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Sun Y, Zhang T, Wu W, Zhao D, Zhang N, Cui Y, Liu Y, Gu J, Lu P, Xue F, Yu J, Wang J. Risk Factors Associated with Precancerous Lesions of Esophageal Squamous Cell Carcinoma: a Screening Study in a High Risk Chinese Population. J Cancer 2019; 10:3284-3290. [PMID: 31289600 PMCID: PMC6603371 DOI: 10.7150/jca.29979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 04/04/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Esophageal squamous cell carcinoma (ESCC) has been having a high mortality rate in China. Most patients are diagnosed in advanced stages, leading to the poor prognosis and low 5-year survival rate. Detection of precancerous lesions or early cancers is the key to improving this situation. Although previous studies have identified some risk factors for ESCC, they rarely paid attention to the premalignant esophageal lesions. We thus initiated a population-based screening study aiming to assess risk factors associated with esophageal precancerous lesions (EPLs) in a high risk Chinese population. Methods: From September 2013 to July 2015, we screened residents aged 40-69 years from 53 randomly selected communities in Feicheng, China (n = 5076). Each participant went through questionnaire interview, physical examination, endoscopy and biopsy. Using logistic regression, we compared participants with EPLs to that with normal esophageal mucosa for finding potential risk factors of EPLs. Results: A total of 570 participants were diagnosed with EPLs. We observed no association between EPLs and tobacco smoking or alcohol consumption in unadjusted or adjusted model. In the adjusted model, the OR (95% CI) was 1.84 (1.18-2.89) for people of drinking shallow-well water comparing to people who was drinking tap-water. In a comparison of participants with good oral health, the ESD/ESCC ORs (95% CI) for those with very poor or poor oral health, were 1.78 (1.28-2.49) and 1.58 (1.16-2.15) respectively. However, no statistical significance was observed after adjustment. Moreover, cereal straw heating (OR= 1.74, 95% CI: 0.90-3.36, P=0.099) may lead to increased risk of EPLs. Conclusion: In Feicheng population, tobacco smoking or alcohol consumption may not be risk factors of EPLs. Low-quality drinking water raised the EPLs risk. Bad house heating materials, such as cereal straw, may lead to high EPLs risk.
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Affiliation(s)
- Yawen Sun
- Department of Science and Education, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China
- Department of Oncology, School of Medicine, Shandong University, Jinan, Shandong, China
| | - Tao Zhang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Wenjie Wu
- Outpatient Department, Shandong Hospital of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Deli Zhao
- Cancer Screening Center, Feicheng Hospital, Jinan, Shandong, China
| | - Nan Zhang
- Department of Science and Education, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Yongchun Cui
- Department of Science and Education, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Yanxun Liu
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jianhua Gu
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Peipei Lu
- Department of Science and Education, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jinming Yu
- Department of Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Jialin Wang
- Department of Science and Education, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China
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Zou GR, Su Z, Li JY, Xie FY, Li Q. Prognostic impact of cigarette smoking on the survival of patients with established esophageal squamous cell carcinoma receiving radiotherapy: A retrospective study from southern China. Exp Ther Med 2019; 17:3671-3681. [PMID: 30988751 PMCID: PMC6447759 DOI: 10.3892/etm.2019.7356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 02/22/2019] [Indexed: 12/18/2022] Open
Abstract
Cigarette smoking is associated with the development of esophageal squamous cell carcinoma (ESCC); however, the influence of smoking on survival of patients with ESCC receiving radiotherapy, with or without chemotherapy, has remained elusive. The present study retrospectively analyzed 479 patients with ESCC from southern China who were categorized based on their smoking history (never, previous or current). To consider the cumulative effect of smoking, the number of pack years (PYs) was used as a representative variable. Associations between cigarette smoking and survival were evaluated using the Kaplan-Meier analysis and Cox proportional hazards model. Among the 497 patients, 308 (64.3%) had reported a history of cigarette smoking. The 5-year overall survival for patients void of a smoking history, former smokers and current smokers was 50.9, 27.0 and 34.3%, respectively. The adjusted hazard ratios (HRs) for previous and current smoking vs. no smoking history were 1.57 [95% confidence interval (CI), 1.06-2.32] and 3.01 (95% CI, 1.15-7.86), respectively. Heavy smokers with a high number of PYs had a HR for death of 1.75 (95% CI, 1.28-2.41) compared with light smokers. In the cohort of 407 patients treated with intensity-modulated radiotherapy/three-dimensional conformal radiotherapy, similarly significant results were obtained. In conclusion, cigarette smoking is an independent and poor prognostic factor for patients with ESCC treated with radiotherapy and/or chemotherapy. It is associated with an increased risk of death, and the risk increases with the increase in PYs. This result may help to manage tobacco use among patients with ESCC. The smoking status should be taken into consideration in prospective studies on ESCC. More frequent follow-ups are recommended for those patients with ESCC with a history of smoking.
