A Case–Control Study to Evaluate Environmental and Lifestyle Risk Factors for Esophageal Cancer in Tanzania

Mmbaga, Elia John; Mushi, Beatrice; Deardorff, Katrina; Mgisha, William; Akoko, Larry; Paciorek, Alan; Hiatt, Robert A.; Buckle, Geoffrey; Mwaiselage, Julius; Zhang, Li; Loon, Katherine Van

doi:10.1158/1055-9965.epi-20-0660

Cited by 27 publications

(46 citation statements)

References 45 publications

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“…For instance, smoking and drinking have been confirmed to be closely related to EC in many studies (7)(8)(9)(10). In China, heavy drinking and smoking are the main risk factors for EC (11), while in a Western study of ESCC, 80% of men and 40% of women had heavy drinking and smoking habits (12). A systematic analysis of 195 countries found that a large part of disability-adjusted life years caused by EC was attributable to smoking and drinking (13).…”

Section: Smoking and Drinkingmentioning

confidence: 98%

The research progress on the association between dietary habits and esophageal cancer: a narrative review

Ye¹,

Lai²,

Song³

et al. 2021

Ann Palliat Med

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Objective: This article summarizes the research progress on the association of dietary habits with esophageal cancer (EC), with the aim of gaining a better understanding of lifestyle, dietary, and drug-related risk factors as well as protective factors of EC.Background: EC is one of the most common malignant cancers and has a high mortality rate. Evidence has suggested that dietary habits are closely related to EC. Several researches refer to the issue of the relationship between dietary habits and EC, but rare of them summary systematically and comprehensively.It is of great importance to study the role of dietary habits in the etiology of EC for the prevention and treatment of this disease.Methods: We searched the China National Knowledge Infrastructure (CNKI), PubMed, Medline and EMBASE databases to identify studies on the association of dietary habits with EC published between the databases' dates of inception and March 2021.Conclusions: This comprehensive review summarizes the state-of-the-art research findings on the association between dietary habits and EC, with the literature we obtained revealing that dietary habits have been increasingly regarded as potential etiologies or protective factors of EC, which reinforce the importance of suitable planning of interventions to reduce the burden of this disease among the population.

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Section: Smoking and Drinkingmentioning

confidence: 98%

The research progress on the association between dietary habits and esophageal cancer: a narrative review

Ye¹,

Lai²,

Song³

et al. 2021

Ann Palliat Med

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“…To date ESCCAPE results have highlighted the role of alcohol, poor oral health and hot beverage consumption, [5][6][7] while other African studies have identified dietary factors (such as daily spicy chilies and salted foods) and indoor air pollution. 8 With a multicausal etiology, a hypothesized contributor to ESCC risk in East Africa is geophagia. Geophagy (also known as pica) is the intentional practice of eating earth or soil and is a habit that spans all continents of the world.…”

Section: Introductionmentioning

confidence: 99%

“…Among these studies are the ESCC African PrEvention research (ESCCAPE) case‐control studies in Kenya, Tanzania and Malawi. To date ESCCAPE results have highlighted the role of alcohol, poor oral health and hot beverage consumption, 5‐7 while other African studies have identified dietary factors (such as daily spicy chilies and salted foods) and indoor air pollution 8 …”

Section: Introductionmentioning

confidence: 99%

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Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies

Narh

Dzamalala

Mmbaga

et al. 2021

Intl Journal of Cancer

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Geophagia, the intentional practice of consuming soil, occurs across the African esophageal cancer corridor, particularly during pregnancy. We investigated whether this practice is linked to endemic esophageal squamous cell carcinoma (ESCC) in this region. We conducted ESCC case-control studies in Tanzania, Malawi and Kenya. Cases were patients with incident histologically/clinically confirmed ESCC and controls were hospital patients/visitors without digestive diseases. Participants were asked if they had ever eaten soil (never/regularly/pregnancy-only). Odds ratios (OR) are adjusted for sex, age, tobacco, alcohol, country, religion and marital status. Overall, 934 cases (Malawi 535, Tanzania 304 and Kenya females 95) and 995 controls provided geophagia information.Among controls, ever-geophagia was common in women (Malawi 49%, Kenya 43% and Tanzania 29%) but not in men (10% Malawi, <1% Tanzania). In women, ESCC ORs were 1.25 (95% CI: 0.70, 2.22) for regular versus never geophagia and 0.88 (95% CI: 0.64, 1.22) for pregnancy-only versus never. Findings were stronger based on comparisons of cases with hospital visitor controls and were null using hospital patients as controls. In conclusion, geophagia is too rare to contribute to the male ESCC burden in Africa. In women, the practice is common but we did not find consistent evidence of a link to ESCC. The study cannot rule out selection bias masking modest effects. Physical effects of geophagia do not appear to have a large impact on overall ESCC risk. Research with improved constituent-based geophagia exposure assessment is needed.

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“…Studies from Asia, Europe, Latin America, Kenya, and Iran have reported associations of ESCC with poor oral hygiene, chronic periodontal disease, dental decay, and tooth loss (7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Recently, three parallel case-control studies in Kenya and Tanzania, conducted as part of the African Esophageal Cancer Consortium (AfrECC) and ESCCAPE (esccape.iarc.fr) collaborations, reported possible associations of poor or infrequent oral hygiene with increased risk for ESCC in East Africa (17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

An international report on bacterial communities in esophageal squamous cell carcinoma

Nomburg

Bullman

Nasrollahzadeh

et al. 2021

Preprint

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The incidence of esophageal squamous cell carcinoma (ESCC) is disproportionately high in the eastern corridor of Africa and parts of Asia. Emerging research has identified a potential association between poor oral health and ESCC. One proposed biological pathway linking poor oral health and ESCC involves the alteration of the microbiome. Thus, we performed an integrated analysis of four independent sequencing efforts of ESCC tumors from patients from high- and low-incidence regions of the world. Using whole genome sequencing (WGS) and RNA sequencing (RNAseq) of ESCC tumors and WGS of synchronous collections of saliva specimens from 61 patients in Tanzania, we identified a community of bacteria, including members of the genera Fusobacterium, Selenomonas, Prevotella, Streptococcus, Porphyromonas, Veillonella, and Campylobacter , present at high abundance in ESCC tumors. We then characterized the microbiome of 238 ESCC tumor specimens collected in two additional independent sequencing efforts consisting of patients from other high-ESCC incidence regions (Tanzania, Malawi, Kenya, Iran, China). This analysis revealed a similar tumor enrichment of the ESCC-associated bacterial community in these cancers. Because these genera are traditionally considered members of the oral microbiota, we explored if there is a relationship between the synchronous saliva and tumor microbiomes of ESCC patients in Tanzania. Comparative analyses revealed that paired saliva and tumor microbiomes are significantly similar with a specific enrichment of Fusobacterium and Prevotella in the tumor microbiome. Together, these data indicate that cancer-associated oral bacteria are associated with ESCC tumors at the time of diagnosis and support a model in which oral bacteria are present in high abundance in both saliva and tumors of ESCC patients. Longitudinal studies of the pre-diagnostic oral microbiome are needed to investigate whether these cross-sectional similarities reflect temporal associations.

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A Case–Control Study to Evaluate Environmental and Lifestyle Risk Factors for Esophageal Cancer in Tanzania

Cited by 27 publications

References 45 publications

The research progress on the association between dietary habits and esophageal cancer: a narrative review

The research progress on the association between dietary habits and esophageal cancer: a narrative review

Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies

An international report on bacterial communities in esophageal squamous cell carcinoma

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