Abstract:Studies evaluating risk factors for the occurrence of oesophageal squamous cell carcinoma (ESCC) in high-risk regions might contribute to a better understanding of the oesophageal cancer aetiology and incidence variation worldwide. We aimed to quantify the association between alcohol, tobacco and dietary history, and the occurrence of ESCC in Mozambique. A case-control study was conducted at Maputo Central Hospital. Cases (n = 143) were patients with newly diagnosed oesophageal cancer recruited in the Gastroen… Show more
“…Another study from Ethiopia reported that eating fruits or vegetables daily reduced the risk of ESCC with OR of 0.49 [ 50 ]. Studies done in Mozambique [ 49 ], Tanzania [ 44 , 47 ], and Zambia [ 41 ] also showed a protective effect of fruit and vegetable consumption to ESCC development. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Overall low SES was associated with increased risk of ESCC. SES was measured using salaries/household income [ 23 , 34 , 47 , 49 ], occupational status [ 52 , 64 ], assets owned [ 45 , 46 ], international wealth index score [ 44 , 47 ], SES score [ 48 ], and type of housing [ 37 , 46 ]. The South African study reported an increased risk of ESCC associated with lower salaries, and found RR ranging from 1.23 to 74.94 for various low-salary levels [ 23 ].…”
Background
The African Esophageal Squamous Cell Carcinoma (ESCC) corridor, which spans from Ethiopia down to South Africa, is an esophageal cancer hotspot. Disproportionately high incidence and mortality rates of esophageal cancer have been reported from this region. The aim of this study was to systematically assess the evidence on environmental and life-style risk factors associated with ESCC in African populations.
Methods
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and carried out a comprehensive search of all African published studies up to March 2023 using PubMed, Embase, Scopus, and African Index Medicus databases.
Results
We identified 45 studies with measures of association [odds ratio (OR), relative risk (RR), and 95% confidence intervals (95%CI)], which reported on several environmental and lifestyle risk factors for ESCC in Africa. We performed a meta-analysis on 38 studies investigating tobacco, alcohol use, combined tobacco and alcohol use, polycyclic aromatic hydrocarbon exposure, hot food and beverages consumption (which served as a proxy for esophageal injury through exposure to high temperature), and poor oral health. We found significant associations between all the risk factors and ESCC development. Analysis of fruit and vegetable consumption showed a protective effect. Using population attributable fraction (PAF) analysis, we calculated the proportion of ESCC attributable to tobacco (18%), alcohol use (12%), combined tobacco and alcohol use (18%), polycyclic aromatic hydrocarbon exposure (12%), hot food and beverages intake (16%), poor oral health (37%), and fruit and vegetable consumption (-12%).
Conclusions
Tobacco smoking and alcohol consumption were the most studied risk factors overall. Areas where there is an emerging body of evidence include hot food and beverages and oral health. Concurrently, new avenues of research are also emerging in PAH exposure, and diet as risk factors. Our results point to a multifactorial etiology of ESCC in African populations with further evidence on prevention potential.
“…Another study from Ethiopia reported that eating fruits or vegetables daily reduced the risk of ESCC with OR of 0.49 [ 50 ]. Studies done in Mozambique [ 49 ], Tanzania [ 44 , 47 ], and Zambia [ 41 ] also showed a protective effect of fruit and vegetable consumption to ESCC development. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Overall low SES was associated with increased risk of ESCC. SES was measured using salaries/household income [ 23 , 34 , 47 , 49 ], occupational status [ 52 , 64 ], assets owned [ 45 , 46 ], international wealth index score [ 44 , 47 ], SES score [ 48 ], and type of housing [ 37 , 46 ]. The South African study reported an increased risk of ESCC associated with lower salaries, and found RR ranging from 1.23 to 74.94 for various low-salary levels [ 23 ].…”
Background
The African Esophageal Squamous Cell Carcinoma (ESCC) corridor, which spans from Ethiopia down to South Africa, is an esophageal cancer hotspot. Disproportionately high incidence and mortality rates of esophageal cancer have been reported from this region. The aim of this study was to systematically assess the evidence on environmental and life-style risk factors associated with ESCC in African populations.
Methods
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and carried out a comprehensive search of all African published studies up to March 2023 using PubMed, Embase, Scopus, and African Index Medicus databases.
Results
We identified 45 studies with measures of association [odds ratio (OR), relative risk (RR), and 95% confidence intervals (95%CI)], which reported on several environmental and lifestyle risk factors for ESCC in Africa. We performed a meta-analysis on 38 studies investigating tobacco, alcohol use, combined tobacco and alcohol use, polycyclic aromatic hydrocarbon exposure, hot food and beverages consumption (which served as a proxy for esophageal injury through exposure to high temperature), and poor oral health. We found significant associations between all the risk factors and ESCC development. Analysis of fruit and vegetable consumption showed a protective effect. Using population attributable fraction (PAF) analysis, we calculated the proportion of ESCC attributable to tobacco (18%), alcohol use (12%), combined tobacco and alcohol use (18%), polycyclic aromatic hydrocarbon exposure (12%), hot food and beverages intake (16%), poor oral health (37%), and fruit and vegetable consumption (-12%).
