AimThere is a high burden of oesophageal cancer in Malawi with dismal outcomes. It is not known whether environmental factors are associated with oesophageal cancer. Without knowing this critical information, prevention interventions are not possible. The purpose of this analysis was to explore environmental factors associated with oesophageal cancer in the Malawian context. MethodsA hospital-based case-control study of the association between environmental risk factors and oesophageal cancer was conducted at Kamuzu Central Hospital in Lilongwe, Malawi and Queen Elizabeth Central Hospital in Blantyre, Malawi. Ninety-six persons with squamous cell carcinoma and 180 controls were enrolled and analyzed. These two groups were compared for a range of environmental risk factors, using logistic regression models. Unadjusted and adjusted odds ratios and 95% confidence intervals (CI) were calculated. ResultsFirewood cooking, cigarette smoking, and use of white maize flour all had strong associations with squamous cell carcinoma of the oesophagus, with adjusted odds ratios of 12.6 (95% CI: 4.2-37.7), 5.4 (95% CI: 2.0-15.2) and 6.6 (95% CI: 2.3-19.3), respectively. ConclusionsSeveral modifiable risk factors were found to be strongly associated with squamous cell carcinoma. Research is needed to confirm these associations and then determine how to intervene on these modifiable risk factors in the Malawian context.

Tobacco corporate sponsorships involved numerous small, community based organisations, both through direct funding and through grants to larger umbrella organisations, and many of these organisations were part of the public health infrastructure. Conclusions-Tobacco corporate sponsorship serves as an important marketing tool for tobacco companies, serving both a sales promotion and public relations function. Public health practitioners need to develop better surveillance systems for monitoring tobacco sponsorship, to seek out alternative funding sources for tobacco company sponsored events and organisations, and to consider promoting a ban on tobacco sponsorship, possibly linking such regulation to the creation of alternative funding sources.