Household air pollution and risk of esophageal cancer: a case-control study in Western Kenya

家庭空气污染与食道癌风险：肯尼亚西部的病例对照研究

• 批准号: MR/S009051/1
• 负责人: Daniel Peter Pope
• 金额: $ 48.84万
• 依托单位: University of Liverpool
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FS009051%2F1
• 关键词: Household; air; pollution; risk; esophageal

Esophageal cancer is the third most common cancer and cause of cancer death in both men and women in Kenya, with 3000+ newly diagnosed patients in 2012. This pattern is common to other East African countries and West Kenya appears to have extremely high rates of the disease. This status contrasts to much of West Africa where the cancer is extremely rare, i.e. 40 times lower. Sadly, the majority of these patients pass away within 6 months of their diagnosis, few being able to afford the limited treatment options. Additionally, up to 15% of patients are very young, in their 20s and 30s. Despite researchers having known about this unusual disease pattern since the 1950s, the risk factors for the disease had hardly been studied prior to 2014. Consequently, there are no targeted strategies to prevent the disease, and no prediction models to identify who might be at high risk of the disease, people whom may benefit from early detection.In 2014, we - i.e. the Kenya PI Dr Diana Menya of Moi University, Eldoret - commenced the first comprehensive study of lifestyle, environmental and genetic factors for esophageal cancer in Kenya. The study was conducted at the Moi Teaching and Referral Hospital, Eldoret, which serves a catchment population stretching to the Ugandan border. In the study, patients newly diagnosed with esophageal cancer were compared to hospital patients and hospital visitors who did not have the disease. The study blood and tumour samples were also collected for genetic analyses. Results from the study have shown that alcohol and tobacco contribute to the disease in older men, but not in women or in young patients, a knowledge gap which the present study hopes to fill through a UK-Kenya collaboration between Dr Menya and Dr Daniel Pope, a household air pollution expert from the University of Liverpool. This study hypothesizes that household air pollution, from using biomass for cooking in poorly ventilated kitchens, is a large contributor to esophageal cancer in the young and in women, through traditional domestic roles associated with cooking. Household air pollution from biomass and coal use is already an established lung carcinogen, but few studies have examined its influence on esophageal cancer. However, work in an Iranian area of high esophageal cancer rates has shown that chemical compounds formed after combustion of biomass fuels are implicated in esophageal cancer risk in that setting. In this UK-Kenya collaboration, we propose to continue the core study as previously successfully implemented, and add to it an in-depth component on household air pollution as measured in kitchens and for personal exposures during household visits to a subset of female and younger (< 40 years) participants who live within reach of the referral hospital. A detailed analysis of oesophageal cancer risk with household air pollution will be provided and finally, considering a range of lifestyle and environmental risk factors, a comprehensive report on the strategies needed for primary prevention esophageal cancer in Kenya will be developed. Rates of this disease have declined in many areas of the world - Kenya should be able to follow this trend.

食管癌是肯尼亚男性和女性第三大常见癌症和癌症死亡原因，2012年有3000多名新诊断患者。这种模式在其他东非国家也很常见，而西肯尼亚似乎有极高的发病率。这一状况与西非大部分地区形成鲜明对比，在那里癌症极为罕见，即发病率低40倍。可悲的是，这些患者中的大多数在诊断后6个月内去世，很少有人能够负担得起有限的治疗选择。此外，高达15%的患者非常年轻，20多岁和30多岁。尽管自20世纪50年代以来，研究人员就已经知道了这种不寻常的疾病模式，但在2014年之前，几乎没有人研究过这种疾病的风险因素。因此，没有针对性的战略来预防这种疾病，也没有预测模型来确定谁可能处于这种疾病的高风险中，谁可能从早期发现中受益。2014年，我们——即埃尔多雷特莫伊大学的肯尼亚PI Diana Menya博士——开始了肯尼亚生活方式、环境和遗传因素对食管癌的第一次全面研究。这项研究是在埃尔多雷特的Moi教学和转诊医院进行的，该医院的服务范围一直延伸到乌干达边境。在这项研究中，研究人员将新诊断出食管癌的患者与没有患食管癌的住院患者和医院访客进行了比较。研究人员还收集了血液和肿瘤样本进行基因分析。研究结果表明，酒精和烟草会导致老年男性患上这种疾病，但对女性或年轻患者没有影响。目前的研究希望通过Menya博士和利物浦大学家庭空气污染专家Daniel Pope博士在英国和肯尼亚的合作来填补这一知识空白。该研究假设，由于在通风不良的厨房中使用生物质烹饪，家庭空气污染是导致年轻人和女性食道癌的一个重要因素，因为传统的家庭角色与烹饪有关。来自生物质和煤炭使用的家庭空气污染已经是一种确定的肺癌物质，但很少有研究调查它对食道癌的影响。然而，在伊朗食道癌高发地区开展的研究表明，生物质燃料燃烧后形成的化合物与该地区食道癌风险有关。在这次英国-肯尼亚合作中，我们建议继续进行先前成功实施的核心研究，并在其基础上增加一个关于家庭空气污染的深入组成部分，如在厨房测量和对居住在转诊医院范围内的一小部分女性和年轻（< 40岁）参与者进行家访期间的个人暴露情况。将提供与家庭空气污染有关的食管癌风险的详细分析，最后，考虑到一系列生活方式和环境风险因素，将编写一份关于肯尼亚初级预防食管癌所需战略的综合报告。这种疾病的发病率在世界许多地区已经下降——肯尼亚应该能够跟上这一趋势。

项目成果

COVID-19 impacts on household energy & food security in a Kenyan informal settlement: The need for integrated approaches to the SDGs.

• DOI: 10.1016/j.rser.2021.111018
• 发表时间: 2021-07
• 期刊: Renewable & sustainable energy reviews
• 影响因子: 15.9
• 作者: Shupler M;Mwitari J;Gohole A;Anderson de Cuevas R;Puzzolo E;Čukić I;Nix E;Pope D
• 通讯作者: Pope D

Pay-as-you-go liquefied petroleum gas supports sustainable clean cooking in Kenyan informal urban settlement during COVID-19 lockdown.

• DOI: 10.1016/j.apenergy.2021.116769
• 发表时间: 2021-06-15
• 期刊: Applied energy
• 影响因子: 11.2
• 作者: Shupler M;O'Keefe M;Puzzolo E;Nix E;Anderson de Cuevas R;Mwitari J;Gohole A;Sang E;Čukić I;Menya D;Pope D
• 通讯作者: Pope D

COVID-19 Lockdown in a Kenyan Informal Settlement: Impacts on Household Energy and Food Security

肯尼亚非正式住区的 COVID-19 封锁：对家庭能源和粮食安全的影响

• DOI: 10.1101/2020.05.27.20115113
• 发表时间: 2020
• 作者: Shupler M

Towards Sustainable Development Goal 7 "Universal Access to Clean Modern Energy": National Strategy in Rwanda to Scale Clean Cooking with Bottled Gas

实现可持续发展目标 7“普遍获得清洁现代能源”：卢旺达扩大瓶装燃气清洁烹饪的国家战略

• DOI: 10.3390/en14154582
• 发表时间: 2021
• 期刊: Energies
• 影响因子: 3.2
• 作者: Cukic I