', 'variables', 'as', 'risk', 'factors', 'for', 'PHC:', 'a)', 'Exposure', 'to', 'aflatoxin', 'Bl;', 'b)', 'Chronic', 'infection', 'with', 'hepatitis', 'C', 'virus;', 'c)', 'Decreased', 'body', 'stores', 'of', 'selenium;', 'd)', 'Increased', 'body', 'ixon', 'stores;', 'e)', 'Tobacco', 'use.', 'The', 'relationship', 'of', 'these', 'variables', 'to', 'each', 'other,', 'to', 'chronic', 'HBV', 'infection,', 'and', 'to', 'PHC', 'risk', 'will', 'be', 'evaluated.', 'Information', 'on', 'alcohol', 'use,', 'water', 'source,', 'dietary', 'consumption', 'of', 'exuciferous', 'vegetables,', 'corn,', 'rice,', 'peanuts,', 'and', 'green', 'tea', 'will', 'be', 'obtained', 'by', 'questionnaire', 'and', 'related', 'to', 'risk', 'of', 'PHC', 'and', 'to', 'interactions', 'with', 'the', 'other', 'variables.', 'About', '125,000', 'people', 'die', 'each', 'year', 'from', 'PHC', 'in', 'China.', 'Vaccination', 'against', 'HBV', 'may', 'eventually', 'reduce', 'this', 'mortality', 'by', '60%,', 'but', 'that', 'is', 'unlikely', 'to', 'happen', 'for', 'several', 'decades.', 'In', 'the', 'meantime,', 'understanding', 'the', 'various', 'environmental', 'and', 'genetic', 'factors', 'that', 'affect', 'thia', 'risk', 'could', 'lead', 'to', 'xelatively', 'simple', 'measures', 'for', 'reducing', 'PHC', 'mortality', 'not', 'only', 'in', 'China,', 'but', 'also', 'in', 'the', 'United', 'States', 'and', 'other', 'developed', 'countries.', '6/7/721', 'DIALOG(R)', 'File', '266:Fed.', 'Res,', 'in', 'Progress', '{c)', 'format', 'only', '1995', 'Dialog', 'Info.Sves.', 'All', 'rta.', 'reserv.', '0117927', 'IDENTIFYING', 'NO.:', '5P01CA40737-08', '00s4', 'AGENCY', 'CODE:', 'CRISP', 'MOLECULAR', 'EPIDEMIOLOGY', 'OF', 'PRIMARY', 'HEPATOCELLULAR', 'CARCINOMA', 'IN', 'SENEGAL', 'PRINCIPAL', 'INVESTIGATOR:', 'LONDON,', 'W', 'THOMAS', 'ADDRESS:', 'FOX', 'CHASE', 'CANCER', 'CENTER', '7701', 'BURHOLME', 'AVENUE', 'PHILADELPHIA,', 'PA', '19112', 'PERFORMING', 'ORG.:', 'FOX', 'CHASE', 'CANCER', 'CENTER,', 'PHILADELPHIA,', 'PENNSYLVANIA', 'SPONSORING', 'ORG.:', 'NATIONAL', 'CANCER', 'INSTITUTE', 'FY', ':', '94', '‘TYPE', 'OF', 'AWARD:', 'Noncompeting', 'Continuation', '(Type', '5)', 'SUMMARY:', 'The', 'primary', 'goal', 'of', 'this', 'project', 'is', 'to', 'test', 'the', 'hypothesis', 'that', 'exposure', 'to', 'aflatoxin-Bl', '(AFB1)', 'is', 'etiologically', 'associated', 'with', 'primary', 'hepatocellular', 'carcinoma', '(PHC)', '.', 'Although', 'there', 'is', 'considerable', 'cireumatantial', 'evidence', 'to', 'support', 'this', 'hypothesis,', 'the', 'lack', 'of', 'both', 'person-specific', 'measurea', 'of', 'exposure', 'and', 'prospective', 'follow-up', 'of', 'exposed', 'individvals', 'have', 'prevented', 'an', 'adequate', 'evaluation.', 'The', 'proposed', 'study', 'will', 'be', 'conducted', 'in', 'Senegal,', 'west', 'Africa,', 'where', 'PHC', 'is', 'the', 'major', 'cause', 'of', 'cancer', 'deaths,', 'consumption', 'of', 'AFB]', 'contaminated', 'peanuts', 'is', 'very', 'common,', 'and', 'hepatitis', 'B', 'virus', '(HBV)', 'infection', 'is', 'endemic.', 'Approximately', '60%', 'of', 'PHCs', 'in', 'Senegal', 'have', 'been', 'asscciated', 'with', 'chronic', 'HSV', 'infection', '.', 'The', 'study', 'population', 'will', 'consist', 'of', 'the', 'entire', '18,000', 'man', 'Senegalese', 'Army,', 'a', 'group', 'that', 'can', 'be', 'followed', 'for', '5', 'or', 'more', 'years', 'with', 'essentially', '100%', 'ascertainment', 'of', 'PHCs.', 'To', 'maximize', 'efficiency', 'and', 'cost', 'effectiveness,', 'a', 'nested', 'case-control', 'design', 'will', 'be', 'used.', 'About', '40', 'cases', 'of', 'PHC', 'are', 'expected', 'to', 'occur', 'during', 'the', 'study.', 'An', 'assay', 'of', 'AFBl-albumin', 'adducts', 'in', 'serum', 'will', 'be', 'used', 'to', 'determine', 'person-specific', 'AFB1', 'exposure', 'over', 'time.', 'In', 'order', 'to', 'estimate', 'an', 'individual’s', 'average', 'AFB1', 'exposure,', 'it', 'will', 'be', 'necessary', 'to', 'ascertain', 'the', 'dntraindividual,', 'seasonal,', 'and', 'geographic', 'variation', 'in', 'AFBI', 'exposure.', 'Environmental', 'and', 'genetic', 'factors', 'may', 'influence', 'an', 'individual’s', 'response', 'to', 'E862', 'SPITS', ' ']