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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.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1119-1123, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683398

RESUMO

Objective: To investigate the association between the promoter region-938 polymorphism of B-cell lymphoma/leukemia-2 (Bcl-2) gene and the esophageal cancer (EC) and gastric cardia adenocarcinoma (GCA) in Hebei Province. Methods: From 2007 to 2010, 145 esophageal cancer patients and 169 cardiaccancer patientsfrom the outpatient department of the Fourth Hospital of Hebei Medical Universitywereselected in a case group, and 195 non-tumor patients were selected in a control group during the same period. A questionnaire survey was used to collect information of research subjects. Pathological tissues were collected to extract genomic DNA and detect the genotype of bcl-2 gene -938. A multivariate logistic regression model was used to analyze the association between the bcl-2 gene locus 938 CC genotype and the EC and GCA. The interaction between age, gender, smoking, drinking, upper gastrointestinal family history and the bcl-2 gene locus 938 CC genotype was analyzed by likelihood ratio test. Results: The age of the esophageal and cardiac cancer groups was (56.3±8.3) and (57.1±8.4) years old, and that of the control group was (54.7±7.1) years old. The proportion of the bcl-2 gene locus 938 CC genotype in the esophageal group [48.3% (70/145)] and the cardiac cancer group [48.5% (82/169)] was higher than that in the control group [33.8% (66/195)] (both P values<0.05).Compared with the AA genotype, the risk of esophageal cancer and cardiac cancerin people with the CC genotype was 2.386 (1.20-4.76) and 2.564 (1.27-5.18) respectively. In the population with CC genotype, compared with the positive family history, drinking, and male, the negative family history, non-drinking, and female had a higher risk of esophageal cancer; compared with the non-smoking, negative family history, non-drinking and male, the smoking, positive family history, drinking, and female had a higher risk of cardiac cancer (all the P interaction values were <0.05). Conclusion: People with bcl-2 gene locus 938 CC genotype in Hebei Provincewere more likely to suffer from the esophageal and gastric cardia adenocarcinoma.


Assuntos
Adenocarcinoma/genética , Cárdia/patologia , Neoplasias Esofágicas/genética , Genes bcl-2/genética , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único/genética , Neoplasias Gástricas/genética , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Idoso , Estudos de Casos e Controles , China/epidemiologia , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/patologia , Feminino , Genótipo , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/patologia
5.
Am Surg ; 85(9): 944-948, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638504

RESUMO

The incidence of esophageal cancer in the United States seems to have significantly increased since the 1970s. In undertaking this study, we sought to describe changes in the incidence, histologic type, and presenting stage of esophageal cancer over the past four decades. With Institutional Review Board approval, the Surveillance, Epidemiology, and End Results database of the National Cancer Institute was queried. Regression analysis was used to analyze data, and significance was accepted with 95 per cent probability. Forty-two thousand seven hundred thirty-nine patients had squamous cell carcinoma or adenocarcinoma located in their upper, middle, and/or lower esophagus from 1973 through 2010, reflecting a 7.5-fold annual increase from 1973 through 2010. Squamous cell carcinoma increased annually 2.5-fold (P < 0.001) and esophageal adenocarcinoma increased annually 57-fold from 1973 through 2010 (P < 0.001), whereas the overall population in the United States increased only 43 per cent (215,092,900 to 308,745,538) in the same period. From 1973 through 2010, there was a significant increase in the incidence of esophageal cancer in the United States. This increase was much greater than the increase in the population in the United States. The incidence of adenocarcinoma increased much more than that of squamous cell carcinoma of the esophagus from 1973 through 2010.


Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Esofágicas/epidemiologia , Adenocarcinoma/patologia , Idoso , Carcinoma de Células Escamosas/patologia , Comorbidade , Neoplasias Esofágicas/patologia , Feminino , Refluxo Gastroesofágico/epidemiologia , Humanos , Incidência , Masculino , Estadiamento de Neoplasias , Obesidade/epidemiologia , Fatores de Risco , Programa de SEER , Estados Unidos/epidemiologia
6.
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
7.
Pan Afr Med J ; 33: 187, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565147

RESUMO

Fumonisin B1 (FB1) is a mycotoxin frequently found in agricultural commodities. The toxin poses a considerable risk for human and animal health. FB1 is among several mycotoxins produced by Fusarium spp. contaminating virtually any cereal and other Poaceae. Their intracellular action includes the promotion of oxidative stress through the generation of reactive oxygen species (ROS) that damage biomolecules such as DNA. These toxic effects were observed in vivo and in vitro. However, the association between esophageal lesions and oxidative stress induced by FB1. Studies in China, Iran and South Africa showed higher exposure to fumonisins in areas with higher risk of esophageal cancer (EC). Exposure to mycotoxins may be inevitable in Mozambique. How mycotoxins, particularly fumonisins from the contaminated food, can be associated with the emergence of EC in Mozambique? Herein, we revise the literature and present some pieces of evidence in order to highlight the burden of mycotoxins and to provide evidence-based considerations for the stakeholders involved in the management of the EC agenda in Mozambique. The information presented herein supports the need to implement novel and/or to revisit the existent detoxification methods to reduce the global burden of mycotoxins and its outcomes in health management.


Assuntos
Carcinógenos Ambientais/toxicidade , Neoplasias Esofágicas/epidemiologia , Fumonisinas/toxicidade , Micotoxinas/toxicidade , Animais , Neoplasias Esofágicas/etiologia , Contaminação de Alimentos/prevenção & controle , Fusarium/metabolismo , Humanos , Moçambique/epidemiologia , Estresse Oxidativo/fisiologia , Espécies Reativas de Oxigênio/metabolismo
8.
Medicine (Baltimore) ; 98(36): e17083, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490413

RESUMO

There have been no studies on implementing effective screening models for esophageal adenocarcinoma and squamous cell carcinoma survivors. We used a proportional subdistribution hazards model to estimate second primary malignancy risks among patients with esophageal adenocarcinoma and squamous cell carcinoma. We validated models using a bootstrap cross-validation method and performed decision curve analysis to evaluate their clinical utility. Age group and SEER historic stage were significantly associated with second primary malignancy risk after diagnosis of esophageal adenocarcinoma and squamous cell carcinoma. Saving positive lymph nodes and distant metastasis were significant factors in the adenocarcinoma group, and marital status, tumor location, and chemotherapy were significant factors in the squamous cell carcinoma group. Calibration plots show good concordance between predicted and actual outcomes except in high-probability areas for the risk of a second primary malignancy in patients with esophageal squamous cell carcinoma. Discrimination performances of the Fine-Gray models were evaluated using c-indices, which were 0.691 and 0.662 for second primary malignancies in patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively. Decision curve analysis yielded a range of threshold probabilities (0.020-0.177 and 0.021-0.133 for patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively) at which the clinical net benefit of the risk model was larger than those of hypothetical all-screening and no-screening scenarios. Our nomograms enable selection of patient populations at high risk for a second primary malignancy and thus will facilitate the design of prevention trials for affected populations.


Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Esofágicas/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Humanos , Lactente , Pessoa de Meia-Idade , Nomogramas , Medição de Risco , Programa de SEER , Estados Unidos/epidemiologia , Adulto Jovem
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 924-929, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484255

