The link between use of solid biomass fuel (wood, charcoal, coal, dung, and crop residues) for cooking and/or heating and esophageal squamous cell carcinoma (ESCC) is inconclusive. We systematically reviewed the literature and performed a meta-analysis to determine whether cooking fuel type influences esophageal squamous cell carcinoma. We searched MEDLINE, EMBASE, Web of Knowledge and Cochrane Database of Systematic Reviews for studies investigating cooking fuel and ESCC from 2000 until March 2019. We performed random effects meta-analysis stratified by the continent, World Bank’s country income classifications and fuel type and calculated pooled odds ratios and 95% CIs for the risk of esophageal squamous cell carcinoma in biomass fuel users compared with non-users. Our analysis included 16 studies (all case-control) with 16,189 participants (5233 cases and 10,956 controls) that compared risk of ESCC among those using nonsolid fuels and biomass fuels. We found use of biomass fuel was associated with Esophageal squamous cell carcinoma with a pooled odds ratio (OR) 3.02 (95% CI 2.22, 4.11, heterogeneity (I2) = 79%). In sub-group analyses by continent, Africa (OR 3.35, 95%CI 2.34, 4.80, I2 = 73.4%) and Asia (OR 3.08, 95%CI 1.27, 7.43, I2 = 81.7%) had the highest odds of ESCC. Use of wood as fuel had the highest odds of 3.90, 95% CI 2.25, 6.77, I2 = 63.5%). No significant publication bias was detected. Biomass fuel is associated with increased risk of Esophageal squamous cell carcinoma. Biomass fuel status should be considered in the risk assessment for Esophageal squamous cell carcinoma.

中文翻译：

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生物质燃料作为食管鳞状细胞癌的危险因素：系统评价和荟萃分析


使用固体生物质燃料（木材、木炭、煤炭、粪便和作物残渣）进行烹饪和/或取暖与食管鳞状细胞癌 (ESCC) 之间的联系尚无定论。我们系统地回顾了文献并进行了荟萃分析，以确定烹饪燃料类型是否影响食管鳞状细胞癌。我们检索了 MEDLINE、EMBASE、Web of Knowledge 和 Cochrane 系统评价数据库，查找 2000 年至 2019 年 3 月期间调查烹饪燃料和 ESCC 的研究。我们按大陆、世界银行的国家收入分类和燃料类型进行了分层的随机效应荟萃分析，并计算与不使用生物质燃料的人相比，生物质燃料使用者患食管鳞状细胞癌风险的汇总比值比和 95% CI。我们的分析包括 16 项研究（均为病例对照），涉及 16,189 名参与者（5233 名病例和 10,956 名对照），比较了使用非固体燃料和生物质燃料的人患 ESCC 的风险。我们发现生物质燃料的使用与食管鳞状细胞癌相关，合并比值比 (OR) 3.02（95% CI 2.22, 4.11，异质性 (I2) = 79%）。在按大陆进行的亚组分析中，非洲（OR 3.35，95%CI 2.34, 4.80，I2 = 73.4%）和亚洲（OR 3.08，95%CI 1.27, 7.43，I2 = 81.7%）发生 ESCC 的几率最高。使用木材作为燃料的几率最高，为 3.90，95% CI 2.25, 6.77，I2 = 63.5%）。没有发现显着的发表偏倚。生物质燃料与食管鳞状细胞癌的风险增加有关。在食管鳞状细胞癌的风险评估中应考虑生物质燃料状态。