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1.
Int J Cancer ; 146(1): 18-25, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30891750

RESUMO

Previous studies have reported an association between hot tea drinking and risk of esophageal cancer, but no study has examined this association using prospectively and objectively measured tea drinking temperature. We examined the association of tea drinking temperature, measured both objectively and subjectively at study baseline, with future risk of esophageal squamous cell carcinoma (ESCC) in a prospective study. We measured tea drinking temperature using validated methods and collected data on several other tea drinking habits and potential confounders of interest at baseline in the Golestan Cohort Study, a population-based prospective study of 50,045 individuals aged 40-75 years, established in 2004-2008 in northeastern Iran. Study participants were followed-up for a median duration of 10.1 years (505,865 person-years). During 2004-2017, 317 new cases of ESCC were identified. The objectively measured tea temperature (HR 1.41, 95% CI 1.10-1.81; for ≥60°C vs. <60°C), reported preference for very hot tea drinking (HR 2.41, 95% CI 1.27-4.56; for "very hot" vs. "cold/lukewarm"), and reported shorter time from pouring tea to drinking (HR 1.51, 95% CI 1.01-2.26; for <2 vs. ≥6 min) were all associated with ESCC risk. In analysis of the combined effects of measured temperature and amount, compared to those who drank less than 700 ml of tea/day at <60°C, drinking 700 mL/day or more at a higher-temperature (≥60°C) was consistently associated with an about 90% increase in ESCC risk. Our results substantially strengthen the existing evidence supporting an association between hot beverage drinking and ESCC.


Assuntos
Ingestão de Líquidos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Temperatura Alta , Chá , Adulto , Idoso , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
2.
BMC Complement Altern Med ; 19(1): 358, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31822288

RESUMO

BACKGROUND: No previous study has investigated the association between oolong tea consumption and esophageal squamous cell carcinoma (ESCC), we aim to elucidate the association between oolong tea consumption and ESCC and its joint effects with a novel composite index. METHODS: In a hospital-based case-control study, 646 cases of ESCC patients and 646 sex and age matched controls were recruited. A composite index was calculated to evaluate the role of demographic characteristics and life exposure factors in ESCC. Unconditional logistic regression was used to calculate the point estimates between oolong tea consumption and risk of ESCC. RESULTS: No statistically significant association was found between oolong tea consumption and ESCC (OR = 1.39, 95% CI: 0.94-2.05). However, drinking hot oolong tea associated with increased risk of ESCC (OR = 1.60, 95% Cl: 1.06-2.41). Furthermore, drinking hot oolong tea increased ESCC risk in the high-risk group (composite index> 0.55) (OR = 3.14, 95% CI: 1.93-5.11), but not in the low-risk group (composite index≤0.55) (OR = 1.16, 95% CI: 0.74-1.83). Drinking warm oolong tea did not influence the risk of ESCC. CONCLUSIONS: No association between oolong tea consumption and risk of ESCC were found, however, drinking hot oolong tea significantly increased the risk of ESCC, especially in high-risk populations.


Assuntos
Dieta/estatística & dados numéricos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Chá , Estudos de Casos e Controles , Feminino , Temperatura Alta , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances
3.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1104-1109, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683395

RESUMO

Objective: To analyze the related factors of esophageal squamous cell carcinoma and precancerous lesions among residents aged 40-69 years old in rural areas of Shandong Province. Methods: In October 2018, 300 villages in 13 counties of the Shandong upper gastrointestinal cancerearly diagnosis and treatment projectin 2017 were selected as research areas, and 30 400 residents aged 40-69 were recruited in this study. The demographic characteristics, health status and lifestyle information were collected through the questionnaire survey, and endoscope iodine staining and indicative biopsy methods were used for cancer screening among eligible people.The multivariate logistic regression model was used to analyze the risk factors for esophageal cancer and precancerous lesions. Results: The subjects in this study were (56.42±7.24) years old, including 13 193 males (43.40%).There were 936 cases of esophageal cancer and precancerous lesions (3.08%), including 521 males and 415 females.Compared with women, 40-49 years old, high level education, drinking tap water, regular intake of meat, eggs and milk, and family average annual income more than 30 000 RMB, men (OR=1.90, 95%CI: 1.65-2.19), 60-69 years old (OR=5.28, 95%CI: 4.11-7.30), primary school education or below (OR=1.50, 95%CI: 1.20-1.89), drinking groundwater (OR=1.71, 95%CI: 1.38-2.13), never eating meat, eggs and milk (OR=1.48, 95%CI: 1.22-1.80), and family average annual income less than 30 000 RMB (OR=1.41, 95%CI: 1.16-1.70) would increase the risk of esophageal cancer and precancerous lesions. Conclusion: The gender, age, educational level, annual household income, drinking water source, the frequency of eating meat, egg and milk were related to the occurrence of esophageal cancer and precancerous lesions among 40-69 years old residents in rural areas of Shandong Province.