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Affiliation(s)
- Guo-Rong Zou
- Department of Oncology, Panyu Central Hospital, Cancer Institute of Panyu, Guangzhou, Guangdong 511400, P.R. China
| | - Zhen Su
- Department of Oncology, Panyu Central Hospital, Cancer Institute of Panyu, Guangzhou, Guangdong 511400, P.R. China
| | - Jun-Yun Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Fang-Yun Xie
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Qun Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
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Hou L, Jiang J, Liu B, Han W, Wu Y, Zou X, Xue F, Chen Y, Zhang B, Pang H, Wang Y, Wang Z, Hu Y, Li J. Is exposure to tobacco associated with extrahepatic cholangiocarcinoma epidemics? A retrospective proportional mortality study in China. BMC Cancer 2019; 19:348. [PMID: 30975121 PMCID: PMC6458766 DOI: 10.1186/s12885-019-5484-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/15/2019] [Indexed: 01/04/2023] Open
Abstract
Background Extrahepatic cholangiocarcinoma (ECC) has become one of the most rapidly increasing malignancies in China during recent decades. The relationship between tobacco exposure and ECC epidemics is unclear; this study aimed to explore this relationship. Methods We included 55,806 participants aged 30 years or older from the National Mortality and Smoking Survey of China. Smoking in participants and spouses was defined as 1 cigarette or more per day for up to 1 year. Spouses’ smoking was taken as a measure of exposure to passive smoking. Smoking information in 1980 was ascertained and outcomes were defined as ECC mortality during 1986–1988. Results We found that either passive or active smoking increased the risk of death from ECC by 20% (risk ratio [RR], 1.20; 95% confidence interval [CI], 0.99–1.47), compared with no exposure to any tobacco. This risk was a notable 98% (RR, 1.98; 95% CI, 1.49–2.64) for individuals exposed to passive plus active smoking. These findings were highly consistent among men and women. Pathology-based analyses showed dose-response relationships of ECC with pack-years for all types of smoking exposure (Ps for trend < 0.05); the RR reached 2.75 (95% CI, 1.20–6.30) in individuals exposed to combined smoking with the highest exposure dose. The findings were similar for non-pathology-based analysis. Conclusions This study indicates that tobacco exposure increases ECC risk. Given the dramatic increase of exposure to secondhand smoke and patients with ECC, an inadequate provision of smoke-free environments could be contributing to ECC epidemics and could further challenge public health and medical services, based on the current disease spectrum. Electronic supplementary material The online version of this article (10.1186/s12885-019-5484-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lei Hou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, A505 Room Mingri Building, 5 Dongdansantiao Street, Dongcheng District, Beijing, 100005, China.,National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jingmei Jiang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, A505 Room Mingri Building, 5 Dongdansantiao Street, Dongcheng District, Beijing, 100005, China.
| | - Boqi Liu
- Cancer Institute & Hospital, Chinese Academy of Medical Sciences / Peking Union Medical College, Beijing, China. .,National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Wei Han
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, A505 Room Mingri Building, 5 Dongdansantiao Street, Dongcheng District, Beijing, 100005, China
| | - Yanping Wu
- Cancer Institute & Hospital, Chinese Academy of Medical Sciences / Peking Union Medical College, Beijing, China
| | - Xiaonong Zou
- Cancer Institute & Hospital, Chinese Academy of Medical Sciences / Peking Union Medical College, Beijing, China
| | - Fang Xue
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, A505 Room Mingri Building, 5 Dongdansantiao Street, Dongcheng District, Beijing, 100005, China
| | - Yuanli Chen
- Cancer Institute & Hospital, Chinese Academy of Medical Sciences / Peking Union Medical College, Beijing, China
| | - Biao Zhang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, A505 Room Mingri Building, 5 Dongdansantiao Street, Dongcheng District, Beijing, 100005, China
| | - Haiyu Pang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, A505 Room Mingri Building, 5 Dongdansantiao Street, Dongcheng District, Beijing, 100005, China
| | - Yuyan Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, A505 Room Mingri Building, 5 Dongdansantiao Street, Dongcheng District, Beijing, 100005, China
| | - Zixing Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, A505 Room Mingri Building, 5 Dongdansantiao Street, Dongcheng District, Beijing, 100005, China
| | - Yaoda Hu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences / School of Basic Medicine Peking Union Medical College, A505 Room Mingri Building, 5 Dongdansantiao Street, Dongcheng District, Beijing, 100005, China
| | - Junyao Li
- Cancer Institute & Hospital, Chinese Academy of Medical Sciences / Peking Union Medical College, Beijing, China
