Retrospective cohort study of risk-factors for esophageal cancer in Linxian, People's Republic of China.
A retrospective cohort study of esophageal (including gastric cardia) cancer was conducted to examine dietary and other potential risk factors in Linxian, a high-risk area in P.R. China. Study subjects were identified based on participation in a cytology examination conducted in 1974. They were interviewed in 1989 to obtain information on esophageal cancer risk-factors and identify new cases and deaths. A total of 1,162 subjects from the analytic cohort of 12,693 were determined to have developed esophageal cancer over the 15-year follow-up period. Results indicate that increased age, male gender, a positive family history, low education level, surface-water use, and pork consumption were the strongest risk factors for esophageal cancer identified in this cohort, while use of corn as a primary staple and infrequent consumption of fresh vegetables also were possible risk factors. Traditional or suspected risk factors for esophageal cancer in this and other populations--smoking and alcohol use, and pickled vegetable and moldy food consumption--were not risk factors in this study. Some variation in risk was seen based on the subject's cytology result from 1974. We conclude that dietary factors appear to play a role in the etiology of esophageal cancer in this high-risk population, but are less important than other constitutional factors such as age, gender, and family history.
Yu
Y
Y
Cancer Institute, Chinese Academy of Medicinal Sciences in Beijing, PRC.
Taylor
P R
PR
Li
J Y
JY
Dawsey
S M
SM
Wang
G Q
GQ
Guo
W D
WD
Wang
W
W
Liu
B Q
BQ
Blot
W J
WJ
Shen
Q
Q
D000328:Adult; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects; D004034:Diet Surveys; D004522:Educational Status; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014881:Water Supply