RESUMO

Objective: To describe the mortality trend of major malignant tumors in Shandong province, from 1970 to 2013. Methods: Data related to cancer mortality were obtained from the Shandong Death Registration System and three nationwide retrospective cause-of-death surveys. Trends of overall mortality and major causes of death were described using the indicators as: mortality rates and age-standardized mortality rates, through comparing the three large-scale mortality surveys in Shandong province. Difference decomposing method was applied to estimate the contribution of demographic and non-demographic factors for the change of mortality. Results: From 1970 to 2013, the crude mortality rate of malignant tumors in Shandong was increasing. The age standard mortality rate was increasing and then decreasing. The composition of cancer deaths in the all-cause-deaths was seen increasing and then decreasing as well. Both demographic and non-demographic factors contributed to the increase of crude cancer mortality rate. With the gradual increase of the proportion of population, its role exceeded the non-demographic factors. The age-standardized mortality rate of malignant tumors in 2011-2013 was lower than that in 2004-2005. Lung cancer mortality rose from the fifth to the first place, with an increase of 6.81 times from 1970-1974 to 2011-2013. Ranking of gastric cancer mortality dropped from first to the third place, with esophageal cancer dropped from second to the fourth. After adjusted by China's standard population in 1964, the mortality rate of lung cancer was still rapidly increasing, but the age-standardized mortality rates of esophageal cancer was gradually decreasing. The crude and age-standardized mortality rates of cervical cancer showed a rapid downward trend, reduced 87.00% and 93.00% respectively from 1970-1974 to 2011-2013. Conclusions: Malignant tumors were still major threats to the residents of Shandong province. The changing trend of different malignant tumors presented an inconsistent nature which called for different intervention strategies be carried out, accordingly.


Assuntos
Neoplasias Esofágicas/epidemiologia , Mortalidade/tendências , Neoplasias Gástricas/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Criança , Pré-Escolar , China/epidemiologia , Demografia , Neoplasias Esofágicas/mortalidade , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Neoplasias Gástricas/mortalidade , Adulto Jovem
10.
Pan Afr Med J ; 33: 73, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448035

RESUMO

Introduction: Esophageal cancer is rare. Poor prognosis is due to delayed diagnosis. Five year survival is less than 20%. This study aimed to investigate the factors associated with survival of patients with esophageal cancer in Cameroon. Methods: We conducted a prognostic study in the General Hospitals in Yaoundé and in Douala over a period of 11 years from 1 January 2005 to 31 December 2015. The parameters studied were those associated with survival. Survival was established on the basis of the date of diagnosis and of the date of death or of the last visit. SPSS software (Statistical Package for Social Sciences) version 23 allowed for data analysis. Kaplan Meier curve was used to estimate the survival function. Log RankTest allowed for comparison among the different groups. Cox regression helped to highlight the different factors associated with it. Significance level was set at 0.05. Results: We collected data from 49 medical records. The average age of patients was 57.83 years. There was a male predominance (71.4%; n=35) with a sex ratio of 2.49. The follow-up period was 3.2 months. Median survival was 6.67 months (CI 95% [1.33-10.4]) and the average survival time was 7.99 months (CI 95% [4.42-11.17]). Multivariate-adjusted analysis showed that stage IV was a predictive factor of mortality (HR = 2.79; CI95% [1.13-6.89], p = 0.025]). Conclusion: Esophageal cancer is a rare disease with poor prognosis. Prognostic factor is the tumor stage.


Assuntos
Neoplasias Esofágicas/patologia , Adulto , Camarões/epidemiologia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/epidemiologia , Feminino , Seguimentos , Hospitais Gerais , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Prognóstico , Taxa de Sobrevida , Fatores de Tempo
11.
J Surg Oncol ; 120(5): 831-846, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31373005

RESUMO

Cancers of the esophagus and stomach remain important causes of mortality worldwide, in large part because they are most often diagnosed at advanced stages. Thus, it is imperative that we identify and treat these cancers in earlier stages. Due to significant heterogeneity in incidence and risk factors for these cancers, it has been challenging to develop standardized screening recommendations. This review summarizes the current recommendations for screening populations at high risk of developing esophagogastric cancers.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias Esofágicas/diagnóstico , Predisposição Genética para Doença , Neoplasias Gástricas/diagnóstico , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/genética , Humanos , Prevalência , Fatores de Risco , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/genética
12.
Anticancer Res ; 39(8): 4441-4448, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366542

