title: Risk factors for esophageal cancer in a low-incidence area of Brazil.
abstract: CONTEXT AND OBJECTIVES Esophageal cancer is the eighth commonest type of cancer worldwide, occupying sixth place in terms of mortality. Smoking and alcohol use are known risk factors for this type of cancer. The aim here was to evaluate the risk factors for esophageal cancer in a low-incidence area. DESIGN AND SETTING Case-control study in Goiânia, with 99 cases of esophageal cancer and 223 controls. METHODS The variables were sociodemographic, dietary, occupational and lifestyle data. The sample was analyzed using the chi-square test, Mann-Whitney test and Mantel-Haenszel approach for multivariate analysis. Odds ratios (OR) were calculated with 5% significance and 95% confidence intervals. RESULTS The risk of esophageal cancer was higher in patients ≥ 55 years (OR = 1.95; P < 0.001). Patients from rural areas were at greater risk of esophageal cancer (OR = 4.9; P < 0.001). Smoking was a risk factor among the cases (OR = 3.8; P < 0.001), as was exposure to woodstoves (OR = 4.42; P < 0.001). The practice of oral sex was not a risk factor (OR = 0.45; P = 0.04). Consumption of apples, pears, vegetables, cruciferous vegetables and fruit juices were protective against esophageal cancer. CONCLUSION In a region in which the incidence of esophageal cancer is low, the most significant risk factors were exposure to woodstoves, smoking and living in rural areas.
authors.affiliation: Associação de Combate ao Câncer em Goiás (ACCG), Goiânia, Goiás, Brazil. omilhomemmota@gmail.com
authors.forename: Orlando Milhomem
authors.initials: OM
authors.lastname: Mota
authors.forename: Maria Paula
authors.initials: MP
authors.lastname: Curado
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Oliveira
authors.forename: Edesio
authors.initials: E
authors.lastname: Martins
authors.forename: Daniela Medeiros Milhomem
authors.initials: DM
authors.lastname: Cardoso
mesh_terms: D001938:Brazil / Q000453:epidemiology; D003296:Cooking / Q000295:instrumentation*; D004032:Diet / Q000009:adverse effects*; D004812:Epidemiologic Methods; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005638:Fruit; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012907:Smoking / Q000009:adverse effects*; D053260:Soot / Q000633:toxicity*; D014675:Vegetables; D014934:Wood
chemical_list: D053260:Soot
references.citation: Br J Surg. 1998 Jul;85(7):891-6
references.pmid: 9692558
references.citation: Int J Cancer. 2000 May 1;86(3):425-8
references.pmid: 10760833
references.citation: Br J Cancer. 2005 Jan 17;92(1):176-81
references.pmid: 15597107
references.citation: PLoS Med. 2007 Dec;4(12):e325
references.pmid: 18076279
references.citation: J Natl Cancer Inst. 2006 Mar 1;98(5):345-54
references.pmid: 16507831
references.citation: Hepatogastroenterology. 2003 Nov-Dec;50(54):1953-5
references.pmid: 14696440
references.citation: Int J Cancer. 2005 Aug 10;116(1):62-8
references.pmid: 15761872
references.citation: BMJ. 2011 Apr 07;342:d1584
references.pmid: 21474525
references.citation: Zhonghua Zhong Liu Za Zhi. 2009 Sep;31(9):664-8
references.pmid: 20021861
references.citation: Zhonghua Yu Fang Yi Xue Za Zhi. 2010 May;44(5):398-402
references.pmid: 20654227
references.citation: Cancer Res. 1990 Jan 15;50(2):426-31
references.pmid: 2295081
references.citation: Anticancer Res. 2005 Jan-Feb;25(1B):425-8
references.pmid: 15816606
references.citation: Asian Pac J Cancer Prev. 2009 Jul-Sep;10(3):419-28
references.pmid: 19640185
references.citation: Int J Cancer. 2005 Jan 20;113(3):475-82
references.pmid: 15455377
references.citation: Int J Cancer. 2009 Mar 15;124(6):1391-7
references.pmid: 19058195
references.citation: Gastroenterol Clin Biol. 2005 May;29(5):534-9
references.pmid: 15980746
references.citation: Int J Cancer. 1998 Mar 30;76(1):7-12
references.pmid: 9533754
references.citation: Am J Epidemiol. 2008 Jul 1;168(1):105-14
references.pmid: 18483122
references.citation: Int J Cancer. 2008 Oct 15;123(8):1935-40
references.pmid: 18688852
references.citation: J Natl Cancer Inst. 1985 Dec;75(6):1005-9
references.pmid: 3865007
references.citation: Am J Clin Nutr. 2003 Sep;78(3 Suppl):559S-569S
references.pmid: 12936950
references.citation: Int J Cancer. 2007 Apr 1;120(7):1518-22
references.pmid: 17205526
references.citation: Int J Cancer. 2009 Jul 15;125(2):406-12
references.pmid: 19378340
references.citation: Int J Cancer. 2010 Dec 15;127(12):2893-917
references.pmid: 21351269
references.citation: Am J Clin Nutr. 2006 May;83(5):1126-34
references.pmid: 16685056
references.citation: Cancer Lett. 2002 Dec 5;186(2):193-9
references.pmid: 12213289
references.citation: World J Gastroenterol. 2009 Jul 7;15(25):3142-7
references.pmid: 19575494
references.citation: Nutr Cancer. 2008;60(3):313-24
references.pmid: 18444165
references.citation: Rev Assoc Med Bras (1992). 1998 Oct-Dec;44(4):269-72
references.pmid: 9852644
references.citation: BMJ. 1998 Sep 26;317(7162):844-7
references.pmid: 9748175
references.citation: BMC Cancer. 2008 Aug 01;8:221
references.pmid: 18673563
references.citation: Arch Iran Med. 2010 Sep;13(5):391-4
references.pmid: 20804305
references.citation: Rev Saude Publica. 2002 Apr;36(2):129-34
references.pmid: 12045791
references.citation: Cancer Causes Control. 2006 Sep;17(7):957-69
references.pmid: 16841263
references.citation: Asian Pac J Cancer Prev. 2010;11(6):1827-31
references.pmid: 21338241
references.citation: Rev Saude Publica. 1995 Jun;29(3):159-65
references.pmid: 8539526