Assuntos
Detecção Precoce de Câncer , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/patologia , Lesões Pré-Cancerosas/patologia , População Rural/estatística & dados numéricos , Adulto , Idoso , Biópsia , China/epidemiologia , Endoscopia , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/epidemiologia , Fatores de Risco
4.
Medicine (Baltimore) ; 98(42): e17637, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626150

RESUMO

The purpose of this study was to assess the impact of tumor burden on the survival of patients with pathologic T3N0M0 (pT3N0M0) esophageal squamous cell carcinoma (ESCC).A total of 84 patients with pathologic T3N0M0 ESCC treated with radical esophagectomy and 3-field lymphadenectomy (3-FL) from January 2008 to December 2009 in our center were analyzed. Receiver-operating characteristic (ROC) curve analysis was performed to calculate the optimal cutoff value. The Kaplan-Meier method and log-rank test were used to assess the overall survival (OS) differences between groups. A regression model was applied to identify prognostic factors for OS. Propensity score matching (PSM) was performed to adjust for the imbalance and indication biases in the 2 groups.The median follow-up time was 62 months (range, 1-84 months), and the 5-year OS rate was 62% (95% confidence interval, 52.2-71.8%). According to the ROC curve analysis, the optimal cutoff values for the maximal esophageal wall thickness, tumor length, and tumor volume were 1.3 cm, 5.9 cm, and 18.6 cc, respectively. Univariate analysis revealed that maximal esophageal wall thickness >1.3 cm (P = .014), tumor volume >18.6 cc (P < .001), and vascular invasion (P < .001) were significantly associated with OS. The multivariate Cox regression model identified tumor volume and vascular invasion as factors affecting OS. After propensity matching, patients with a tumor volume ≤18.6 cc had a better OS than those with a tumor volume >18.6 cc (5-year OS, 85% vs 50%, P = .008).Tumor volume may serve as a good prognostic factor for patients with pT3N0M0 ESCC treated with radical esophagectomy and 3-FL. Larger-scale studies are warranted to validate these findings.


Assuntos
Carcinoma de Células Escamosas do Esôfago/diagnóstico , Estadiamento de Neoplasias/métodos , Pontuação de Propensão , Carga Tumoral , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Esofagectomia , Feminino , Seguimentos , Humanos , Imagem Tridimensional , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida/tendências , Fatores de Tempo , Tomografia Computadorizada por Raios X
5.
Wei Sheng Yan Jiu ; 48(5): 757-764, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31601316

RESUMO

OBJECTIVE: To elucidate the association between lifestyle and dietary factors and esophageal squamous cell carcinoma( ESCC) in three different sections of the esophagus. METHODS: From January 2010 to December 2016, a hospital-based case-control study was conducted, and a total of 550 patients with ESCC and gender and age( ±3 age) frequency-matched 550 cancer-free control subjects were recruited in this study. Odds ratios( ORs) and their corresponding 95% confidence intervals( CIs) were calculated by using unconditional binary or multinomial logistic regression. Multiple correspondence analysis( MCA) was applied to illustrate the influence of the risk factors on different sections of the esophagus. RESULTS: Tea drinking was associated with lower risk of upper( Ut) and lower thoracic( Lt) ESCC( OR = 0. 40, 95% CI 0. 22-0. 73; OR= 0. 50, 95% CI 0. 31-0. 81; for Ut and Lt, respectively), and lower intake of vegetables increased the risk of Ut and Lt ESCC( OR = 3. 93, 95% CI 1. 61-9. 61; OR =2. 68, 95% CI 1. 30-5. 53; for Ut and Lt, respectively). Intake of hot food, hard food and lower intake of fruits were associated with an elevated risk of the ESCC in all subsites( P<0. 05). The strength of association between drinking and ESCC was lower in middle thoracic( Mt) compared with the Lt ESCC( OR = 0. 58, 95% CI 0. 35-0. 98). Moreover, this reduction of association strength were also found in eating hot food( OR = 0. 45, 95%CI 0. 27-0. 76) and lower intake of vegetables( Ut OR = 0. 44, 95% CI 0. 20-0. 99). However, the association between lower intake of fruits and the Mt ESCC risk was stronger compared with Lt ESCC( OR = 1. 66, 95% CI 1. 08-2. 55). In additional, the association between lower intake of fruits and the Ut ESCC risk was stronger compared with Mt ESCC. Joint category plot of MCA also identified the heterogeneous associations between risk factors and different sections of the esophagus. CONCLUSION: Differences in risk factors of ESCC in different subsites, intake of hot food, hard food, and lower intake of vegetables were common risk factors for three subsites of ESCC.


