title: Oesophageal carcinoma--a study of risk factors (emphasis on nutrition) in a teaching hospital of Kumaon region of Uttarakhand.
abstract: BACKGROUND
  Cancer oesophagus is common in India and is the third leading cause of cancer death in males and fourth in females. Various factors are responsible for it and present study was undertaken to study the various risk factors with stress on nutritional factors associated with it.
  
  
  METHODS
  Ninety-four cases of oesophagus cancer and matched equal number of healthy individuals (control) constituted the study. They were assessed for their dietary pattern during the preceding 10-15 years with the help of standard food frequency questionnaire method. Information regarding consumption of alcohol, smoking and tobacco chewing with or without betel leaf was taken in detail.
  
  
  RESULTS
  Seven hundred and eighty upper GI endoscopy revealed 94 (12.05%) cases of oesophageal carcinoma. Histopathology revealed squamous cell carcinoma in 87 cases (92.50%), adenocarcinoma in 6 cases (6.30%) and one with mixed picture of adenocarcinoma and squamous cell carcinoma. Sixth (36.17%) and 7th (23.40%) decade of persons were mainly affected with male to female ratio of 2.1:1. They were mostly of lower socio-economic (82.90%) status. Various risk factors came across were less consumption of green and leafy vegetables and fruits and consuming more spicy fried and hot food and beverages. Increased risk was seen more often with consumption of alcohol (neat and without or less salad and snacks), smoking beedi and cigarette, and tobacco chewing with or without betel leaf. It is directly related to amount, frequency, mode and duration of use.
  
  
  CONCLUSIONS
  Malignancies in general are result of multiple factors and interaction of several environmental factors. One factor cannot be blamed but combination of factors increases the risk of oesophageal carcinoma. Nutritional factor is also one of the major contributing factor increasing the risk of oesophagus cancer.
authors.affiliation: Department of Medicine, Dr. Sushila Tiwari Memorial Forest Hospital and Uttarakhand Forest Hospital Trust Medical College, Haldwani-263139.
authors.forename: Subhash C
authors.initials: SC
authors.lastname: Joshi
authors.forename: Sandeep R
authors.initials: SR
authors.lastname: Saxena
authors.forename: V N
authors.initials: VN
authors.lastname: Satyawali
authors.forename: Arun
authors.initials: A
authors.lastname: Joshi
authors.forename: Pranesh
authors.initials: P
authors.lastname: Nigam
authors.forename: V K
authors.initials: VK
authors.lastname: Singh
authors.forename: S P
authors.initials: SP
authors.lastname: Rai
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology*; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D004032:Diet / Q000009:adverse effects*; D004938:Esophageal Neoplasms / Q000209:etiology*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014030:Tobacco, Smokeless / Q000009:adverse effects