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      Prevalence and risk factors for esophageal squamous cell cancer and precursor lesions in Anyang, China: a population-based endoscopic survey

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          Abstract

          Background:

          The etiology of esophageal squamous cell cancer (ESCC) in high prevalence regions of China remains unclear.

          Methods:

          Endoscopic biopsies were conducted among 7381 inhabitants aged from 25 to 65 of Anyang, China.

          Results:

          In this study, 2.57, 0.20 and 0.16% of the participants had mild, moderate and severe squamous dysplasia, respectively; 0.19 and 0.08% showed squamous carcinoma in situ and invasive ESCC. Using deep well (depth >100 meters) as water source (odds ratio=0.72, 95% confidence interval: 0.54–0.96) was negatively associated with ESCC and its precursors, whereas tobacco and alcohol use were not significantly associated with ESCC.

          Conclusions:

          Water source and other factors in this region need further evaluation by longitudinal studies.

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          Most cited references19

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          Prospective study of risk factors for esophageal and gastric cancers in the Linxian general population trial cohort in China.

          Gina D Tran, Xiu-Di Sun, Christian C Abnet … (2005)
          Esophageal cancer incidence and mortality rates in Linxian, China are among the highest in the world. We examined risk factors for esophageal squamous cell carcinoma (ESCC), gastric cardia cancer (GCC), and gastric noncardia cancer (GNCC) in a population-based, prospective study of 29,584 adults who participated in the Linxian General Population Trial. All study participants completed a baseline questionnaire that included questions on demographic characteristics, personal and family history of disease, and lifestyle factors. After 15 years of follow-up, a total of 3,410 incident upper gastrointestinal cancers were identified, including 1,958 ESCC, 1,089 GCC and 363 GNCC. Cox proportional hazard models were used to estimate risks. Increased age and a positive family history of esophageal cancer (including ESCC or GCC) were significantly associated with risk at all 3 cancer sites. Additional risk factors for ESCC included being born in Linxian, increased height, cigarette smoking and pipe smoking; for GCC, male gender, consumption of moldy breads and pipe smoking; and for GNCC, male gender and cigarette smoking. Protective factors for ESCC included formal education, water piped into the home, increased consumption of meat, eggs and fresh fruits and increased BMI; for GCC, formal education, water piped into the home, increased consumption of eggs and fresh fruits and alcohol consumption; and for GNCC, increased weight and BMI. General socioeconomic status (SES) is a common denominator in many of these factors and improving SES is a promising approach for reducing the tremendous burden of upper gastrointestinal cancers in Linxian.
          Article 0 comments Cited 240 times – based on 0 reviews     Review now
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            Histological precursors of oesophageal squamous cell carcinoma: results from a 13 year prospective follow up study in a high risk population.

            Y Qiao, Guirong Wang, Xiao Sun … (2005)
            Oesophageal squamous cell carcinoma (OSCC) has a very poor prognosis, which is largely due to late diagnosis. Successful early detection strategies will require identification of clinically relevant precursor lesions that can be targets for screening and treatment. To identify the clinically relevant histological precursors of OSCC. A cohort of 682 endoscoped patients from a high risk rural population in Linxian, China. Subjects were endoscoped and biopsied at baseline and followed for 13.5 years. We estimated the relative risk of developing OSCC for each of the initial histological diagnoses using Cox proportional hazards regression models. A total of 114 (16.7%) patients developed OSCC during the follow up period. After adjusting for potential confounding factors, relative risks (95% confidence intervals) for incidence of this tumour, by initial histological diagnosis, were: normal 1.0 (reference), oesophagitis 0.8 (0.2-3.2), basal cell hyperplasia 1.9 (0.8-4.5), mild dysplasia 2.9 (1.6-5.2), moderate dysplasia 9.8 (5.3-18.3), severe dysplasia 28.3 (15.3-52.3), and carcinoma in situ 34.4 (16.6-71.4). In this study, squamous dysplasia and carcinoma in situ were the only histological lesions associated with a significantly increased risk of developing OSCC within 13.5 years after endoscopy. There was no evidence that oesophagitis predisposed to this tumour. Increasing grades of dysplasia were strongly associated with increasing risk, indicating that the histological grading was clinically meaningful. The follow up experience of severe dysplasia and carcinoma in situ was equivalent, suggesting that this distinction is not clinically relevant. Documenting these precursor lesions of OSCC should assist in the development of effective prevention, early detection, and treatment strategies for this disease.
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              A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes.

              Traci Mouw, Amy Subar, Andrew Freedman … (2007)
              Rates of esophageal adenocarcinoma and gastric cardia adenocarcinoma have increased, while rates of esophageal squamous cell carcinoma (ESCC) and gastric noncardia adenocarcinoma have decreased, suggesting distinct etiologies. The authors prospectively investigated the associations of alcohol and tobacco with these cancers in 474,606 US participants using Cox models adjusted for potential confounders. Between 1995/1996 and 2000, 97 incident cases of ESCC, 205 of esophageal adenocarcinoma, 188 of gastric cardia, and 187 of gastric noncardia cancer occurred. Compared with nonsmokers, current smokers were at increased risk for ESCC (hazard ratio (HR) = 9.27, 95% confidence interval (CI): 4.04, 21.29), esophageal adenocarcinoma (HR = 3.70, 95% CI: 2.20, 6.22), gastric cardia (HR = 2.86, 95% CI: 1.73, 4.70), and gastric noncardia (HR = 2.04, 95% CI: 1.32, 3.16). Assuming causality, ever smoking had population attributable risks of 77% (95% CI: 0.55, 0.89) for ESCC, 58% (95% CI: 0.38, 0.72) for esophageal adenocarcinoma, 47% (95% CI: 0.27, 0.63) for gastric cardia, and 19% (95% CI: 0.00, 0.37) for gastric noncardia. For drinkers of more than three alcoholic beverages per day, compared with those whose intake was up to one drink per day, the authors found significant associations between alcohol intake and ESCC risk (HR = 4.93, 95% CI: 2.69, 9.03) but not risk for esophageal, gastric cardia, or gastric noncardia adenocarcinoma.
              Article 0 comments Cited 107 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Br J Cancer
                Title: British Journal of Cancer
                Publisher: Nature Publishing Group
                ISSN (Print): 0007-0920
                ISSN (Electronic): 1532-1827
                Publication date (Print): 28 September 2010
                Publication date (Electronic): 10 August 2010
                Volume: 103
                Issue: 7
                Pages: 1085-1088
                Affiliations
                [1 ]simpleKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Laboratory of Genetics, Peking University School of Oncology, Beijing Cancer Hospital & Institute , 52 Fucheng Rd. Hai Dian District, 100142 Beijing, People's Republic of China
                [2 ]simpleAnyang Cancer Hospital , Henan Province, People's Republic of China
                Author notes
                [3]

                These authors contributed equally to this work.

                Article
                Publisher Item ID: 6605843
                DOI: 10.1038/sj.bjc.6605843
                PMC ID: 2965859
                PubMed ID: 20700119
                SO-VID: 7c9f980c-726f-417d-ad99-7d2408212e64
                Copyright © Copyright © 2010 Cancer Research UK
                History
                Date revision received : 06 July 2010
                Date accepted : 15 July 2010
                Categories
                Subject: Short Communication

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: prevalence,risk factor,esophageal cancer,china,precursor lesion
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: prevalence, risk factor, esophageal cancer, china, precursor lesion

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