Assuntos
Dieta/estatística & dados numéricos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Estudos de Casos e Controles , China/epidemiologia , Comportamento Alimentar , Humanos , Estilo de Vida , Fatores de Risco
6.
Cancer Biomark ; 25(3): 243-250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31282406

RESUMO

OBJECTIVE: The aim of this study was to evaluate the prognostic value of a novel tumor marker index (TMI) based on preoperative serum levels of squamous cell carcinoma antigen (SCC) and cytokeratin 19 fragment (CYFRA 21-1) for patients with resectable esophageal squamous cell carcinoma (ESCC). METHODS: A total of 315 ESCC patients who had underwent curative surgery between 2008 and 2012 were retrospectively included in this study. The TMI was defined as the geometric mean of normalized SCC and CYFRA21-1 levels. Univariate and multivariate survival analyses were performed to confirm the clinical and prognostic significance of preoperative SCC and CYFRA 21-1 levels and TMI. RESULTS: Elevated preoperative SCC was associated with histological grade, pT status, lymph node status and TNM stage. Elevated preoperative CYFRA 21-1 was correlated with tumor size, lymph node status and TNM stage. The overall survival of patients with elevated SCC and CYFRA 21-1 levels was significantly poorer than that of patients with normal levels. Multivariate survival analysis identified that preoperative SCC (P= 0.353) and CYFRA 21-1 (P= 0.139) were not independent prognostic factors. The cut-off value of TMI based on SCC and CYFRA 21-1 was 0.531, and the patients were subdivided into high and low TMI groups. The 5-year survival rate of patients with high TMI was 30.9%, which was significantly lower than that of patients with low TMI (50.4%, P< 0.05). Multivariate analysis identified the TMI (HR 1.371; 95% CI 1.024-1.836; P= 0.034) as an independent prognostic factor. CONCLUSIONS: Elevated preoperative SCC and CYFRA 21-1 levels were associated with aggressive cancer behavior in ESCC. The TMI based on preoperative SCC and CYFRA 21-1 might serve as a novel marker that can be used to predict the prognosis of ESCC patients.


Assuntos
Antígenos de Neoplasias/genética , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas do Esôfago/genética , Queratina-19/genética , Serpinas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígeno Carcinoembrionário/genética , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Taxa de Sobrevida
7.
Biomed Res Int ; 2019: 2741598, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31240208

RESUMO

Objective: This study constructs, calibrates, and verifies a mathematical simulation model designed to project the natural history of ESCC and is intended to serve as a platform for testing the benefits and cost-effectiveness of primary and secondary ESCC prevention alternatives. Methods: The mathematical model illustrates the natural history of ESCC as a sequence of transitions among health states, including the primary health states (e.g., normal mucosa, precancerous lesions, and undetected and detected cancer). Using established calibration approaches, the parameter sets related to progression rates between health states were optimized to lead the model outputs to match the observed data (specifically, the prevalence of precancerous lesions and incidence of ESCC from the published literature in Chinese high-risk regions). As illustrative examples of clinical and policy application, the calibrated and validated model retrospectively simulate the potential benefit of two reported ESCC screening programs. Results: Nearly 1,000 good-fitting parameter sets were identified from 1,000,000 simulated sets. Model outcomes had sufficient calibration fit to the calibration targets. Additionally, the verification analyses showed reasonable external consistency between the model-predicted effectiveness of ESCC screening and the reported data from clinical trials. Conclusions: This parameterized mathematical model offers a tool for future research investigating benefits, costs, and cost-effectiveness related to ESCC prevention and treatment.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Programas de Rastreamento/métodos , Modelos Teóricos , Calibragem , China/epidemiologia , Análise Custo-Benefício , Progressão da Doença , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/prevenção & controle , Neoplasias Esofágicas/terapia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/prevenção & controle , Carcinoma de Células Escamosas do Esôfago/terapia , Humanos , Incidência , Prevalência , Estudos Retrospectivos
8.
Surg Clin North Am ; 99(3): 479-499, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31047037

RESUMO

Human evolutionary genetic divergence and distinctive environmental exposures have contributed to the development of clinicopathologic variations of esophageal cancer in Eastern and Western countries. Different treatment strategies have derived from the disparate regional experiences. Treatment strategy is more standardized in the West. Trimodality treatment with neoadjuvant chemoradiation followed by surgery is widely accepted as the standard treatment of locally advanced esophageal adenocarcinoma and esophageal squamous cell carcinoma. Trimodality treatment has not been adopted in many Eastern countries, and standard treatment is neoadjuvant chemotherapy. Several randomized trials are ongoing that may alter the standard management of esophageal cancer worldwide.


