NCT01494558.

No abstract

Quantification of the association between the intake of fruit and vegetables and risk of esophageal squamous cell carcinoma (ESCC) is controversial even though several studies have explored this association. We summarized the evidence from observational studies in categorical, linear and non-linear dose-response meta-analyses. Eligible studies published up to 31 July 2012 were retrieved via computer searches of MEDLINE and EMBASE as well as manual review of references. Random-effects models were used to calculate summary relative risks (SRRs) and the corresponding 95% confidence intervals (CIs). A total of 32 studies involving 10,037 cases of ESCC were included in this meta-analysis. The SRRs for the highest vs. lowest intake were 0.56 (95% CI: 0.45-0.69) for vegetable intake and 0.53 (95% CI: 0.44-0.64) for fruit intake (p heterogeneity <0.001 for both). Similar results were observed in a linear dose-response analysis. There was evidence of non-linear associations for intakes of fruit (p non-linearity <0.001) and vegetables (p non-linearity 50.041). There was no evidence of publication bias. These data support the hypothesis that intakes of vegetables and fruit may significantly reduce the risk of ESCC. Further investigation with prospective designs, validated questionnaires and good control of important confounders is warranted.Esophageal cancer (EC) exists in two main histological types: esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). These two entities are distinct with regard to etiological and pathological characteristics. Although a dramatic increment in the incidence rate of EAC has been reported in Western countries.1,2 ESCC remains the dominant histological type (ESCC ranks as the sixth most common cancer in the world and fourth in "developing" countries).3-5 Importantly, ESCC occurs at a higher incidence in certain regions in the "Asian EC belt" that ranges from the Caucasian mountains, across northern Iran and through to northern China. 6 Epidemiological studies have revealed that tobacco smoking and alcohol use are the well-established risk factors for ESCC; >90% of cases can be attributed to these two factors in western countries. 7 In addition, mounting epidemiological evidence supports the important role of diet in the pathogenesis of ESCC. 8-10The intake of fruit and vegetables has long been associated with a decreased risk of various cancers, including EC. The suggested mechanisms for the major role of vegetables and fruit in the prevention of cancer include: modulation of DNA methylation; protection from and repair of DNA damage; promotion of apoptosis and induction of detoxifying phase-II enzymes.11,12 Based on a narrative review involving data from five cohort and 37 case-control studies, the Working Group from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) 2007 report concluded that high consumption of vegetables and fruit "probably" protects against EC.12 Unfortunately, in that report, no distinction was made between ESCC an...

BackgroundYoung non-small cell lung cancer (NSCLC) patients under the age of 40 can further be categorized into different age subgroups. Whether they have homogeneous clinical features and survival outcomes remains unexplored.MethodsInformation of 4623 NSCLC patients up to 40 years old from 1988 to 2012 was retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Clinicopathologic characteristics and survival outcomes were compared between patients diagnosed at 18–30 years old (younger group) and those at 31–40 years old (older group).ResultsThe proportion of patients in the younger group among all lung cancer patients was stable between 1988 and 2012. However, the proportion of patients in the older group decreased from 1.2% to 0.5%. The younger patients had a higher proportion of adenocarcinoma (P = 0.016), a lower proportion of large cell carcinoma (P = 0.008), a higher proportion of stage I disease (P = 0.002) and a lower proportion of stage III disease (P < 0.001). The younger patients had significantly better lung cancer-specific survival (LCSS) in the whole cohort (P < 0.001) and in the subgroup of patients with stage I (P = 0.038) or stage IV (P < 0.001) disease. Multivariate survival analysis showed that patients under 30 years old was an independent predictor of both better LCSS (P = 0.010) and overall survival (OS) (P = 0.018).ConclusionsAdult NSCLC patients under 30 years old had distinctive clinicopathologic characteristics and survival outcomes compared to patients diagnosed at 31–40 years old.