<p>Aflatoxin B1 is a recognized dietary carcinogen linked to hepatocellular carcinoma (HCC); however, its quantitative burden estimates remain limited in West Africa. This study aimed to estimate the burden of HCC attributable to dietary aflatoxin exposure in Ghana and Nigeria using the Integrated Hazard and Health Impact Assessment Model (IHHIAM). A systematic review of 65 studies (2010–2024) provided aflatoxin concentration data, which were integrated with WHO/GEMS food consumption patterns, body weight data, and probabilistic exposure modeling. Monte Carlo simulations at 10⁵ iterations were used to propagate uncertainty and estimate attributable Years of Life Lost (YLL), Years Lived with Disability (YLD), and Disability-Adjusted Life Years (DALYs). The analysis revealed substantial differences in aflatoxin-attributable HCC burden between the two countries. Median five-year attributable DALYs were 503.67 per 10⁵ persons in Ghana and 4,382 per 10⁵ persons in Nigeria. These estimates reflect numerical differences in modeled exposure distributions and health outcome parameters but do not infer causation beyond the variables included in the assessment. The study provides a comparative, evidence-based quantification of aflatoxin-related HCC burden and demonstrates the utility of probabilistic modeling for dietary carcinogen risk assessment in high-exposure settings. These findings offer robust burden estimates that can support national food safety planning and guide future evaluations of aflatoxin mitigation strategies.</p>