Assuntos
Adenocarcinoma/terapia , Neoplasias Esofágicas/terapia , Carcinoma de Células Escamosas do Esôfago/terapia , Adenocarcinoma/epidemiologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia/métodos , Terapia Combinada/métodos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Esofagectomia/métodos , Previsões , Humanos , Excisão de Linfonodo/métodos , Terapia Neoadjuvante/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia de Salvação/métodos , Resultado do Tratamento
9.
J Pak Med Assoc ; 69(5): 738-740, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31105301

RESUMO

To determine the frequency of human papilloma virus (HPV) in patients with oesophageal squamous cell carcinoma. A descriptive, cross-sectional method was adopted and the study was conducted in the histopathology department of Rehman Medical Institute, Peshawar, Pakistan, from January to June 2017, and included patients with Oesophageal squamous cell carcinoma. Non-probability consecutive sampling technique was used. SPSS v.22 was used for data analysis. Out of 121 patients, 67(55.37%) were male and 54(44.62%) were female. The overall mean age was 50±1.72 years. Most of the patients were in the age group of over 50 years and only 12% were in the age group below 40 years. In our study patients with oesophageal squamous cell carcinma, human papillomavirus was found in 3%.


Assuntos
Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Infecções por Papillomavirus/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia
10.
Ecotoxicol Environ Saf ; 178: 79-85, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-30999183

RESUMO

BACKGROUND: Despite decades of research and intervention programs, the epidemic of esophageal squamous cell carcinoma (ESCC) in the Taihang Mountain area of north China has not seen convincing explanation by any risk factor yet and the incidence has not seen a substantial decrease. Based on recently disclosed association of aridity and wheat consumption with esophageal cancer, we revisited the hypothesis of biogenic silica in esophageal cancer development. METHODS: From the archives of the Pathology Department of Heping Hospital, Changzhi Medical College, we selected three pairs of formalin-fixed samples, tumor tissues and distant normal tissues, of three patients operated for ESCC who had no history of workplace exposure to silica dust. Two pairs of dried tissue samples were used for phytolith (silica body) analysis and another pair for microanalysis with Transmission Electron Microscope (TEM). RESULTS: One of the phytoliths in ESCC tumor tissue was similar to the prickle hair on the surface of wheat bract. In the mineral particles detected in the tumor tissue the predominant elements were Si, Ca, and P, whereas Si signals were not obvious in the distant normal tissue. CONCLUSIONS: The preliminary findings on the detection of phytoliths and the higher than normal Si concentration in ESCC tumor tissue warrants further testing the role of biogenic silica in esophageal cancer.


Assuntos
Exposição Dietética/efeitos adversos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Dióxido de Silício/análise , Triticum/química , Adulto , China/epidemiologia , Neoplasias Esofágicas/química , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/química , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Dióxido de Silício/administração & dosagem , Dióxido de Silício/efeitos adversos , Triticum/ultraestrutura
11.
Expert Rev Gastroenterol Hepatol ; 13(1): 71-88, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30791842

RESUMO

INTRODUCTION: Esophageal carcinoma causes over 380 000 deaths per year, ranking sixth worldwide in mortality amongst all malignancies. Globally, the squamous cell subtype is most common and accounts for 80% of esophageal cancers. Nonetheless, esophageal squamous cell carcinoma is much more poorly understood than esophageal adenocarcinoma, including what is driving such high prevalences, why it often presents in young patients, and shows such marked geographical delineations Areas covered: The current literature was searched for articles focusing on aetiopathogenesis of squamous cell esophageal carcinoma via a systematic review, particularly in low-resource settings. This was supplemented by papers of interest known to the authors. Expert commentary: Current putative mechanisms include polycyclic aromatic hydrocarbons, nitrosamines, acetaldehyde, cyclo-oxygenase-2 pathways, androgen and their receptor levels, as well as smoking & alcohol, micronutrient deficiencies and diet, mycotoxins, thermal damage, oral hygiene and microbiotal factors, inhaled smoke, viral infections such as HPV, and chronic irritative states. Etiology is likely multifactorial and varies geographically. Though smoking and alcohol play a predominant role in high-income settings, there is strong evidence that mycotoxins, diet and temperature effects may play an under-recognized role in low and middle-income settings.