RESUMO

BACKGROUND/AIM: Oral mucositis (OM) is one of the frequent adverse events experienced by patients receiving chemotherapy. Most diagnoses of OM are based on complaints from patients. The aim of this study was to develop a tool to diagnose OM accurately. MATERIALS AND METHODS: A central review system (CRS) was created to allow judgment when the patient background is completely unknown. The primary endpoint was the rate of grade 2 or higher OM, and the secondary endpoint was the difference in grade between each institution's clinician judgement and that of the CRS. RESULTS: In total, 53 patients were registered from four institutions. CRS successfully detected grade 2 or higher OM in 16 (30.2%) of the 53 patients. The detection rate of all grades of OM was 41.5% (22 of 53 patients) by each institution's clinician judgement and 84.9% (45 of 53 patients) by CRS judgement (p<0.0001). CONCLUSION: OM during chemotherapy may be underestimated.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/epidemiologia , Estomatite/epidemiologia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Estudos de Coortes , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Estomatite/induzido quimicamente , Estomatite/patologia
13.
S Afr J Surg ; 57(2): 4-9, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31342677

RESUMO

BACKGROUND: There are limited prospective data sets on clinical characteristics, stage of presentation and treatment of patients with Oesophageal Squamous Cell Carcinoma (OSCC) in South Africa. This study aimed to assess the frequency and severity of clinical characteristics associated with late presentation of patients with OSCC presenting to a cancer referral centre in KwaZulu-Natal, South Africa. METHODS: A prospective consecutive series of patients presenting with confirmed OSCC treated at Greys Hospital in 2016/2017 were enrolled. Data collected included: age, gender, home language, referral centre, clinical and laboratory characteristics: dysphagia score, Eastern Cooperative Oncology Group (ECOG) performance status, body mass index (BMI), serum albumin, tumour pathology and treatment administered. RESULTS: One hundred patients were analysed. Ninety four percent spoke isiZulu. The mean age was 61 with a male to female ratio of 1.5:1 Ninety percent had palliative treatment as their overall assessment precluded curative treatment. Five patients underwent curative treatment. The age standardised incidence (ASR) was 25.2 per 100 000. The factors associated with late presentation and their frequency were: advanced dysphagia grade (

Assuntos
Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , África do Sul/epidemiologia
14.
S Afr J Surg ; 57(2): 10-15, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31342678

RESUMO

BACKGROUND: For most patients with oesophageal cancer worldwide, palliation of dysphagia is the goal which is most commonly achieved with self-expanding metal stents (SEMS). The aim of this study was to assess the profile and management of oesophageal cancer patients at Frere Hospital in the Eastern Cape, and compare this to a similar cohort from Groote Schuur Hospital (GSH) in the Western Cape Province. METHOD: This study is a retrospective comparative cohort which reviewed all patients diagnosed with oesophageal cancer by the Frere Hospital and GSH endoscopy units from January to December 2015. Independent prospective electronic databases for the two hospitals were merged for comparative analysis. RESULTS: During the study period, 346 and 108 patients were diagnosed with oesophageal cancer at Frere Hospital and GSH respectively. The rate of curative intended intervention was similarly low, with 3% of cases at Frere Hospital undergoing oesophagectomy or definitive radiotherapy as compared to 5% at GSH (p=0.48). In terms of palliation, significantly more patients received palliative oncological therapy at GSH as compared to Frere Hospital (21% vs 8%, p < 0.001). At Frere Hospital, 281 patients (81%) were treated primarily with serial dilatations. At GSH, 9 patients received a single dilatation, all as a bridge to radiotherapy or stenting. At Frere Hospital, 28 patients (8%) were stented, as compared to GHS where 69 patients (64%) were managed with a stent (p < 0.001). CONCLUSION: This study shows significant differences in the oncological and endoscopic palliation of patients between the two institutions, highlighting a gross disparity in healthcare provision between them. The reasons for these disparities should be investigated and equipoise addressed by national health policy makers.


