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

Abstract

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.

Nontuberculous Mycobacteria as Sapronoses: A Review

“…A case study conducted in Tanzania, Malawi, and Kenya showed that geophagia was a common practice in women: 49% in Malawi, 43% in Kenya, and 29% in Tanzania. Whereas in men, the practice of geophagia was significantly lower: 10% in Malawi and up to 1% in Kenya and Tanzania [ 105 ]. The practice of soil consumption has been described in Nigeria and Ghana, where it is associated with efforts to alleviate the symptoms of morning sickness in pregnant women [ 101 , 106 ].…”

Environmental and life-style risk factors for esophageal squamous cell carcinoma in Africa: a systematic review and meta-analysis

“…A Zambian study reported no association between geophagia and ESCC. In a multicenter case control study (Tanzania, Malawi, Kenya) and the most comprehensive study on ESCC and geophagia thus far, non-significant increase in ESCC risk (OR 1.66; 0.77–3.55 95%CI) was reported in Tanzanian women who consumed soil during pregnancy and regularly [ 69 ]. Results from Malawi and Tanzania did not show a significant association between women who consumed soil during pregnancy or regularly, and ESCC development.…”

Os desafios do diagnóstico de Carcinoma Escamoso de Esôfago em gestante: uma revisão de literatura acompanhada de relato de caso

“…Jorgensen N et al constataram em seu estudo que a regulação da resposta imunológica nos seres humanos depende, entre outros fatores, da atuação das células T reguladoras (TRegs), Brazilian Journal of Health Review, Curitiba, v. 6, n. 6, p.27780-27789, nov./dec., 2023 as quais modulam a intensidade das respostas imunes, seja direcionando a resposta contra diferentes patógenos e tumores, seja restringindo aberrantes respostas inflamatórias desproporcionais. Na gestação, os mecanismos responsáveis pela indução da tolerância imunológica são os mesmos envolvidos no controle das respostas inflamatórias, além de serem também os responsáveis por criar um ambiente pró-tumor.…”