Esophageal cancer (EC) is one of the most common cancers in China. The purpose of this study was to investigate the updated incidence rates and risk factors of EC in Nan'ao Island, where the EC incidence rate was chronically the highest in southern China. To calculate the annual incidence rate, data on 338 EC cases from Nan'ao Cancer Registry system diagnosed during 2005-2011 were collected. A case-control study was conducted to explore the EC risk factors. One hundred twenty-five alive EC patients diagnosed during 2005-2011 and 250 controls were enrolled into the case-control study. A pre-test questionnaire on demography, dietary factors, drinking water treatment, and behavioral factors was applied to collect information of all participants. The average EC incidence rates during 2005-2011 were 66.09/105, 94.62/105, 36.83/105 for both genders, males and females, respectively, in Nan'ao Island. The EC incidence rate in males was 2.40- to 4.55-fold higher than that in females in the period from 2006 to 2011 (P < 0.05). Considering the onset age, males tend to be much younger than females and reached peak incidence rate at a younger age (P < 0.05). Drinking water treatment by filter (odds ratio [OR] = 0.28, 95% confidence interval [95% CI] = 0.13-0.58) and fruit consumption (OR = 0.55, 95% CI = 0.32-0.94) reduced the risk for EC. On the contrary, the pickled vegetables consumption (OR = 2.64, 95% CI = 1.46-4.76) and liquor drinking (OR = 2.32, 95% CI = 1.21-4.44) increased the risk for EC. These results may be of importance for future research on EC etiology and prevention strategies.

Visceral adipose tissue (VAT)-related metabolic syndromes are hypothesized to promote colorectal neoplasia; however, the results from studies investigating whether VAT directly measured by computed tomography is a risk factor for colorectal adenomas (CRA) have been inconsistent. We carried out a meta-analysis of epidemiological studies to quantitatively assess this association and dose-response relationship between VAT and the risk of CRA. We searched PubMed for relevant studies that were published in any language, from January, 1950 to June, 2010. Three case-control studies and eight cross-sectional studies involving 11 111 participants contributed toward this meta-analysis. We pooled the odds ratio (OR) from individual studies and carried out dose-response, heterogeneity, and publication bias analyses. In a pooled analysis of all studies, the amount of VAT (in a comparison of the highest and lowest categories) was associated with an increased risk of CRA (OR=1.67, 95% confidence interval: 1.29-2.16). Subgroup meta-analyses by both sexes, VAT measurements, study designs, and Asian ethnicity yielded similar results. An increase of 500 cm of VAT volume was related to an increased risk of CRA from the dose-response meta-analysis (OR=1.06; 95% confidence interval: 1.03-1.11). These results suggest that a large amount of VAT measured by computed tomography significantly increases the risk of CRA both in men and in women.