Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case-control study
Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case-control study
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DOI：
10.1002/ijc.32032
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发表时间：
2019-06-01
影响因子：
6.4
通讯作者：
McCormack, Valerie
中科院分区：
文献类型：
--
作者：
Middleton, Daniel R. S.;Menya, Diana;McCormack, Valerie
食道鳞状细胞癌(ESCC)在肯尼亚和东非大部分地区的发病率非常高，预后极差，病因知之甚少。在其他环境中，饮用热饮料可能是人类的致癌物质，与ESCC风险增加有关，在肯尼亚是习惯性做法。2013年8月至2018年3月，我们在肯尼亚西部的埃尔多雷特进行了一项病例对照研究。这些病例是经内窥镜确诊的食道癌患者，其组织学检查不排除食管鳞癌。年龄和性别匹配的对照是医院访客和医院出院和住院患者，不包括消化系统疾病的患者。使用调整了潜在混杂因素的Logistic回归模型，估计了自我报告的饮酒温度、消费频率、灼口频率和热粥消费的优势比(OR)和95%可信区间(CI)。同时还研究了饮酒温度与肿瘤部位的关系。这项研究包括430例患者和440名对照。饮用热饮和热饮(>；95%茶)的人患ESCC的风险分别是热饮的3.7倍(95%可信区间：2.1-6.5)和1.4倍(1.0-2.0)。这一趋势在男性、女性、从不喝酒/吸烟的人中是一致的，而且50岁以上的人比50岁以下的人更强烈。肿瘤的亚位置分布(上/中/下食道)没有报告的饮酒温度不同。我们的研究是迄今为止在这一背景下观察东非热饮料消费与ESCC之间联系的第一次全面调查。这些发现为这种潜在的可改变的危险因素在ESCC病因中的作用提供了进一步的证据。有什么新的？食道鳞状细胞癌(ESCC)在肯尼亚和东非大部分地区的发病率非常高，预后极差，病因知之甚少。在其他环境中，饮用热饮料--一种可能的致癌物质--与ESCC风险的增加有关。在这项首次全面的病例对照研究中，作者调查了热饮料在肯尼亚和东非食道癌中的作用，作者发现，饮用非常热和热饮料的总体风险分别是温热饮料的3.7倍和1.4倍。这些发现将通过解决这一潜在的可改变的风险因素，有助于当地和全球的预防工作。
Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Consumption of hot beveragesa probable carcinogen to humansis associated with increased ESCC risk in other settings and is habitually practiced in Kenya. We conducted a case-control study in Eldoret, western Kenya between August 2013 and March 2018. Cases were patients with endoscopically confirmed oesophageal cancer whose histology did not rule out ESCC. Age and sex-matched controls were hospital visitors and hospital out and in-patients excluding those with digestive diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for self-reported drinking temperatures; consumption frequency; mouth burning frequency and hot porridge consumption using logistic regression models adjusted for potential confounders. Drinking temperature association with tumour sub-location was also investigated. The study included 430 cases and 440 controls. Drinkers of very hot' and hot' beverages (>95% tea) had a 3.7 (95% CI: 2.1-6.5) and 1.4-fold (1.0-2.0) ESCC risk, respectively compared to warm' drinkers. This trend was consistent in males, females, never and ever alcohol/tobacco and was stronger over than under age 50 years. The tumour sub-location distribution (upper/middle/lower oesophagus) did not differ by reported drinking temperature. Our study is the first comprehensive investigation in this setting to-date to observe a link between hot beverage consumption and ESCC in East Africa. These findings provide further evidence for the role of this potentially modifiable risk factor in ESCC aetiology.What's new? Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Hot beverage consumption - a probable carcinogen to humans - is associated with increased ESCC risk in other settings. In this first comprehensive case-control study to investigate the role of hot beverages in esophageal cancer in Kenya and East Africa, the authors find overall risks of 3.7 and 1.4-fold for drinking very hot and hot beverages, respectively, compared to warm These findings will contribute to local and global prevention efforts by addressing this potentially modifiable risk factor.