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Huang X, Guan S, Wang J, Zhao L, Jia Y, Lu Z, Yin C, Yang S, Song Q, Han L, Wang C, Li J, Zhou W, Guo X, Cheng Y. The effects of air pollution on mortality and clinicopathological features of esophageal cancer. Oncotarget 2017; 8:58563-58576. [PMID: 28938579 PMCID: PMC5601675 DOI: 10.18632/oncotarget.17266] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/27/2017] [Indexed: 12/18/2022] Open
Abstract
This study aimed to estimate the associations between air pollution and esophageal cancer. In the ecologic cross-sectional study, correlation analyses were made between city-level mean concentrations of particulate matter less than 10μm in aerodynamic diameter (PM10), SO2, NO2 and city-level age-standardized mortality rates of esophageal cancer in Shandong Province, China. PM10 (p=0.046) and NO2 (p=0.03) both had significant linear correlations with esophageal cancer mortality rates. After introducing smoking as a risk factor in models of multiple linear regression analyses, PM10 was still an independent risk factor that increased esophageal cancer mortality rates. This study further compared clinicopathological features of 1,255 eligible esophageal squamous cell carcinoma patients by dividing them into different pollution level groups. There was statistically significant difference in gender distributions (p=0.02) between groups after subgroup analysis. Female patients accounted for a higher proportion in the high PM10 level group than in the low PM10 level group. It suggested that females were more sensitive to higher PM10 level pollution. The features that manifested the degree of malignancy of esophageal cancer, including primary tumor invasion, regional lymph nodes metastasis, histological grade, stage, lymph-vascular invasion and tumor size demonstrated no statistically significant difference between groups.
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Affiliation(s)
- Xiaochen Huang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Shanghui Guan
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Jiangfeng Wang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Linli Zhao
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Yibin Jia
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Zilong Lu
- Department of Noncommunicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong, China
| | - Cuiping Yin
- Department of Rehabilitation, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Shengsi Yang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Qingxu Song
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Lihui Han
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Cong Wang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Jingyi Li
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Wei Zhou
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Xiaolei Guo
- Department of Noncommunicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong, China
| | - Yufeng Cheng
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
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Sun P, Chen C, Zhang F, Yang H, Bi XW, An X, Wang FH, Jiang WQ. Combined heavy smoking and drinking predicts overall but not disease-free survival after curative resection of locoregional esophageal squamous cell carcinoma. Onco Targets Ther 2016; 9:4257-64. [PMID: 27471400 PMCID: PMC4948733 DOI: 10.2147/ott.s104182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The prognostic impact of smoking and drinking on esophageal squamous cell carcinoma (ESCC) was scarcely discussed. We investigated the prognostic value of smoking and drinking and their relationships with clinicopathological characteristics in a large cohort of patients with locoregional ESCC. PATIENTS AND METHODS We retrospectively analyzed 488 patients who underwent curative treatment at a single institution between January 2007 and December 2008. A chi-square test was used to evaluate the relationships between smoking and drinking and clinicopathological variables, the Kaplan-Meier method was used for 5-year overall survival (OS) and disease-free survival, and Cox proportional hazards models were applied for univariate and multivariate analyses of variables with respect to OS and disease-free survival. RESULTS Heavy smokers were more likely to have advanced Tumor-Node-Metastases (TNM) stage and higher neutrophil/lymphocyte ratio at diagnosis (P<0.05). Drinkers were more likely to have advanced TNM stage, to present with a larger tumor, and to undergo multidisciplinary treatment (P<0.05). For patients who used neither heavy tobacco nor alcohol, used either tobacco or alcohol, and used both, the 5-year OS rates and OS times were 57.4%, 46.4%, and 39.1% (P<0.05) and not reached, 55.2 months, and 41.2 months (P<0.05), respectively. On multivariate analysis, patients who both heavily smoked and drank had 1.392 times the risk of dying during follow-up compared with neither-users (95% CI =1.020-1.901, P=0.037). CONCLUSION We identified that combined heavy smoking and drinking might predict poor prognosis in ESCC patients.
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Affiliation(s)
- Peng Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Department of Medical Oncology, Sun Yat-Sen University Cancer Center
| | - Cui Chen
- Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People's Republic of China
| | - Fei Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Department of Medical Oncology, Sun Yat-Sen University Cancer Center
| | - Hang Yang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Department of Medical Oncology, Sun Yat-Sen University Cancer Center
| | - Xi-Wen Bi
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Department of Medical Oncology, Sun Yat-Sen University Cancer Center
| | - Xin An
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Department of Medical Oncology, Sun Yat-Sen University Cancer Center
| | - Feng-Hua Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Department of Medical Oncology, Sun Yat-Sen University Cancer Center
| | - Wen-Qi Jiang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Department of Medical Oncology, Sun Yat-Sen University Cancer Center
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Sewram V, Sitas F, O'Connell D, Myers J. Tobacco and alcohol as risk factors for oesophageal cancer in a high incidence area in South Africa. Cancer Epidemiol 2016; 41:113-21. [PMID: 26900781 DOI: 10.1016/j.canep.2016.02.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/31/2015] [Accepted: 02/04/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND The Eastern Cape Province of South Africa, which includes the former Transkei has high rates of squamous cell oesophageal cancer (OC), thought to be caused mainly by nutritional deficiencies and fungal contamination of staple maize. A hospital-based case-control study was conducted at three of the major referral hospitals in this region to measure, among other suspected risk factors, the relative importance of tobacco smoking and alcohol consumption for the disease in this population. METHODS Incident cases (n=670) of OC and controls (n=1188) were interviewed using a structured questionnaire which included questions on tobacco and alcohol-related consumption. Odds ratios (ORs) with 95% confidence intervals for each of the risk factors were calculated using unconditional multiple logistic regression models. RESULTS A monotonic dose-response was observed across the categories of each tobacco-related variable in both sexes. Males and females currently smoking a total of >14g of tobacco per day were observed to have over 4-times the odds of developing OC (males OR=4.36, 95% CI 2.24-8.48; females OR=4.56, 95% CI 1.46-14.30), with pipe smoking showing the strongest effect. Similar trends were observed for the alcohol-related variables. The quantity of ethanol consumed was the most important factor in OC development rather than any individual type of alcoholic beverage, especially in smokers. Males and females consuming >53g of ethanol per day had approximately 5-times greater odds in comparison to non-drinkers (males OR=4.72, 95% CI 2.64-8.41; females OR=5.24, 95% CI 3.34-8.23) and 8.5 greater odds in those who smoked >14g tobacco daily. The attributable fractions for smoking and alcohol consumption were 58% and 48% respectively, 64% for both factors combined. CONCLUSION Tobacco and alcohol use are major risk factors for OC development in this region. IMPACT This study provides evidence for further reinforcement of cessation of smoking and alcohol consumption to curb OC development.
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Affiliation(s)
- Vikash Sewram
- African Cancer Institute, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Division of Community Health, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa.
| | - Freddy Sitas
- Cancer Research Division, Cancer Council New South Wales, P.O. Box 572, Kings Cross, NSW 1340, Australia; Sydney School of Public Health, University of Sydney, Camperdown, Australia; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia
| | - Dianne O'Connell
- Cancer Research Division, Cancer Council New South Wales, P.O. Box 572, Kings Cross, NSW 1340, Australia; Sydney School of Public Health, University of Sydney, Camperdown, Australia; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia; School of Medicine and Public Health, University of Newcastle, Australia
| | - Jonny Myers
- Centre for Occupational and Environmental Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa
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Hou L, Jiang J, Liu B, Han W, Wu Y, Zou X, Nasca PC, Xue F, Chen Y, Zhang B, Pang H, Wang Y, Wang Z, Li J. Smoking and adult glioma: a population-based case-control study in China. Neuro Oncol 2015; 18:105-13. [PMID: 26409568 DOI: 10.1093/neuonc/nov146] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/24/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Smoking increases the risk of numerous cancers; however, an association of smoking with adult gliomas has not been found in a population. METHODS This case-control study included 4556 glioma cases (ICD-9 code 191.0-191.9) aged ≥ 30 years and 9112 controls from a national survey of smoking and mortality in China in 1989-1991. Controls from 325 255 surviving spouses of all-cause deaths were randomly assigned to cases in each of 103 areas according to sex and age groups at a ratio of 2:1. Smoking information was ascertained retrospectively by interviewing surviving spouses. RESULTS After adjustment for confounders, smoking increased the risk of glioma deaths by 11% (odds ratio [OR] = 1.11; 95% confidence interval [CI]: 1.03-1.21). Compared with non-smokers; the increased risk was 9% (OR = 1.09; 95% CI: 0.99-1.20) in men and 16% (OR = 1.16; 95% CI: 1.00-1.36) in women. The risk increased with age and doses. For individuals aged ≥ 50 years, smoking was associated with higher risk of glioma death by 25% (OR = 1.25; 95% CI: 1.15-1.38); this increased risk for smokers who smoked ≥ 20 cigarettes daily for ≥ 30 years was 53% (OR = 1.53; 95% CI: 1.34-1.74). There were similar findings in both men and women and with either pathology-based or non-pathology-based comparisons. CONCLUSIONS This study indicates that smoking is associated with glioma deaths in the Chinese population. Long-term heavy smoking could be a factor for risk stratification in individuals attending brain tumor clinics.