Assuntos
Neoplasias Esofágicas/terapia , Cuidados Paliativos , Idoso , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/terapia , Neoplasias Esofágicas/epidemiologia , Esofagoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , África do Sul/epidemiologia , Stents
15.
S Afr J Surg ; 57(2): 16-19, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31342679

RESUMO

BACKGROUND: The frequency of the occurrence and type of oesophageal cancer from pathology laboratory data from the private and public sector has never been compared in KwaZulu-Natal (KZN). This study aims to compare data from the public and private pathology services in the province. METHOD: All the malignant and pre-malignant oesophageal biopsies at the academic department of histopathology and at three private laboratories in the KZN were retrieved for comparison. RESULTS: Between January 2012 and December 2014, there were a total of 1087 new diagnoses of an oesophageal malignancy or pre-malignant diagnosis. There were 613 specimens from the private laboratories in KZN and 474 from IALCH. The sex distribution was (41%) females and (59%) males. In the private sector, the mean age was 61.6 years and in the public sector it was 62.7 years. (Range 18-75 years) Africans comprised 63% of the total, Whites 28% and Indians 7%. In the public sector 89.5 % of patients were African whereas in the private sector, Africans comprised 45.7% and Whites made up 46% of the total. Eighty-eight per cent of biopsy specimens were malignant lesions of which 68% were squamous carcinoma. Squamous carcinomas accounted for 87.5% and 54% of all lesions in the public and private sectors respectively. Pre-malignant lesions accounted for 5% and 23% of diagnoses in the public and private sectors respectively. Pre-malignant lesions in the public sector showed mainly dysplastic squamous cell dysplasia whereas dysplastic Barrett's oesophagus lesions accounted for the majority in the private sector. CONCLUSION: Oesophageal cancer is a major public health problem in KZN. Although squamous carcinoma predominates, adenocarcinoma is a significant problem in the White population. It would appear that surveillance for oesophageal adenocarcinoma is taking place in the private sector albeit in a non-systematic or coordinated fashion. This does not appear to be the case in the state sector.


Assuntos
Neoplasias Esofágicas/epidemiologia , Setor Privado , Setor Público , Adulto , Idoso , Biópsia , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , África do Sul/epidemiologia
16.
BMC Cancer ; 19(1): 682, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299920

RESUMO

BACKGROUND: Oesophagectomy remains the only curative intervention for oesophageal cancer, with defined nutritional and health-related quality of life (HR-QOL) consequences. It follows therefore that there is a significant risk of decline in physical wellbeing with oesophagectomy however this has been inadequately quantified. This study prospectively examines change in physical functioning and habitual physical activity participation, from pre-surgery through 6-months post-oesophagectomy. METHODS: Patients scheduled for oesophagectomy with curative intent were recruited. Key domains of physical functioning including exercise tolerance (six-minute walk test (6MWT)) and muscle strength (hand-grip strength), and habitual physical activity participation, including sedentary behaviour (accelerometry) were measured pre-surgery (T0) and repeated at 1-month (T1) and 6-months (T2) post-surgery. HR-QOL was measured using the EORTC-QOL C30. RESULTS: Thirty-six participants were studied (mean age 62.4 (8.8) years, n = 26 male, n = 26 transthoracic oesophagectomy). Mean 6MWT distance decreased significantly from T0 to T1 (p = 0.006) and returned to T0 levels between T1 and T2 (p < 0.001). Percentage time spent sedentary increased throughout recovery (p < 0.001) and remained significantly higher at T2 in comparison to T0 (p = 0.003). In contrast, percentage time spent engaged in either light or moderate-to-vigorous intensity activity, all reduced significantly (p < 0.001 for both) and remained significantly lower at T2 in comparison to T0 (p = 0.009 and p = 0.01 respectively). Patients reported deficits in multiple domains of HR-QOL during recovery including global health status (p = 0.04), physical functioning (p < 0.001) and role functioning (p < 0.001). Role functioning remained a clinically important 33-points lower than pre-operative values at T2. CONCLUSION: Habitual physical activity participation remains significantly impaired at 6-months post-oesophagectomy. Physical activity is a measurable and modifiable target for physical rehabilitation, which is closely aligned with patient-reported deficits in role functioning. Rehabilitation aimed at optimising physical health in oesophageal cancer survivorship is warranted.


