Oesophageal cancer and risk factors by histological type


Authors: S. Magnusková 1;  K. Azeem 1;  V. Kamarád 2;  H. Tomášková 3;  V. Janout 1,3;  H. Kollárová 1
Authors‘ workplace: Ústav preventivního lékařství, LF UP v Olomouci 1;  Ústav histologie a embryologie, LF OU, Ostrava 2;  Ústav epidemiologie a veřejného zdraví, LF OU, Ostrava 3
Published in: Gastroent Hepatol 2012; 66(5): 364-371
Category: Clinical and Experimental Gastroenterology: Original Article

Overview

Design:
Oesophageal cancer is a disease with multifactorial aetiology and possible differences with regard to histological type. The aim of this paper is to assess the relationship between individual selected risk factors and determine the degree of association in oesophageal cancer development while taking histological types into account.

Methods:
Within the framework of the multicenter study led by the IARC (International Agency for Research on Cancer) for Middle and Eastern European countries, carried out from March 2000 to November 2002 for the purpose of elucidating the relationship between lifestyle, the environment and working environment, its risks and health disorders, the influence of selected risk factors in 88 oesophageal cancer patients (76 males and 12 females) and 200 controls (123 males and 77 females) was monitored as well. The participants were interviewed by a trained interviewer using a standardized questionnaire.

Results:
The assessment was carried out using OR (odds ratio) and adjusted OR for age, BMI, smoking, alcohol consumption, profession, pyrosis and regurgitation. In the study group, males diagnosed with oesophageal cancer regardless of histological type were younger than females and this difference was statistically significant. When evaluating overweight and obesity using OR, a statistically significant inverse association (OR = 0.38; OR = 0.22, respectively) was ascertained. In current smokers, there was a significant positive association (OR = 5.84). After adjustment for the studied factors, a relatively strong statistically significant positive association was found only in oesophageal adenocarcinoma (OR = 26.89). A dose-response relationship was revealed for the frequency of cumulative consumption of alcohol and the risk of oesophageal carcinoma development where the OR rose depending on the dose, from 4.93 in a group consuming doses of under 100 g of pure alcohol weekly to 14.10 in a group consuming 300 or more grams of pure alcohol weekly. The results of ORs for each profession showed a higher risk for professions exposed to combustion fumes, asbestos, silica, concrete dust and black carbon, with OR of 2.31, and the result was statistically significant also for technical professions where a relatively strong positive association was found (OR = 2.51). The adjusted OR for pyrosis and regurgitation was twice as high in oesophageal adenocarcinoma (OR = 25.98) compared to oesophageal squamous cell carcinoma (OR = 12.44).

Conclusion:
The presented study is exceptional due to its analysis of risk factors in relation to different histological types of oesophageal cancer and is quite unique for the Czech Republic. So far in the Czech Republic, the evaluation of selected risk factors to such an extent has not been performed yet. Therefore, the results are compared with the foreign literature. The uniqueness of the presented study lies in the fact that the results are related to individual histological subtypes, which are not even sufficiently described in foreign literature.

Key words:
cancer – esophageal neoplasms – risk factors

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
21. 2. 2012

Accepted:
1. 5. 2012


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Paediatric gastroenterology Gastroenterology and hepatology Surgery

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