Conclusions
Tobacco smoking and alcohol consumption were the most studied risk factors overall. Areas where there is an emerging body of evidence include hot food and beverages and oral health. Concurrently, new avenues of research are also emerging in PAH exposure, and diet as risk factors. Our results point to a multifactorial etiology of ESCC in African populations with further evidence on prevention potential.
“…Another study from Ethiopia reported that eating fruits or vegetables daily reduced the risk of ESCC with OR of 0.49 [50]. Studies done in Mozambique [49], Tanzania [44,47], and Zambia [41] also showed a protective effect of fruit and vegetable consumption to ESCC development.…”
Background The African Esophageal Squamous Cell Carcinoma (ESCC) corridor, which spans from Ethiopia down to South Africa, is an esophageal cancer hotspot. Disproportionately high incidence and mortality rates of esophageal cancer have been reported from this region.Methods We systematically assessed the evidence on environmental and life-style risk factors associated with ESCC in African populations. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and carried out a comprehensive search of all African published studies up to March 2023 using PubMed, Embase, Scopus, and African Index Medicus databases.Results We identified 45 studies with measures of association [odds ratio (OR), relative risk (RR), and 95% confidence intervals (95%CI)], which reported on several environmental and lifestyle risk factors for ESCC in Africa. We performed a meta-analysis on 38 studies investigating tobacco, alcohol use, combined tobacco and alcohol use, polycyclic aromatic hydrocarbon exposure, hot food and beverages consumption, and poor oral health. We found significant associations between ESCC risk and all the risk factors. Analysis of fruit and vegetable consumption showed a protective effect. Using population attributable fraction (PAF) analysis, we calculated the proportion of ESCC attributable to tobacco (18%), alcohol use (12%), combined tobacco and alcohol use (18%), polycyclic aromatic hydrocarbon exposure (12%), hot food and beverages consumption (16%), poor oral health (37%), and fruit and vegetable consumption (-12%).Conclusions Tobacco smoking and alcohol consumption were the most studied risk factors overall. Areas where there is an emerging body of evidence include hot food and beverages, oral health and geophagia. Concurrently, new avenues of research are also emerging in PAH exposure, and diet as risk factors. Our results point to a multifactorial etiology of ESCC in African populations with further evidence on prevention potential.
“…Several meta-analyses showed more than two-fold increased ESCC risk for drinking beverages at higher versus lower temperatures [67][68][69][70]. Despite the differences in the beverage types (green tea, salt tea, black tea, coffee, and mate), when drank at high temperatures, they were frequently linked to increased ESCC risk [40,[71][72][73][74][75][76][77][78][79][80]. While the majority of the available studies estimated thermal exposures during the consumption of hot beverages by self-reported perceptions that may vary across individuals [66,67], several studies assessed ESCC risk in relation to objectively measured drinking tea temperature at first sip and found around two-fold increased ESCC risk among those who drink tea at≥ 60 • C versus <60 • C [71,81,82].…”
Section: Hot Food and Drinksmentioning
confidence: 99%
“…While incidence rates of ESCC are higher in low-and middle-income countries and the converse holds for EAC, in within-country analyses, low SES is associated with a 1.5 to 2-fold increased risk of both ESCC and EAC subtypes [43,61,76,[84][85][86][87][87][88][89]. SES is a complex concept and has traditionally been defined by education, wealth, and occupation [90].…”
Esophageal cancer (EC) is the ninth most common cancer and the sixth leading cause of cancer deaths worldwide. Esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) are the two main histological subtypes with distinct epidemiological and clinical features. While the global incidence of ESCC is declining, the incidence of EAC is increasing in many countries. Decades of epidemiologic research have identified distinct environmental exposures for ESCC and EAC subtypes. Recent advances in understanding the genomic aspects of EC have advanced our understanding of EC causes and led to using specific genomic alterations in EC tumors as biomarkers for early diagnosis, treatment, and prognosis of this cancer. Nevertheless, the prognosis of EC is still poor, with a five-year survival rate of less than 20%. Currently, there are significant challenges for early detection and secondary prevention for both ESCC and EAC subtypes, but Cytosponge™ is shifting this position for EAC. Primary prevention remains the preferred strategy for reducing the global burden of EC. In this review, we will summarize recent advances, current status, and future prospects of the studies related to epidemiology, time trends, environmental risk factors, prevention, early diagnosis, and treatment for both EC subtypes.
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