Assuntos
Neoplasias Esofágicas/epidemiologia , Esofagectomia/efeitos adversos , Exercício , Nível de Saúde , Adulto , Idoso , Sobreviventes de Câncer , Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Vigilância em Saúde Pública , Qualidade de Vida , Fatores de Risco
17.
World J Gastroenterol ; 25(24): 3069-3078, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31293342

RESUMO

BACKGROUND: Esophageal adenocarcinoma (EAC) and high-grade dysplasia (HGD) may appear in young patients with Barrett's esophagus (BE). However, characteristics of Barrett's-related neoplasia in this younger population remain unknown. AIM: To identify clinical characteristics that differ between young and old patients with early-stage Barrett's-related neoplasia. METHODS: We conducted a retrospective analysis of a prospectively maintained database comprised of consecutive patients with early-stage EAC (pT1) and HGD at a tertiary-referral center between 2001 and 2017. Baseline characteristics, drug and risk factor exposures, clinicopathological staging of EAC/HGD and treatment outcomes [complete eradication of neoplasia (CE-N), complete eradication of intestinal metaplasia (CE-IM), recurrence of neoplasia and recurrence of intestinal metaplasia] were retrieved. Multivariate analyses were performed to identify factors that differed significantly between older and younger (≤ 50 years) patients. RESULTS: We identified 450 patients with T1 EAC and HGD (74% and 26%, respectively); 45 (10%) were ≤ 50 years. Compared to the older group, young patients were more likely to present with ongoing gastroesophageal reflux disease (GERD) symptoms (55% vs 38%, P = 0.04) and to be obese (body mass index > 30, 48% vs 32%, P = 0.04). Multivariate logistic regression analysis showed that young patients were significantly more likely to have ongoing GERD symptoms [odds ratio (OR) 2.00, 95% confidence interval (CI) 1.04-3.85, P = 0.04] and to be obese (OR 2.06, 95%CI 1.07-3.98, P = 0.03) whereas the young group was less likely to have a smoking history (OR 0.39, 95%CI 0.20-0.75, P < 0.01) compared to the old group. However, there were no significant differences regarding tumor histology, CE-N, CE-IM, recurrence of neoplasia and recurrence of intestinal metaplasia (mean follow-up, 44.3 mo). CONCLUSION: While guidelines recommend BE screening in patients > 50 years of age, younger patients should be considered for screening endoscopy if they suffer from obesity and GERD symptoms.


Assuntos
Adenocarcinoma/epidemiologia , Esôfago de Barrett/diagnóstico por imagem , Neoplasias Esofágicas/epidemiologia , Esôfago/patologia , Lesões Pré-Cancerosas/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma/prevenção & controle , Fatores Etários , Esôfago de Barrett/epidemiologia , Esôfago de Barrett/patologia , Comorbidade , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/normas , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/prevenção & controle , Esofagoscopia/normas , Esôfago/diagnóstico por imagem , Feminino , Seguimentos , Refluxo Gastroesofágico/epidemiologia , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Obesidade/epidemiologia , Guias de Prática Clínica como Assunto , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/patologia , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco
18.
Chemosphere ; 235: 288-296, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31260869

RESUMO

The Huai'an area in Jiangsu Province of East China is an endemic region of esophageal cancer (EC). The regional heterogeneity of EC suggests that the levels of potential carcinogens might vary throughout the environment. It has been suggested that the most likely carcinogens related to EC are a group known as the N-nitrosamines. In this study, we measured the concentrations of nine nitrosamines in drinking water and human urine in two areas in China, one with a high incidence of EC (Huai'an) and one with a low incidence (Nanjing). Among the nine target analytes, N-nitrosodi-n-propylamine (NDPA), N-nitrosodibutylamine (NDBA), N-nitrosopyrrolidine (NPyr), N-nitrosodiethylamine (NDEA) and N-nitrosomorpholine (NMor) occurred at higher concentrations in drinking water in the high incidence area. Inhabitants from the high incidence area also had urinary excretions with significantly higher concentrations of NDEA, NDBA, N-nitrosopiperidine (NPip) and N-nitrosodiphenylamine (NDPhA). These findings indicated that people in the high EC incidence area were exposed to higher levels of nitrosamines. However, the association between the incidence of EC and nitrosamines exposure will need to be evaluated in more detail.


