Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case-control studies.
Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case-control studies.
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DOI：
10.1002/ijc.33688
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发表时间：
2021-09-15
影响因子：
6.4
通讯作者：
ESCCAPE team
中科院分区：
文献类型：
--
作者：
Narh CT;Dzamalala CP;Mmbaga BT;Menya D;Mlombe Y;Finch P;Nyakunga G;Schüz J;McCormack V;ESCCAPE team
食土癖是一种有意吃掉土壤的行为，在非洲食道癌走廊中普遍存在，尤其是在怀孕期间。我们调查了这种做法是否与该地区地方性食管鳞状细胞癌（ESCC）有关。我们在坦桑尼亚、马拉维和肯尼亚进行了 ESCC 病例对照研究。病例是经组织学/临床证实患有食管鳞癌的患者，对照是没有消化系统疾病的住院患者/访客。参与者被问及是否曾经吃过土壤（从不/经常/仅在怀孕期间）。比值比 (OR) 根据性别、年龄、烟草、酒精、国家、宗教和婚姻状况进行调整。总体而言，934 例病例（马拉维 535 例、坦桑尼亚 304 例和肯尼亚女性 95 例）和 995 例对照提供了食地信息。在对照组中，经常性食石行为在女性中很常见（马拉维 49%、肯尼亚 43% 和坦桑尼亚 29%），但在男性中并不常见（马拉维 10%，坦桑尼亚 <1%）。在女性中，经常吃食与从未食食的 ESCC OR 分别为 1.25 (95% CI: 0.70, 2.22)，仅怀孕与从未吃食的食管鳞癌 OR 分别为 0.88 (95% CI: 0.64, 1.22)。基于病例与医院访客对照的比较，研究结果更为有力，而使用医院患者作为对照时，结果无效。总之，食地癖太罕见，不会增加非洲男性食管鳞癌的负担。在女性中，这种做法很常见，但我们没有发现与食管鳞癌有关的一致证据。该研究不能排除选择偏差掩盖了适度的影响。食土癖的身体影响似乎对食管鳞癌的整体风险没有很大影响。需要对基于成分的食地暴露评估进行改进的研究。
Geophagia, the intentional practice of consuming soil, occurs across the African esophageal cancer corridor, particularly during pregnancy. We investigated whether this practice is linked to endemic esophageal squamous cell carcinoma (ESCC) in this region. We conducted ESCC case‐control studies in Tanzania, Malawi and Kenya. Cases were patients with incident histologically/clinically confirmed ESCC and controls were hospital patients/visitors without digestive diseases. Participants were asked if they had ever eaten soil (never/regularly/pregnancy‐only). Odds ratios (OR) are adjusted for sex, age, tobacco, alcohol, country, religion and marital status. Overall, 934 cases (Malawi 535, Tanzania 304 and Kenya females 95) and 995 controls provided geophagia information. Among controls, ever‐geophagia was common in women (Malawi 49%, Kenya 43% and Tanzania 29%) but not in men (10% Malawi, <1% Tanzania). In women, ESCC ORs were 1.25 (95% CI: 0.70, 2.22) for regular versus never geophagia and 0.88 (95% CI: 0.64, 1.22) for pregnancy‐only versus never. Findings were stronger based on comparisons of cases with hospital visitor controls and were null using hospital patients as controls. In conclusion, geophagia is too rare to contribute to the male ESCC burden in Africa. In women, the practice is common but we did not find consistent evidence of a link to ESCC. The study cannot rule out selection bias masking modest effects. Physical effects of geophagia do not appear to have a large impact on overall ESCC risk. Research with improved constituent‐based geophagia exposure assessment is needed.
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影响因子：
6.4
作者：
Middleton, Daniel R. S.;Menya, Diana;McCormack, Valerie
通讯作者：
McCormack, Valerie
DOI：
10.4269/ajtmh.2009.80.36
发表时间：
2009-01-01
影响因子：
3.3
作者：
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影响因子：
2.3
作者：
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影响因子：
24.5
作者：
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通讯作者：
MCGLASHAN, ND
影响因子：
4.2
作者：
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通讯作者：
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