title: Dietary and demographical risk factors for oesophageal squamous cell carcinoma in the Eastern Anatolian region of Turkey where upper gastrointestinal cancers are endemic.
abstract: BACKGROUND
  Oesophageal squamous cell carcinoma (ESCC) is endemic in the Eastern Anatolian region of Turkey. The present study was performed to identify risk factors for ESCC that specifically reflect the demography and nutritional habits of individuals living in this region.
  
  
  METHODS
  The following parameters were compared in 208 ESCC patients and 200 control individuals in the Eastern Anatolian region: age, sex, place of living, socioeconomic level, education level, smoking, alcohol intake, nutritional habits, and food preservation methods.
  
  
  RESULTS
  The mean age of ESCC patients was 56.2 years, and 87 (41.8%) were 65 years-old or older. The ratio of women to men in the patient group was 1.39/1. ESCC patients consumed significantly less fruit and yellow or green vegetables and more hot black tea, 'boiled yellow butter', and mouldy cheese than did control individuals. Residence in rural areas, smoking, and cooking food by burning animal manure were also significantly associated with ESCC.
  
  
  CONCLUSIONS
  The consumption of boiled yellow butter and mouldy cheese, which are specific to the Eastern Anatolian region, and the use of animal manure for food preparation were identified as risk factors in this region. Further studies are required to potentially identify the carcinogenic substances that promote the development of ESCC in this region.
authors.affiliation: Department of Radiation Oncology, Regional Training and Research Hospital, Erzurum, Turkey E-mail : timurkoca3@gmail.com.
authors.forename: Timur
authors.initials: T
authors.lastname: Koca
authors.forename: Deniz
authors.initials: D
authors.lastname: Arslan
authors.forename: Hamit
authors.initials: H
authors.lastname: Basaran
authors.forename: Arda Kaymak
authors.initials: AK
authors.lastname: Cerkesli
authors.forename: Didem
authors.initials: D
authors.lastname: Tastekin
authors.forename: Duygu
authors.initials: D
authors.lastname: Sezen
authors.forename: Ozlem
authors.initials: O
authors.lastname: Koca
authors.forename: Dogan Nasir
authors.initials: DN
authors.lastname: Binici
authors.forename: Cumhur Ibrahim
authors.initials: CI
authors.lastname: Bassorgun
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozdogan
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D003710:Demography; D004032:Diet; D004938:Esophageal Neoplasms / Q000453:epidemiology*; D000077277:Esophageal Squamous Cell Carcinoma; D005247:Feeding Behavior; D005260:Female; D061353:Food Storage / Q000379:methods; D006801:Humans; D008297:Male; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014421:Turkey / Q000453:epidemiology