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Affiliation(s)
- Lei Hou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Jingmei Jiang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Boqi Liu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Wei Han
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Yanping Wu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Xiaonong Zou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Philip C Nasca
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Fang Xue
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Yuanli Chen
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Biao Zhang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Haiyu Pang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Yuyan Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Zixing Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
| | - Junyao Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, China (L.H., J.J., W.H., F.X., B.Z., H.P., Y.W., Z.W.); Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (B.L., Y.W., X.Z., Y.C., J.L.); School of Public Health, State University of New York, Albany, New York (P.C.N.)
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Lin H, Ning B, Li J, Zhao G, Huang Y, Tian L. Temporal trend of mortality from major cancers in Xuanwei, China. Front Med 2015; 9:487-95. [PMID: 26303302 DOI: 10.1007/s11684-015-0413-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 06/10/2015] [Indexed: 11/29/2022]
Abstract
Although a number of studies have examined the etiology of lung cancer in Xuanwei County, China, other types of cancer in this county have not been reported systematically. This study aimed to investigate the temporal trend of eight major cancers in Xuanwei County using data from three mortality surveys (1973-1975, 1990-1992, and 2004-2005). The Chinese population in 1990 was used as a standard population to calculate agestandardized mortality rates. Cancers of lung, liver, breast, brain, esophagus, leukemia, rectum, and stomach were identified as the leading cancers in this county in terms of mortality rate. During the three time periods, lung cancer remained as the most common type of cancer. The mortality rates for all other types of cancer were lower than those of the national average, but an increasing trend was observed for all the cancers, particularly from 1990-1992 to 2004-2005. The temporal trend could be partly explained by changes in risk factors, but it also may be due to the improvement in cancer diagnosis and screening. Further epidemiological studies are warranted to systematically examine the underlying reasons for the temporal trend of the major cancers in Xuanwei County.
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Affiliation(s)
- Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Bofu Ning
- Xuanwei Center for Disease Control and Prevention, Xuanwei, 655400, China
| | - Jihua Li
- Qujing Center for Disease Control and Prevention, Qujing, 655000, China
| | - Guangqiang Zhao
- Yunnan Province Tumor Hospital and The Third Affiliated Hospital of Kunming Medical University, Kunming, 650106, China
| | - Yunchao Huang
- Yunnan Province Tumor Hospital and The Third Affiliated Hospital of Kunming Medical University, Kunming, 650106, China
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Hong Kong, China.
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Zheng Y, Cao X, Wen J, Yang H, Luo K, Liu Q, Huang Q, Chen J, Fu J. Smoking affects treatment outcome in patients with resected esophageal squamous cell carcinoma who received chemotherapy. PLoS One 2015; 10:e0123246. [PMID: 25874561 PMCID: PMC4395356 DOI: 10.1371/journal.pone.0123246] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 03/02/2015] [Indexed: 01/25/2023] Open
Abstract
Background Cigarette smoking is reported to decrease survival and induce chemotherapy resistance in patients with various cancers. However, the impact of cigarette smoking on patients with esophageal squamous cell carcinoma (ESCC) remains unknown. Methods A total of 1,084 ESCC patients were retrospectively enrolled from a southern Chinese institution. Patients were divided into two groups according to their treatment modalities: the SC group (surgery with chemotherapy) (n = 306) and the S group (surgery without chemotherapy) (n = 778). Smoking status was quantified as smoking history (non-smoker, ex-smoker, and current smoker) and cumulative smoking (0, between 0 and 20, and greater than 20 pack-years). The association between cigarette smoking and overall survival (OS) was evaluated using the Kaplan-Meier method and univariate/multivariate regression analysis. Results Among 1,084 patients, 702 (64.8%) reported a cigarette smoking history, and the 5-year OS for non-smokers and smokers was 45.8% and 37.3%, respectively. In the SC group, compared with non-smoker, the adjusted HRs of ex-smoker and current smoker were 1.540 (95% CI, 1.1–2.2) and 2.110 (95% CI, 1.4–3.1), respectively; there is a correlative trend of decreased OS with increased cigarette smoking (Ptrend = 0.001). These associations were insignificant in the S group. In subgroup analysis of the SC group, the lower OS conferred by smoking was not significantly modified by age, gender, body mass index, alcohol drinking, or chemotherapy method (chemotherapy and chemoradiotherapy). Conclusion Our results suggest that smoking may affect treatment outcome in patients with resected ESCC who received chemotherapy.
