title: Attributable causes of esophageal cancer incidence and mortality in China.
abstract: BACKGROUND
  To estimate the contribution of tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake to esophageal cancer mortality and incidence in China.
  
  
  RESULTS
  We calculated the proportion of esophageal cancer attributable to four known modifiable risk factors [population attributable fraction (PAF)]. Exposure data was taken from meta-analyses and large-scale national surveys of representative samples of the Chinese population. Data on relative risks were also from meta-analyses and large-scale prospective studies. Esophageal cancer mortality and incidence came from the 3(rd) national death cause survey and population-based cancer registries in China. We estimated that 87,065 esophageal cancer deaths (men 67,686; women: 19,379) and 108,206 cases (men: 83,968, women: 24,238) were attributable to tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake in China in 2005. About 17.9% of esophageal cancer deaths among men and 1.9% among women were attributable to tobacco smoking. About 15.2% of esophageal cancer deaths in men and 1.3% in women were caused by alcohol drinking. Low vegetable intake was responsible for 4.3% esophageal cancer deaths in men and 4.1% in women. The fraction of esophageal cancer deaths attributable to low fruit intake was 27.1% in men and 28.0% in women. Overall, 46% of esophageal cancers (51% in men and 33% in women) were attributable to these four modifiable risk factors.
  
  
  CONCLUSIONS
  Tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake were responsible for 46% of esophageal cancer mortality and incidence in China in 2005. These findings provide useful data for developing guidelines for esophageal cancer prevention and control in China.
authors.affiliation: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Jian-Bing
authors.initials: JB
authors.lastname: Wang
authors.forename: Jin-Hu
authors.initials: JH
authors.lastname: Fan
authors.forename: Hao
authors.initials: H
authors.lastname: Liang
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Hui-Juan
authors.initials: HJ
authors.lastname: Xiao
authors.forename: Wen-Qiang
authors.initials: WQ
authors.lastname: Wei
authors.forename: Sanford M
authors.initials: SM
authors.lastname: Dawsey
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Qiao
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
mesh_terms: D002423:Cause of Death; D002681:China / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012306:Risk