Assuntos
Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Renda , Estilo de Vida , Pobreza , Distribuição por Idade , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Carcinógenos Ambientais/efeitos adversos , Dieta/efeitos adversos , Neoplasias Esofágicas/diagnóstico , Microbiologia de Alimentos , Temperatura Alta/efeitos adversos , Humanos , Micotoxinas/efeitos adversos , Prevalência , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia
12.
Environ Sci Pollut Res Int ; 26(8): 8340-8343, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30689109

RESUMO

Certain areas in North China have the highest incidence of esophageal squamous cell carcinoma (ESCC) in the world, which has not seen convincing explanation by any risk factor yet. Biogenic silica in millet bran was linked to ESCC in the early 1980s but the hypothesis was largely dismissed because of the lack of geographic correlation between millet consumption and ESCC. Later epidemiological studies disclosed the linkage of wheat consumption in North China to ESCC instead. Now, we hypothesize silica phytoliths (silicified bodies that have definite shapes) from wheat chaff are a major etiologic factor of ESCC in this region. This hypothesis is supported by the potentially high abundance of silica phytoliths on the bracts of wheat (Triticum aestivum) in North China due to favorable Si-accumulation genotype, arid climate, and siallitic soil with bioavailable Si. These silica phytoliths can contaminate wheat flour and cause repeated local injuries in the esophagus and stimulate proliferation by providing anchorage.


Assuntos
Exposição Dietética/efeitos adversos , Neoplasias Esofágicas/induzido quimicamente , Carcinoma de Células Escamosas do Esôfago/induzido quimicamente , Dióxido de Silício/efeitos adversos , Solo/química , Triticum , China/epidemiologia , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Genótipo , Humanos , Incidência , Fatores de Risco , Dióxido de Silício/administração & dosagem , Triticum/química , Triticum/genética
13.
Gastroenterology ; 156(5): 1416-1427, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30611753

RESUMO

BACKGROUND & AIMS: Northeast Iran has one of the highest reported rates of esophageal squamous cell carcinoma (ESCC) worldwide. Decades of investigations in this region have identified some local habits and environmental exposures that increase risk. We analyzed data from the Golestan Cohort Study to determine the individual and combined effects of the major environmental risk factors of ESCC. METHODS: We performed a population-based cohort of 50,045 individuals, 40 to 75 years old, from urban and rural areas across Northeast Iran. Detailed data on demographics, diet, lifestyle, socioeconomic status, temperature of drinking beverages, and different exposures were collected using validated methods, questionnaires, and physical examinations, from 2004 through 2008. Participants were followed from the date of enrollment to the date of first diagnosis of esophageal cancer, date of death from other causes, or date of last follow-up, through December 31, 2017. Proportional hazards regression models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for the association between different exposures and ESCC. RESULTS: During an average 10 years of follow-up, 317 participants developed ESCC. Opium smoking (HR 1.85; 95% CI 1.18-2.90), drinking hot tea (≥60°C) (HR 1.60; 95% CI 1.15-2.22), low intake of fruits (HR 1.48; 95% CI 1.07-2.05) and vegetables (HR 1.62; 95% CI 1.03-2.56), excessive tooth loss (HR 1.66; 95% CI 1.04-2.64), drinking unpiped water (HR 2.04; 95% CI 1.09-3.81), and exposure to indoor air pollution (HR 1.57; 95% CI 1.08-2.29) were significantly associated with increased risk of ESCC, in a dose-dependent manner. Combined exposure to these risk factors was associated with a stepwise increase in the risk of developing ESCC, reaching a more than 7-fold increase in risk in the highest category. Approximately 75% of the ESCC cases in this region can be attributed to a combination of the identified exposures. CONCLUSIONS: Analysis of data from the Golestan Cohort Study in Iran identified multiple risk factors for ESCC in this population. Our findings support the hypothesis that the high rates of ESCC are due to a combination of factors, including thermal injury (from hot tea), exposure to polycyclic aromatic hydrocarbons (from opium and indoor air pollution), and nutrient-deficient diets. We also associated ESCC risk with exposure to unpiped water and tooth loss.


