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J Cancer. 2019 Jun 2;10(14):3284-3290. doi: 10.7150/jca.29979. eCollection 2019.

Risk Factors Associated with Precancerous Lesions of Esophageal Squamous Cell Carcinoma: a Screening Study in a High Risk Chinese Population.

Author information

1
Department of Science and Education, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China.
2
Department of Oncology, School of Medicine, Shandong University, Jinan, Shandong, China.
3
Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China.
4
Outpatient Department, Shandong Hospital of Traditional Chinese Medicine, Jinan, Shandong, China.
5
Cancer Screening Center, Feicheng Hospital, Jinan, Shandong, China.
6
Department of Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China.

Abstract

Background: Esophageal squamous cell carcinoma (ESCC) has been having a high mortality rate in China. Most patients are diagnosed in advanced stages, leading to the poor prognosis and low 5-year survival rate. Detection of precancerous lesions or early cancers is the key to improving this situation. Although previous studies have identified some risk factors for ESCC, they rarely paid attention to the premalignant esophageal lesions. We thus initiated a population-based screening study aiming to assess risk factors associated with esophageal precancerous lesions (EPLs) in a high risk Chinese population. Methods: From September 2013 to July 2015, we screened residents aged 40-69 years from 53 randomly selected communities in Feicheng, China (n = 5076). Each participant went through questionnaire interview, physical examination, endoscopy and biopsy. Using logistic regression, we compared participants with EPLs to that with normal esophageal mucosa for finding potential risk factors of EPLs. Results: A total of 570 participants were diagnosed with EPLs. We observed no association between EPLs and tobacco smoking or alcohol consumption in unadjusted or adjusted model. In the adjusted model, the OR (95% CI) was 1.84 (1.18-2.89) for people of drinking shallow-well water comparing to people who was drinking tap-water. In a comparison of participants with good oral health, the ESD/ESCC ORs (95% CI) for those with very poor or poor oral health, were 1.78 (1.28-2.49) and 1.58 (1.16-2.15) respectively. However, no statistical significance was observed after adjustment. Moreover, cereal straw heating (OR= 1.74, 95% CI: 0.90-3.36, P=0.099) may lead to increased risk of EPLs. Conclusion: In Feicheng population, tobacco smoking or alcohol consumption may not be risk factors of EPLs. Low-quality drinking water raised the EPLs risk. Bad house heating materials, such as cereal straw, may lead to high EPLs risk.

KEYWORDS:

drinking water; esophageal precancerous lesions; esophageal squamous dysplasia; house heating method; oral health; population-based

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

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