title: Atrophic gastritis: risk factor for esophageal squamous cell carcinoma in a Latin-American population.
abstract: OBJECTIVE
  To study the association between atrophic gastritis (AG) and esophageal squamous cell carcinoma (ESCC) in a Latin-America population.
  
  
  METHODS
  A case-control study was performed at two reference Brazilian hospitals including patients diagnosed with advanced ESCC and dyspeptic patients who had been subjected to upper gastrointestinal endoscopy, with biopsies of the gastric antrum and body. All cases with ESCC were reviewed by a single pathologist, who applied standard criteria for the diagnosis of mucosal atrophy, intestinal metaplasia, and dysplasia, all classified as AG. The data on the patients' age, sex, smoking status, and alcohol consumption were collected from clinical records, and any missing information was completed by telephone interview. The association between AG and ESCC was assessed by means of univariate and multiple conditional logistic regressions.
  
  
  RESULTS
  Most patients were male, and the median age was 59 years (range: 37-79 years) in both the ESCC and control groups. Univariate analysis showed that an intake of ethanol greater than 32 g/d was an independent risk factor that increased the odds of ESCC 7.57 times (P = 0.014); upon multiple analysis, alcohol intake of ethanol greater than 32 g/d exhibited a risk of 4.54 (P = 0.081), as adjusted for AG and smoking. Smoking was shown to be an independent risk factor that increased the odds of ESCC 14.55 times (P = 0.011) for individuals who smoked 0 to 51 packs/year and 21.40 times (P = 0.006) for those who smoked more than 51 packs/year. Upon multiple analyses, those who smoked up to 51 packs/year exhibited a risk of 7.85 (P = 0.058), and those who smoked more than 51 packs/ year had a risk 11.57 times higher (P = 0.04), as adjusted for AG and alcohol consumption. AG proved to be a risk factor that increased the odds of ESCC 5.33 times (95%CI: 1.55-18.30, P = 0.008) according to the results of univariate conditional logistic regression.
  
  
  CONCLUSIONS
  There was an association by univariate conditional logistic regression between AG and ECSS in this sample of Latin-American population.
authors.affiliation: Endoscopy Department, Cancer Hospital of Barretos, Barretos, São Paulo 147830-066, Brazil.
authors.forename: Emiliano de Carvalho
authors.initials: Ede C
authors.lastname: Almodova
authors.forename: Walmar Kerche
authors.initials: WK
authors.lastname: de Oliveira
authors.forename: Lucas Faria Abrahão
authors.initials: LF
authors.lastname: Machado
authors.forename: Juliana Rigotto
authors.initials: JR
authors.lastname: Grejo
authors.forename: Thiago Rabelo
authors.initials: TR
authors.lastname: da Cunha
authors.forename: Wagner
authors.initials: W
authors.lastname: Colaiacovo
authors.forename: Erika Veruska Paiva
authors.initials: EV
authors.lastname: Ortolan
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001938:Brazil; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D005757:Gastritis, Atrophic / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000473:pathology; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking
keywords: Alcohol; Atrophic gastritis; Esophagus; Risk factor; Squamous cell carcinoma; Tobacco