Risk factors for esophageal squamous cell carcinoma and its histological precursor lesions in China: a multicenter cross-sectional study,BMC Cancer

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Risk factors for esophageal squamous cell carcinoma and its histological precursor lesions in China: a multicenter cross-sectional study
BMC Cancer ( IF 3.4 ) Pub Date : 2021-09-16 , DOI: 10.1186/s12885-021-08764-x
Chen Niu ₁ , Yong Liu ₂ , Jialin Wang ₃ , Yuqin Liu ₄ , Shaokai Zhang ₅ , Yongzhen Zhang ₆ , Liwei Zhang ₇ , Deli Zhao ₈ , Fugang Liu ₉ , Lina Chao ₁₀ , Xinzheng Wang ₁₁ , Chunli Zhang ₁₂ , Guohui Song ₁₃ , Zhiyi Zhang ₁₄ , Youpeng Li ₁₅ , Zheng Yan ₁₆ , Yongxiu Wen ₁₇ , Yinyin Ge ₁₈ , Zhaoping Zang ₁ , Wei Feng ₁ , Haiping Zhang ₁ , Lixin Tao ₁ , Rena Nakyeyune ₁ , Yi Shen ₁ , Yi Shao ₁ , Xiuhua Guo ₁ , Toni Miles ₁₉ , Aiming Yang ₂₀ , Fen Liu ₁ , Guiqi Wang ₂

Affiliation

Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China.
Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, 250000, China.
Gansu Provincial Cancer Hospital, Gansu, 730000, China.
Department of Cancer Epidemiology and Prevention, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Henan, 450008, China.
Department of Epidemiology, Shanxi Cancer Hospital, Shanxi, 030013, China.
The Fourth Hospital of Hebei Medical University, Hebei, 050000, China.
Feicheng People's Hospital, Shandong, 271600, China.
Dongping People's Hospital, Shandong, 271500, China.
Department of Epidemiology, Hebi People's Hospital, Henan, 458030, China.
Yangcheng Cancer Hospital, Shanxi, 048100, China.
The First People's Hospital of Ningyang County, Shandong, 271400, China.
Cixian Institute for Cancer Prevention and Control, Hebei, 056500, China.
Gansu Wuwei Cancer Hospital, Gansu, 733000, China.
Minqin County People's Hospital, Gansu, 733000, China.
Linze County People's Hospital, Gansu, 734200, China.
Shandan County People's Hospital, Gansu, 734000, China.
Gaotai County People's Hospital, Gansu, 734300, China.
Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA.
Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.

Despite research efforts, the causative factors that contribute to esophageal squamous cell carcinoma (ESCC) in high-risk areas have not yet been understood. In this study, we, therefore, aimed to describe the risk factors associated with ESCC and its precursor lesions. We performed an endoscopic examination of 44,857 individuals aged 40–69 years from five high incidence regions of China in 2017–2018. Participants were classified as 4 groups of normal control, esophagitis, low-grade intraepithelial neoplasia (LGIN) and high-grade intraepithelial neoplasia/esophageal squamous cell carcinoma (HGIN/ESCC) using an unconditional logistic regression determine risk factors. We identified 4890 esophagitis, 1874 LGIN and 437 HGIN/ESCC cases. Crude odds ratios (ORs) and adjusted odds ratios were calculated using unconditional logistic regression. Drinking well and surface water, salty diet, and positive family history of cancer were the common risk factors for esophagitis, LGIN and HGIN/ESCC. History of chronic hepatitis/cirrhosis was the greatest risk factor of esophagitis (adjusted OR 2.96, 95%CI 2.52–3.47) and HGIN/ESCC (adjusted OR 1.91, 95%CI 1.03–3.22). Pesticide exposure (adjusted OR 1.20, 95%CI 1.05–1.37) was essential risk factor of LGIN. Among individuals aged 40–69 years in high incidence regions of upper gastrointestinal cancer, the results provided important epidemiological evidence for the prevention of different precancerous lesions of ESCC.

更新日期：2021-09-16

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