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Affiliation(s)
- Yuzhen Zheng
- Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China
- Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China
| | - Xun Cao
- Department of Intensive Care Unit, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China
| | - Jing Wen
- Department of Experimental Research, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China
- Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China
| | - Hong Yang
- Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China
- Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China
| | - Kongjia Luo
- Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China
- Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China
| | - Qianwen Liu
- Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China
- Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China
| | - Qingyuan Huang
- Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China
- Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China
| | - Junying Chen
- Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China
- Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China
| | - Jianhua Fu
- Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China
- Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China
- * E-mail:
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A Relationship Between Replication Protein A and Occurrence and Prognosis of Esophageal Carcinoma. Cell Biochem Biophys 2013; 67:175-80. [DOI: 10.1007/s12013-013-9530-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Lopes AB, Fagundes RB. Esophageal squamous cell carcinoma - precursor lesions and early diagnosis. World J Gastrointest Endosc 2012; 4:9-16. [PMID: 22267978 PMCID: PMC3262175 DOI: 10.4253/wjge.v4.i1.9] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 12/03/2011] [Accepted: 01/12/2012] [Indexed: 02/05/2023] Open
Abstract
Squamous cell carcinoma of the esophagus (SCCE) carries a poor prognosis due to late diagnosis. Early detection is highly desirable, since surgical and endoscopic resection offers the only possible cure for esophageal cancer. Population screening should be undertaken in high risk areas, and in low or moderate risk areas for people with risk factors (alcoholics, smokers, mate drinkers, history of head and neck cancer, achalasia and lye stricture of the esophagus). Esophageal balloon cytology is an easy and inexpensive sampling technique, but the current methods are insufficient for primary screening due to sampling errors. Conventional endoscopy with biopsy remains the standard procedure for the identification of pre-malignant and early malignant changes in esophageal mucosa and endoscopic detection. It may be enhanced by several techniques such as dye and optic chromoendoscopy, magnifying endoscopy, and optical-based spectroscopic and imaging modalities. Since more than 80% of SCCE deaths occur in developing countries, where expensive techniques such as narrow band imaging (NBI) and autofluorescence imaging are unavailable, the most cost-effective tool for targeting biopsies may be Lugol dye chromoendoscopy, since it is easy, accurate, inexpensive and available worldwide. In ideal conditions, or in developed countries, is it reasonable to think that optimal detection will require a combination of techniques, such as the combination of Lugol’s chromoendoscopy and NBI to identify esophageal areas that require further characterization by a high resolution technique. The efficacy and cost-effectiveness will determine whether these modalities will become part of standard endoscopy practice.
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Affiliation(s)
- Antonio Barros Lopes
- Antonio Barros Lopes, Renato Borges Fagundes, Post-Graduate Program: Sciences in Gastroenterology and Hepatology - Universidade Federal do Rio Grande do Sul, Rio Grande do Sul 90035-003, Brazil
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Gao Y, Hu N, Han XY, Ding T, Giffen C, Goldstein AM, Taylor PR. Risk factors for esophageal and gastric cancers in Shanxi Province, China: a case-control study. Cancer Epidemiol 2011; 35:e91-9. [PMID: 21846596 DOI: 10.1016/j.canep.2011.06.006] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Revised: 06/23/2011] [Accepted: 06/25/2011] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Smoking and alcohol consumption explain little of the risk for upper-gastrointestinal (UGI) cancer in China, where over half of all cases in the world occur. METHODS We evaluated questionnaire-based risk factors for UGI cancers in a case-control study from Shanxi Province, China, including 600 esophageal squamous cell carcinomas (ESCCs), 599 gastric cardia adenocarcinomas (GCAs), 316 gastric noncardia adenocarcinomas (GNCAs), and 1514 age- and gender-matched controls. RESULTS Ever smoking and ever use of any alcohol were not associated with risk of UGI cancer; only modest associations were observed between ESCC risk and highest cumulative smoking exposure, as well as GNCA risk and beer drinking. While several associations were noted for socioeconomic and some dietary variables with one or two UGI cancers, the strongest and most consistent relations for all three individual UGI cancers were observed for consumption of scalding hot foods (risk increased 150-219% for daily vs. never users) and fresh vegetables and fruits (risk decreased 48-70% for vegetables and 46-68% for fruits, respectively, for high vs. low quartiles). CONCLUSION This study confirms the minor role of tobacco and alcohol in UGI cancers in this region, and highlights thermal damage as a leading etiologic factor.