Assuntos
Meio Ambiente , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Estilo de Vida , Fatores Socioeconômicos , Adulto , Idoso , Poluição do Ar em Ambientes Fechados/efeitos adversos , Dieta/efeitos adversos , Exposição Ambiental/efeitos adversos , Neoplasias Esofágicas/diagnóstico , Carcinoma de Células Escamosas do Esôfago/diagnóstico , Feminino , Seguimentos , Temperatura Alta/efeitos adversos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Dependência de Ópio/epidemiologia , Hidrocarbonetos Policíclicos Aromáticos/efeitos adversos , Medição de Risco , Fatores de Risco , Saúde da População Rural , Chá/efeitos adversos , Fatores de Tempo , Perda de Dente/epidemiologia , Saúde da População Urbana , Abastecimento de Água
14.
Gastrointest Endosc ; 89(4): 726-732.e2, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30616974

RESUMO

BACKGROUND AND AIMS: This study aimed to develop a prediction model for identifying individuals at high absolute risk of esophageal squamous cell carcinoma (ESCC) for endoscopic screening at a curable stage based on readily identifiable risk factors. METHODS: This was a nationwide Swedish population-based, case-control study, including 167 new cases of ESCC and 820 randomly selected control participants. Odds ratios with 95% confidence intervals (CI) were assessed by using multivariable unconditional logistic regression. The discriminative accuracy of the model was assessed by the area under the receiver operating characteristic curve (AUC) with leave-1-out cross validation. Models for projecting individuals' absolute 5-year risk of ESCC were developed by incorporating the age-specific and sex-specific incidence rates and competing risk of death from other causes. RESULTS: A model including the risk factors age, sex, tobacco smoking, alcohol overconsumption, education, duration of living with a partner, and place of residence during childhood generated an AUC of 0.81 (95% CI, 0.77-0.84). A model based only on age, sex, tobacco smoking, and alcohol overconsumption obtained a similar AUC (0.79; 95% CI, 0.75-0.82). A 5-year follow-up of 355 men aged 70 to 74 years with over 35 years' smoking and alcohol overconsumption history is needed to detect 1 ESCC case. The estimated individuals' absolute 5-year risk of ESCC varied according to the combinations of risk factors. CONCLUSION: This easy-to-use risk prediction model showed a good discriminative accuracy and had the potential to identify individuals at high absolute risk of ESCC who might benefit from tailored endoscopic screening and surveillance.


Assuntos
Carcinoma de Células Escamosas do Esôfago/diagnóstico por imagem , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Fatores Etários , Idoso , Alcoolismo/epidemiologia , Área Sob a Curva , Estudos de Casos e Controles , Detecção Precoce de Câncer , Escolaridade , Endoscopia Gastrointestinal , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Curva ROC , Medição de Risco/métodos , Fatores de Risco , Fatores Sexuais , Suécia/epidemiologia , Fumar Tabaco
15.
Int J Cancer ; 144(11): 2669-2676, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30496610

RESUMO

Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Consumption of hot beverages-a probable carcinogen to humans-is associated with increased ESCC risk in other settings and is habitually practiced in Kenya. We conducted a case-control study in Eldoret, western Kenya between August 2013 and March 2018. Cases were patients with endoscopically confirmed oesophageal cancer whose histology did not rule out ESCC. Age and sex-matched controls were hospital visitors and hospital out and in-patients excluding those with digestive diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for self-reported drinking temperatures; consumption frequency; mouth burning frequency and hot porridge consumption using logistic regression models adjusted for potential confounders. Drinking temperature association with tumour sub-location was also investigated. The study included 430 cases and 440 controls. Drinkers of 'very hot' and 'hot' beverages (>95% tea) had a 3.7 (95% CI: 2.1-6.5) and 1.4-fold (1.0-2.0) ESCC risk, respectively compared to 'warm' drinkers. This trend was consistent in males, females, never and ever alcohol/tobacco and was stronger over than under age 50 years. The tumour sub-location distribution (upper/middle/lower oesophagus) did not differ by reported drinking temperature. Our study is the first comprehensive investigation in this setting to-date to observe a link between hot beverage consumption and ESCC in East Africa. These findings provide further evidence for the role of this potentially modifiable risk factor in ESCC aetiology.


Assuntos
Bebidas/efeitos adversos , Ingestão de Líquidos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Temperatura Alta/efeitos adversos , Distribuição por Idade , Idoso , Estudos de Casos e Controles , Neoplasias Esofágicas/etiologia , Carcinoma de Células Escamosas do Esôfago/etiologia , Feminino , Humanos , Quênia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Distribuição por Sexo , Inquéritos e Questionários/estatística & dados numéricos
16.
Auris Nasus Larynx ; 46(2): 260-266, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30107961

