Abstract
Although the major risk factors for liver cancer have been established, preventive factors for liver cancer have not been fully explored. We evaluated the association between raw garlic consumption and liver cancer in a large population-based case-control study in Eastern China. The study was conducted in Jiangsu, China, from 2003 to 2010. A total of 2011 incident liver cancer cases and 7933 randomly selected population-controls were interviewed. Epidemiological data including raw garlic intake and other exposures were collected, and serum markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection were assayed. Overall, eating raw garlic twice or more per week was inversely associated with liver cancer, with an adjusted odds ratio (aOR) of 0.77 (95% confidence interval (CI): 0.62–0.96) compared to those ingesting no raw garlic or less than twice per week. In stratified analyses, high intake of raw garlic was inversely associated with liver cancer among Hepatitis B surface antigen (HBsAg) negative individuals, frequent alcohol drinkers, those having history of eating mold-contaminated food or drinking raw water, and those without family history of liver cancer. Marginal interactions on an additive scale were observed between low raw garlic intake and HBsAg positivity (attributable proportion due to interaction (AP) = 0.31, 95% CI: -0.01–0.62) and heavy alcohol drinking (AP = 0.28, 95% CI: 0.00–0.57). Raw garlic consumption is inversely associated with liver cancer. Such an association shed some light on the potential etiologic role of garlic intake on liver cancer, which in turn might provide a possible dietary intervention to reduce liver cancer in Chinese population.
Highlights
It was estimated that 841,000 new patients with liver cancer were diagnosed worldwide in 2018, and 46.7% of them occurred in China [1]
We investigated the association of raw garlic consumption with liver cancer in a population-based case-control study in four counties of Jiangsu Province, China, and further explored the potential interactions between raw garlic intake and known risk factors on the development of liver cancer
It is the first time in the published medical literature, that an inverse association of raw garlic intake with liver cancer has been observed from a large population-based case-control study in China
Summary
It was estimated that 841,000 new patients with liver cancer were diagnosed worldwide in 2018, and 46.7% of them occurred in China [1]. Allium sativum (garlic) is a species in the onion genus, Allium. It has been used by humans in both culinary and traditional medicine for thousands of years worldwide. The organosulfur compounds (OSCs), including diallyl sulfide (DAS), diallyl disulfide (DADS), diallyl trisulfide (DATS) and ajoene from garlic, were found to have anti-cancer effects in experimental studies [5,6]. A population-based cohort study in China showed an inverse association between habitual garlic consumption and all-cause mortality [7]. The associations of garlic intake with cancer risks have been evaluated for a variety of sites, including stomach [8,9,10,11,12,13,14,15], colon and rectum [16,17,18,19], esophagus [15,20,21,22], breast [23,24,25,26], lung [27,28], larynx [29]
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