title: Risk factors for developing synchronous esophageal neoplasia in patients with head and neck cancer.
abstract: BACKGROUND
  This study investigated the risk factors for synchronous esophageal neoplasia in patients with head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  All 315 consecutive patients with newly diagnosed HNSCC received endoscopic esophageal screening with image-enhanced endoscopy.
  
  
  RESULTS
  Sixty-nine patients (21.9%) had synchronous esophageal neoplasia, 37 (53.6%) with superficial neoplasia and 21 (30.4%) with multiple esophageal lesions. Univariate analysis revealed age <50 years, drinking alcohol, and location of index HNSCC were significant risk factors for developing synchronous esophageal neoplasia. In multivariate analysis, drinking alcohol (odds ratio [OR], 3.792; p = .0035), index oropharynxgeal cancers (OR, 3.618; p = .0045) and hypopharyngeal cancers (OR, 2.627; p = .0029) were independent risk factors. Drinking alcohol was clearly dose-response related (p = .001).
  
  
  CONCLUSIONS
  Alcohol consumption and index tumor location are associated with the development of synchronous esophageal neoplasia in patients with HNSCC. Because of the high prevalence, routine endoscopic examination of the esophagus should be recommended, especially in patients with the risk factors identified.
authors.affiliation: Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, Republic of China.
authors.forename: Wen-Lun
authors.initials: WL
authors.lastname: Wang
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Lee
authors.forename: Yi-Chia
authors.initials: YC
authors.lastname: Lee
authors.forename: Tzer-Zen
authors.initials: TZ
authors.lastname: Hwang
authors.forename: Chih-Chun
authors.initials: CC
authors.lastname: Wang
authors.forename: Jau-Chung
authors.initials: JC
authors.lastname: Hwang
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Tai
authors.forename: Chi-Yang
authors.initials: CY
authors.lastname: Chang
authors.forename: Shang-Shyue
authors.initials: SS
authors.lastname: Tsai
authors.forename: Cheng-Ping
authors.initials: CP
authors.lastname: Wang
authors.forename: Jenq-Yuh
authors.initials: JY
authors.lastname: Ko
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
mesh_terms: D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D015331:Cohort Studies; D016001:Confidence Intervals; D055088:Early Detection of Cancer; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology