Esophageal cancer in West Kenya

 描述（由申请人提供）：食道癌是东非部分地区最常诊断的癌症之一，但这种癌症在西非极为罕见。肯尼亚西部是非洲大裂谷的一个高海拔地区，是东非的流行区之一。通常情况下，患者在很晚的阶段被诊断出来，大多数人在几个月内死亡。没有进行大规模的研究来系统地调查这种癌症的潜在原因。在成功进行的试点病例对照研究的基础上，将食管癌患者与非癌症患者进行比较，我们建议继续并扩大这项研究，以调查该疾病的潜在危险因素。风险因素是通过与参与者的访谈获得的，包括关于酒精、烟草、接触室内污染和饮用热饮的信息。我们还旨在研究一种新的假设，即饮食中某些矿物质的缺乏可能导致该地区的这种疾病。东非食管癌带与非洲裂谷同处一处，表明饮食不足可能发挥作用，因为饮食是当地来源和谷物/植物为基础的。食管癌患者的饮食缺乏很难评估，因为患者在诊断时通常体重减轻，因此尿液和血液中维生素和矿物质的水平受到疾病的影响。由于家庭成员通常有非常相似的饮食，我们将评估这样的家庭成员的营养水平是否可以用来近似患者患病前的正常营养水平。正在研究的因素都是可以改变的，因此，如果发现这些因素是肯尼亚西部食管癌的原因，可以采取干预措施，消除对致癌物的接触（例如，建议饮酒，特别是烈性酒），或通过强化肥料。

 DESCRIPTION (provided by applicant): Cancer of the esophagus is one of the most frequently diagnosed cancers in parts of East Africa, yet this cancer is extremely rare in West Africa. West Kenya, a region at altitude in Africa's Rift Valley, is one of East Africa's endemic areas. Typically patients are diagnosed at very late stages, and most die within months. No large-scale studies have been conducted to systematically investigate the potential causes of this cancer. Building on a successfully conducted pilot case-control study in which esophageal cancer patients are compared to non-cancer patients, we propose to continue and expand this study to investigate potential risk factors for the disease. Risk factors are obtained through interviews with participants, and include information on alcohol, tobacco, exposures to indoor pollution and hot beverage drinking. We also aim to investigate a novel hypothesis that deficiencies of some minerals in the diet may contribute to this disease in this area. The co-location of the East African esophageal cancer belt with the African rift valley suggest the dietary deficiencies may play a role as the diet is locally-source and cereal/plant based. Dietary deficiencies are difficult to evaluate in esophageal cancer patients, as patients have typically lost considerable weight by the time of diagnosis so urine and blood levels of vitamins and minerals are affected by their disease. As household members often have very similar diets, we will evaluate whether nutrient levels in such a household member can be used to approximate the patient's levels usual nutrient levels before they were ill. The factors being studied are all modifiable, thus if they are found to be causes of esophageal cancer in West Kenya, interventions could be implemented to remove exposures to carcinogens (e.g. advice on alcohol intake, particularly stronger spirits), or through fortification of fertilizers.