Assuntos
Carcinógenos/análise , Água Potável/química , Neoplasias Esofágicas/epidemiologia , Nitrosaminas/análise , China , Neoplasias Esofágicas/induzido quimicamente , Neoplasias Esofágicas/etiologia , Humanos , Incidência , Nitrosaminas/urina
19.
Oncology ; 97(3): 149-154, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31195394

RESUMO

BACKGROUND AND OBJECTIVE: Esophagectomy, which is one of the most invasive operations among gastrointestinal surgeries, deteriorates the physical condition of patients. Such deterioration may be severe in elderly patients and advanced age may negatively affect long-term survival. However, elderly patients are more likely to die from cancer-unrelated causes than younger patients. Therefore, when comparing the survival of elderly patients after cancer surgery with that of younger patients, it is necessary to control the influence of cancer-unrelated death. To address this problem, we calculated the relative survival and applied the excess hazard model to control the influence of competing risk of death from cancer. METHODS: We retrospectively analyzed 505 patients with thoracic esophageal cancer who underwent transthoracic esophagectomy. Prognostic information was followed up to 10 years after surgery or until death in all patients. Prognostic information of patients lost to follow-up was retrieved from the Osaka Cancer Registry's database. First, we identified prognostic variables as confounders of age by univariate and multivariate analysis. Then, we estimated age effects using the excess hazard model including the prognostic variables as confounders. RESULTS: Univariate and multivariate analysis showed that clinical stage, residual tumor, and postoperative complications (p < 0.1) were confounders of age. Multivariate excess hazard model revealed that age was not a significant prognostic factor at any cutoff point. However, the excess hazard ratio of death tended to increase continuously in patients aged 70 years or older. CONCLUSIONS: When clinicians offer esophagectomy for esophageal cancer, age per se should not be a limiting factor. Strict evaluation of patients should be performed before surgery, especially in the elderly.


Assuntos
Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/cirurgia , Esofagectomia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/epidemiologia , Esofagectomia/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Sistema de Registros , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
20.
J Clin Pathol ; 72(12): 825-829, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31235543

RESUMO

AIMS: Aim was to assess the feasibility of serum markers to identify individuals at risk for gastro-oesophageal adenocarcinoma to reduce the number of individuals requiring invasive assessment by endoscopy. METHODS: Blood samples from 56 patients with Barrett's oesophagus and 202 non-Barrett controls who previously took part in a trial assessing the accuracy of the Cytosponge for Barrett's oesophagus were assessed for serum pepsinogen (PG) 1 and 2, gastrin-17, trefoil factor 3 (TFF3) and Helicobacter pylori infection. RESULTS: PG1 was pathological (<50 ng/mL) in 26 patients (10.1%), none of whom had Barrett's oesophagus (p<0.001). Smoking and drinking had no influence on these results. Pathological PG1 was associated with stomach pain (p=0.029), disruption of sleep (p=0.027) and disruption of diet by symptoms (p=0.019). Serum TFF3 was not associated with any clinical parameter. CONCLUSIONS: Assessment of serum PG1 could be combined with a test for Barrett's oesophagus to identify additional patients requiring endoscopy.


Assuntos
Adenocarcinoma/sangue , Esôfago de Barrett/sangue , Biomarcadores Tumorais/sangue , Detecção Precoce de Câncer/métodos , Neoplasias Esofágicas/sangue , Testes Sorológicos , Manejo de Espécimes , Neoplasias Gástricas/sangue , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Esôfago de Barrett/epidemiologia , Esôfago de Barrett/patologia , Estudos de Casos e Controles , Detecção Precoce de Câncer/instrumentação , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/patologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pepsinogênio A/sangue , Pepsinogênio C/sangue , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Manejo de Espécimes/instrumentação , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/patologia , Fator Trefoil-3/análise , Adulto Jovem
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