RESUMO

OBJECTIVE: Hypopharyngeal carcinoma has a very poor prognosis. The high incidence of second esophageal neoplasia is one of the major causes. To establish an efficient follow-up scheme for increasing the diagnostic yield and reducing the adverse impact of second esophageal neoplasia on survival, the purpose of this study was to explore a biomarker to predict second esophageal neoplasia. METHODS: In this retrospective cohort study, consecutive tissue specimens from those patients who underwent tumor resection between September 2007 and October 2015 were collected. Gene amplification was performed by real-time PCR. The expression of cortactin was evaluated by immunohistochemistry. The predictive risk factors of developing second esophageal neoplasia and prognostic factors related to survival were analyzed. RESULTS: A total of 187 patients were included with a mean follow-up of 48months (12-118months). Second esophageal tumors were found in 53 (28.3%), including 41 (21.9%) esophageal squamous cell carcinoma and 12 severe dysplasia. The results of multivariate analyses revealed that age (OR 2.81, 95% CI 1.16-6.78), cortactin overexpression (OR 2.49, 95% CI 1.17-5.33), and stage IV versus I (OR 6.49, 95% CI 1.68-25.18) were independent predictors of second esophageal neoplasia, and second esophageal neoplasia (HR 1.78, 95% CI 1.05-3.01) was an independent predictor of overall survival. CONCLUSION: This is the first report to identify a potential biomarker for predicting second esophageal neoplasia in patients with hypopharyngeal carcinoma. In those patients with cortactin overexpression and younger age (≤60years old), close surveillance for second esophageal neoplasia is required. In addition, the real effect of cortactin overexpression on development of primary esophageal carcinoma is required to be validated in a large cohort study.


Assuntos
Cortactina/genética , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Neoplasias Hipofaríngeas/genética , Segunda Neoplasia Primária/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Cortactina/metabolismo , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/metabolismo , Humanos , Neoplasias Hipofaríngeas/epidemiologia , Neoplasias Hipofaríngeas/metabolismo , Estimativa de Kaplan-Meier , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Taxa de Sobrevida
17.
Int J Cancer ; 144(3): 459-469, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30117158

RESUMO

Squamous cell esophageal cancer is common throughout East Africa, but its etiology is poorly understood. We investigated the contribution of alcohol consumption to esophageal cancer in Kenya, based on a hospital-based case-control study conducted from 08/2013 to 03/2018 in Eldoret, western Kenya. Cases had an endoscopy-confirmed esophageal tumor whose histology did not rule out squamous cell carcinoma. Age and gender frequency-matched controls were recruited from hospital visitors/patients without digestive diseases. Logistic regression was used to calculate odds ratios (ORs) and their 95% confidence intervals (CI) adjusting for tobacco (type, intensity) and 6 other potential confounders. A total of 422 cases (65% male, mean at diagnosis 60 (SD 14) years) and 414 controls were included. ORs for ever-drinking were stronger in ever-tobacco users (9.0, 95% CI: 3.4, 23.8, with few tobacco users who were never drinkers) than in never-tobacco users (2.6, 95% CI: 1.6, 4.1). Risk increased linearly with number of drinks: OR for >6 compared to >0 to ≤2 drinks/day were 5.2 (2.4, 11.4) in ever-tobacco users and 2.1 (0.7, 4.4) in never-tobacco users. Although most ethanol came from low ethanol alcohols (busaa or beer), for the same ethanol intake, if a greater proportion came from the moonshine chang'aa, it was associated with a specific additional risk. The population attributable fraction for >2 drinks per day was 48% overall and highest in male tobacco users. Alcohol consumption, particularly of busaa and chang'aa, contributes to half of the esophageal cancer burden in western Kenya.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Bebidas Alcoólicas/classificação , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Quênia/epidemiologia , Masculino , Pessoa de Meia-Idade , Risco
18.
Int J Cancer ; 145(1): 99-109, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-30582155

RESUMO

There are no studies of oral health in relation to esophageal cancer in Africa, or of Eastern Africa's endemic dental fluorosis, an irreversible enamel hypo-mineralization due to early-life excessive fluoride intake. During 2014-18, we conducted a case-control study of squamous cell esophageal cancer in Eldoret, western Kenya. Odds ratios (AORs (95% confidence intervals)) were adjusted for design factors, tobacco, alcohol, ethnicity, education, oral hygiene and missing/decayed teeth. Esophageal cancer cases (N = 430) had poorer oral health and hygiene than controls (N = 440). Compared to no dental fluorosis, moderate/severe fluorosis, which affected 44% of cases, had a crude OR of 20.8 (11.6, 37.4) and on full adjustment was associated with 9.4-fold (4.6, 19.1) increased risk, whilst mild fluorosis (43% of cases) had an AOR of 2.3 (1.3, 4.0). The prevalence of oral leukoplakia and tooth loss/decay increased with fluorosis severity, and increased cancer risks associated with moderate/severe fluorosis were particularly strong in individuals with more tooth loss/decay. Using a mswaki stick (AOR = 1.7 (1.0, 2.9)) rather than a commercial tooth brush and infrequent tooth brushing also independently increased risk. Geographic variations showed that areas of high esophageal cancer incidence and those of high groundwater fluoride levels have remarkably similar locations across Eastern Africa. In conclusion, poor oral health in combination with, or as a result of, high-altitude susceptibility to hydro-geologically influenced dental fluorosis may underlie the striking co-location of Africa's esophageal cancer corridor with the Rift Valley. The findings call for heightened research into primary prevention opportunities of this highly fatal but common cancer.