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Affiliation(s)
- Ying Gao
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20852, USA.
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Wu M, Zhao JK, Zhang ZF, Han RQ, Yang J, Zhou JY, Wang XS, Zhang XF, Liu AM, van' t Veer P, Kok FJ, Kampman E. Smoking and alcohol drinking increased the risk of esophageal cancer among Chinese men but not women in a high-risk population. Cancer Causes Control 2011; 22:649-57. [PMID: 21321789 PMCID: PMC3059761 DOI: 10.1007/s10552-011-9737-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Accepted: 01/25/2011] [Indexed: 01/06/2023]
Abstract
Although the association for esophageal cancer with tobacco smoking and alcohol drinking has been well established, the risk appears to be less strong in China. To provide more evidence on the effect of smoking and alcohol consumption with esophageal cancer in China, particularly among Chinese women, a population-based case–control study has been conducted in Jiangsu, China, from 2003 to 2007. A total of 1,520 cases and 3,879 controls were recruited. Unconditional multivariate logistic regression analysis was applied. Results showed that the odds ratio (OR) and confidence interval (CI) for ever smoking and alcohol drinking were 1.57 (95% CI: 1.34–1.83) and 1.50 (95% CI: 1.29–1.74). Dose–response relationships were observed with increased intensity and longer duration of smoking/drinking. Risk of smoking and alcohol drinking at the highest joint level was 7.32 (95% CI: 4.58–11.7), when compared to those never smoked and never drank alcohol. Stratifying by genders, smoking and alcohol drinking increased the risk among men with an OR of 1.74 (95% CI: 1.44–2.09) and 1.76 (95% CI: 1.48–2.09); however, neither smoking nor alcohol consumption showed a significant association among women. In conclusion, smoking and alcohol drinking were associated with esophageal cancer risk among Chinese men, but not among Chinese women.
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Affiliation(s)
- Ming Wu
- Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Nanjing, Jiangsu, 210009, China.
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Jiang J, Liu B, Sitas F, Zeng X, Chen J, Han W, Zou X, Wu Y, Zhao P, Li J. Case-spouse control design in practice: an experience in estimating smoking and chronic obstructive pulmonary disease deaths in Chinese adults. J Formos Med Assoc 2010; 109:369-77. [PMID: 20497870 DOI: 10.1016/s0929-6646(10)60065-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Revised: 06/26/2009] [Accepted: 08/31/2009] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND/PURPOSE We assessed the effect of smoking on death from chronic obstructive pulmonary disease (COPD) in China by employing a large population-based, case-spouse control study design using data from a nationwide survey of mortality. METHODS During 1989-1991, a nationwide retrospective survey of mortality was conducted in China. For approximately 1,000,000 adults dying from all causes during 1986-1988, their surviving spouses or other informants provided detailed information about their own as well as the deceased person's smoking history. For this study, 183,393 individuals who died of COPD at age > or = 40 years were taken as cases, while 272,984 sex-matched surviving spouses of subjects who died from any cause were taken as controls. RESULTS COPD death rates for smokers were more than twice as high as those of non-smokers, with a dose-response risk pattern, despite the fact that COPD death rates varied widely by region and age. Tobacco accounted for 41.4% of COPD deaths in men, but only 13.5% of those in women, who had a lower rate of smoking. CONCLUSION A case-spouse control study, as an alternative design, is valid and feasible in utilizing information from population-based, retrospective mortality survey data for an analytical epidemiological study of disease etiology.
