Long term disease detection in small tribal communities?

I am interested in this herb called erythrina mulungu. It has been taken medicinally for a long period of time in the Amazon rainforest. It’s apparently been used for a few hundred years ‘without incidence’. However since it is mostly only really used by indigenous Amazonians I wonder if there were any issues, would it be flagged up and be called to attention in the sphere of modern medicine/the internet, etc. I mean things like curare we know cause fatal paralysis and that is used by the same tribes tho the results of that are instant rather than chronic, which is what I’m concerned with here.

Someone has argued that it would be easier than ever to find such things out in this day and age and news be spread were anything awry, but for something such as cancer say which only developed down the line due to the substance how would people know to make the link?

It isn’t only used in these remote tribes but also in urbanised Brazil although I’m not sure how long it’s been known in the latter parts. I presume quite a while.

So, the particular substance in question isn’t important. My question is more on the reaches of modern technology and the likelihood that if there were something which a given substance caused what is the likelihood it would be known about after a few hundred years of usage when the substance is a herbal folk medicine which doesn’t have rigorous western science watching its every move.

There have been some studies done today on the substance in the urban centres of Brazil but that is only just coming to be rather than with a pharmaceutical for instance.

So of course it would be easy for any layman to see the acute toxic effects of a substance if it say killed the person who ingested it immediately. But what about something which a small community took regularly which only led to something like cancer over a long period of time. Would they ever realise something was amiss, i.e. over and above natural incidence of cancer? or would it just be written off as some evil spirits etc.

So since I do not have the luxury of scientific research on the given substance I am wondering if I can use processes of deduction to put my mind at ease as to the relative danger of regular usage.

As I said there are no recorded deaths or ailments from using this herb over several hundred years of use however what is the likelihood there may be some hidden long term issue associated with it? Ofc anything is possible but I mean what is the probability given that there has been no recorded data on any problems with it over a few hundred years.

What are other examples from the past we can draw from? For instance how hard was it for them to find the cancer link in smoking from the time ppl started smoking heavily- not exactly the same though since that was the west we are talking about with the scientific method at hand? If given substance caused such serious effects would they have been obviously noted by now? or would the lag time of onset make it more mysterious.

It’s more a general question I guess of how long range diseases are identified in less developed smaller communities but particularly in the area of Brazil and the amazon as mentioned. Maybe there are some good examples from Africa?

It appears to be a natural sedative.
Cancer is the result of oxygen and vitamin deficiency as well as chemical poisoning.
Smoking causes blockages via sticky tar substances.
Diseases like Ebola, Polio and MS are all pesticide related ‘diseases’ which attack the nervous system via toxic halogen poisoning which causes hormone disruption.