Assuntos
Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Fluorose Dentária/epidemiologia , África/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Bucal/estatística & dados numéricos , Prevalência
19.
Cancer Epidemiol ; 57: 45-52, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30300838

RESUMO

BACKGROUND: Case-control studies remain an important study design for aetiologic research on cancer, particularly when cohorts are not available. In addition to the potential biases inherent in this design, conducting fieldwork in settings with weak health care and information systems for cancer, such as in sub Saharan Africa, confer additional challenges which we present here with the aim to share experience to guide future studies. METHODS: We undertook a hospital-based case-control study of squamous cell esophageal cancer at the Moi Teaching and Referral Hospital in Eldoret, West Kenya. Cases were recruited at endoscopy and controls from hospital wards, age and gender frequency-matched to cases. Urine, toenails, blood and tumour biopsy were collected and a questionnaire administered. RESULTS: During this pilot phase, 143 cases and 155 controls were successfully recruited. Complete questionnaire data was obtained through e-data collection. Biospecimen collection was possible with support of an already existing equipped laboratory. We introduce changes made in the main study phase, including on expansion of the control groups to allow to consideration of selection bias. CONCLUSIONS: Extra attention and funding to train and monitor data quality and biospecimen collection and collaboration of a large group held together by strong leadership are essential. We recommend studies based on regional treatment centres with their more defined catchment areas rather than in the capital cities as referral routes in multi-level health care systems are severely attrition prone.


Assuntos
Estudos de Casos e Controles , Métodos Epidemiológicos , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Países em Desenvolvimento , Feminino , Humanos , Quênia/epidemiologia , Masculino , Projetos Piloto , Projetos de Pesquisa , Inquéritos e Questionários
20.
PLoS One ; 13(10): e0205508, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30339710

RESUMO

Esophageal squamous cell carcinoma (ESCC) is one of the aggressive malignancies and mechanisms underlying its pathogenesis remain unclear. Cyclooxygenase-2 (COX-2) enzyme system plays a crucial role in many gastrointestinal malignancies and is an important regulator of cell growth, proliferation, apoptosis, differentiation and transformation. More precise outcome of COX-2 in ESCC is less investigated. In this study we investigated the risk factors of ESCC and expression of COX-2 in Carcinoma in situ (CIS) and ESCC compared to normal esophageal mucosa. ESCC relationship to clinico-pathological parameters using immunohistochemistry was also part of this investigation. Current study was conducted in the Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan. A total of 69 diagnosed patients of ESCC, both Pakistanis and Afghans were enrolled. Various risk factors associated with ESCC were recorded. Mean age at the time of diagnosis was 55 years. Out of 69 patients of ESCC 46 (67%) were users of dipping tobacco (Naswar). Expression of COX-2 was determined in normal esophageal mucosa, CIS and invasive ESCC using Immunohistochemistry (IHC). Differences of mean were computed using ANOVA followed by applying Post Hoc test. Patients were categorized as positive with high expression or negative with low to nil expression. ANOVA showed large differences in expression of COX-2 in normal healthy mucosa compared with CIS and ESCC with the mean difference of -9.529 and -7.370 respectively, p-value being <.05 at 95% confidence interval (CI). No significant difference was noticed in the expression of COX-2 in CIS compared with ESCC with p-value >.05 at 95% CI. Our complete cohort (23-85 years) showed statistically significant difference in the expression of COX-2 gene in ESCC and CIS tissue samples compared with normal healthy mucosa. Results of this study indicate that over-expression of COX-2 is positively associated with ESCC.


Assuntos
Ciclo-Oxigenase 2/metabolismo , Neoplasias Esofágicas/enzimologia , Carcinoma de Células Escamosas do Esôfago/enzimologia , Biomarcadores Tumorais/metabolismo , Mucosa Esofágica/enzimologia , Mucosa Esofágica/patologia , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Uso de Tabaco/epidemiologia , Uso de Tabaco/metabolismo , Uso de Tabaco/patologia , Tabaco sem Fumaça
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