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Affiliation(s)
- Jingmei Jiang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
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Decreased expression of GST pi is correlated with a poor prognosis in human esophageal squamous carcinoma. BMC Cancer 2010; 10:352. [PMID: 20602752 PMCID: PMC2909209 DOI: 10.1186/1471-2407-10-352] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Accepted: 07/05/2010] [Indexed: 11/25/2022] Open
Abstract
Background Glutathione S-transferase pi (GST pi) is a subgroup of GST family, which provides cellular protection against free radical and carcinogenic compounds due to its detoxifying function. Expression patterns of GST pi have been studied in several carcinomas and its down-regulation was implicated to be involved in malignant transformation in patients with Barrett's esophagus. However, neither the exact role of GST pi in the pathogenesis nor its prognostic impact in squamous esophageal carcinoma is fully characterized. Methods Immunohistochemistry was used to investigate GST pi expression on 153 archival squamous esophageal carcinoma specimens with a GST pi monoclonal antibody. Statistic analyses were performed to explore its association with clinicopathological factors and clinical outcome. Results The GST pi expression was greatly reduced in tissues of esophageal carcinomas compared to adjacent normal tissues and residual benign tissues. Absent of GST pi protein expression in cytoplasm, nuclear and cytoplasm/nucleus was found in 51%, 64.7% and 48% of all the carcinoma cases, respectively. GST pi deficiency in cytoplasm, nucleus and cytoplasm/nucleus was significantly correlated to poor differentiation (p < 0.001, p < 0.001 and p < 0.001, respectively). UICC stage and T stage were found significantly correlated to negative expression of GST pi in cytoplasm (p < 0.001 and p = 0.004, respectively) and cytoplasm/nucleus (p = 0.017 and p = 0.031, respectively). In univariate analysis, absent of GST pi protein expression in cytoplasm, nucleus and cytoplasm/nucleus was significantly associated with a shorter overall survival (p < 0.001, p < 0.001 and p < 0.001, respectively), whereas only GST pi cytoplasmic staining retained an independent prognostic significance (p < 0.001) in multivariate analysis. Conclusions Our results show that GST pi expression is down regulated in the squamous esophageal carcinoma, and that the lack of GST pi expression is associated with poor prognosis. Therefore, deficiency of GST pi protein expression may be an important mechanism involved in the carcinogenesis and progression of the squamous esophageal carcinoma, and the underlying mechanisms leading to decreased GST pi expression deserve further investigation.
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Ansary-Moghaddam A, Huxley RR, Lam TH, Woodward M. The risk of upper aero digestive tract cancer associated with smoking, with and without concurrent alcohol consumption. ACTA ACUST UNITED AC 2010; 76:392-403. [PMID: 19642154 DOI: 10.1002/msj.20125] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Smoking and alcohol are major causal factors for upper aerodigestive tract cancer, but reliable quantification of the combined impact of smoking and alcohol on this cancer and its major subtypes has not been performed. METHODS A meta-analysis of studies that had published quantitative estimates of smoking and upper aerodigestive tract cancer by January 2007 was performed. Pooled estimates of relative risks were obtained. Publication bias was investigated through funnel plots and corrected if found to be present. RESULTS Overall, 85 studies with information on 53,940 individuals with upper aerodigestive tract cancer were included. The pooled estimate for the association between smoking and the risk of this cancer was 3.47 (95% confidence interval, 3.06-3.92). The risk remained elevated for a decade after smoking cessation but declined thereafter. Individuals who both smoked and consumed alcohol had double the risk of upper aerodigestive tract cancer in comparison with those who only smoked: the relative risk was 6.93 (95% confidence interval, 4.99-9.62) for the former and 2.56 (95% confidence interval, 2.20-2.97) for the latter (P < 0.001). CONCLUSIONS Public health interventions that simultaneously discourage smoking and heavy drinking would have greater benefits than would be expected from those that target only one of these risk factors.
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Sitas F, O’Connell DL, Jamrozik K, Lopez AD. Smoking questions on the Australian death notification form: adopting international best practice? Med J Aust 2009; 191:166-8. [DOI: 10.5694/j.1326-5377.2009.tb02730.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Accepted: 05/31/2009] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Konrad Jamrozik
- School of Population Health and Clinical Practice, University of Adelaide, Adelaide, SA
| | - Alan D Lopez
- School of Population Health, University of Queensland, Brisbane, QLD
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Smoking and the risk of upper aero digestive tract cancers for men and women in the Asia-Pacific region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:1358-70. [PMID: 19440523 PMCID: PMC2681196 DOI: 10.3390/ijerph6041358] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Accepted: 04/01/2009] [Indexed: 11/16/2022]
Abstract
Although smoking is an established causal factor for upper aero digestive tract cancer (UADTC), most of the evidence originates from the West. Thus, we analysed data from 455,409 subjects in the Asia Pacific Cohort Studies Collaboration. Over a median of around six years follow-up, 371 deaths from UADTC were observed. The hazard ratio (95% confidence interval) for current smokers, compared with those who had never smoked, was 2.36 (1.76 – 3.16), adjusted for age and alcohol drinking. Tobacco control policies are urgently required in Asia to prevent millions of deaths from UADTC that smoking will otherwise cause.
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Jiang J, Liu B, Nasca PC, Chen J, Zeng X, Wu Y, Zou X, Zhao P, Li J. Age-related Effects of Smoking on Lung Cancer Mortality: A Nationwide Case-Control Comparison in 103 Population Centers in China. Ann Epidemiol 2008; 18:484-91. [DOI: 10.1016/j.annepidem.2008.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2007] [Revised: 01/21/2008] [Accepted: 01/22/2008] [Indexed: 11/27/2022]
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