title: Consumption of salted meat and its interactions with alcohol drinking and tobacco smoking on esophageal squamous-cell carcinoma.
abstract: Etiology of esophageal cancer has not yet been clearly documented, especially in high-risk regions. To evaluate the association between salted meat intake and esophageal squamous-cell carcinoma (ESCC) and to explore its joint effects with alcohol drinking and smoking, a population-based case-control study was conducted in a high ESCC risk area in China, including 942 incident ESCC cases and 942 age- and sex-matching controls. A validated food frequency questionnaire was used to collect information on dietary factors, alcohol drinking and tobacco smoking. Conditional logistic regressions were applied to estimate the association between salted meat intake and ESCC and its interactions with alcohol drinking and smoking, with adjustment for other confounders, including total energy intake. Salted meat intake was associated with an increased risk of ESCC, showing an exposure-response relationship (p for trend <0.001). Consumption of 50 g salted meat per week was related to an increased risk by 18% (odds ratio = 1.18, 95% confidence interval: 1.13-1.23). Salted meat in combination with either alcohol drinking or smoking had a greater risk than salted meat alone, which was more than additive. The strongest association was seen in the combination of all the three factors, particularly at the highest level of salted meat intake (odds ratio = 29.27, 95% confidence interval: 13.21-64.89). Salted meat intake is strongly associated with ESCC and its interactions with alcohol drinking and/or smoking highlights the significance of reducing salted meat intake among smokers and drinkers with respect to ESCC prevention.
authors.affiliation: JC School of Public Health and Primary Care, Division of Occupational and Environmental health, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Sihao
authors.initials: S
authors.lastname: Lin
authors.affiliation: JC School of Public Health and Primary Care, Division of Occupational and Environmental health, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Wang
authors.affiliation: West China School of Public Health, Department of nutrient hygiene, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Chengyu
authors.initials: C
authors.lastname: Huang
authors.affiliation: JC School of Public Health and Primary Care, Division of Occupational and Environmental health, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Xudong
authors.initials: X
authors.lastname: Liu
authors.affiliation: JC School of Public Health and Primary Care, Division of Occupational and Environmental health, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Hong Kong Occupational and Environmental Health Academy, Kowloon, Hong Kong, China.
authors.forename: Ignatius T S
authors.initials: IT
authors.lastname: Yu
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, MA.
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000209:etiology*; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D000077277:Esophageal Squamous Cell Carcinoma; D005247:Feeding Behavior; D005260:Female; D057141:Food, Preserved; D006801:Humans; D008297:Male; D008461:Meat Products; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
keywords: alcohol drinking; esophageal cancer; high-risk individuals; interaction; salt-processed meat; tobacco smoking