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Baidya K, Devi YS, Rai HK, Devi ND, Sinam N, Kilari GLT. Clinicopathological profile and survival analysis of esophageal carcinoma: A retrospective study in a tertiary care hospital in Northeast India. J Cancer Res Ther 2023:01363817-990000000-00014. [PMID: 38102907 DOI: 10.4103/jcrt.jcrt_7_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 02/01/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Esophageal cancer (EC) is an extremely aggressive tumor with one of the highest geographic, ethnic, and gender variations. Various factors including tobacco consumption, unhealthy diet, and socioeconomic status have been implicated in the etiology of EC. Despite the advent of modern treatments, the prognosis of EC is dismal. This study has been undertaken to review the clinical and pathologic profiles, treatment approach, and survival pattern in patients with EC in a tertiary care hospital in northeast India. MATERIALS AND METHODS A retrospective descriptive study was done with 179 EC patients presented to our department between January 2013 and December 2020. Statistical analysis was done by using IBM Statistical Package for the Social Sciences version 21. P- value <0.05 was considered significant. RESULTS The majority of the patients presented in the sixth decade of life from rural areas with male to female ratio of 3.7:1. Dysphagia was the most common presenting feature. High incidence of tobacco and alcohol use was found. Mid-esophagus is the most common site and squamous cell carcinoma is the most common type. Fifty-two (29.1%) and 71 (39.6%) patients presented in stages III and IV, respectively. Twenty-four (13.4%) patients presented with metastatic disease, the lung being the most common site. Patients were treated with surgery, chemotherapy, radiotherapy, or combination of any of these. Overall median survival for the EC patients was 6 months. Patients treated with concurrent chemoradiation had better survival. CONCLUSION EC is a serious malignancy with a dismal prognosis due to the advanced stage at presentation. Larger clinical trials using new therapeutic strategies are the need of the hour.
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Affiliation(s)
- Kishalay Baidya
- Department of Radiation Oncology, RIMS, Imphal, Manipur, India
| | | | - Hari K Rai
- Department of Radiation Oncology, STNM Hospital, Gangtok, Sikkim, India
| | | | - Neeta Sinam
- Department of Radiation Oncology, RIMS, Imphal, Manipur, India
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Ghasemi-Kebria F, Semnani S, Fazel A, Etemadi A, Amiriani T, Naeimi-Tabiei M, Hasanpour-Heidari S, Salamat F, Jafari-Delouie N, Sedaghat S, Sadeghzadeh H, Akbari M, Mehrjerdian M, Weiderpass E, Roshandel G, Bray F, Malekzadeh R. Esophageal and gastric cancer incidence trends in Golestan, Iran: An age-period-cohort analysis 2004 to 2018. Int J Cancer 2023; 153:73-82. [PMID: 36943026 DOI: 10.1002/ijc.34518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023]
Abstract
Golestan province in the northeast of Iran is part of the Asian esophageal cancer belt and is known as a high-risk area for esophageal (EC) and gastric cancers (GC). Data on incident cases of EC and GC during 2004 to 2018 were obtained from the Golestan Population-based Cancer Registry (GPCR). The age-standardized incidence rates (ASRs) were calculated and presented per 100 000 person-years. The estimated annual percentage change (EAPC) with 95% confidence interval (95% CI) were calculated. We also fitted age-period-cohort (APC) models to assess nonlinear period and cohort effects as incidence rate ratios (IRRs). Overall, 3004 new cases of EC (ASR = 15.7) and 3553 cases of GC (ASR = 18.3) were registered in the GPCR. We found significant decreasing trends in incidence rates of EC (EAPC = -5.0; 95% CI: -7.8 to -2.2) and less marked nonsignificant trends for GC (EAPC = -1.4; 95% CI: -4.0 to 1.4) during 2004 to 2018. There was a strong cohort effect for EC with a consistent decrease in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924; IRR = 1.9 vs the reference birth cohort of 1947) through to the most recent cohort born in 1988 (IRR = 0.1). The marked declines in EC incidence rates in Golestan relate to generational changes in its underlying risk factors. Despite favorable trends, this population remains at high risk of both EC and GC. Further studies are warranted to measure the impact of the major risk factors on incidence with a view to designing effective preventative programs.
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Affiliation(s)
- Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolreza Fazel
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Taghi Amiriani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Susan Hasanpour-Heidari
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Faezeh Salamat
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nastaran Jafari-Delouie
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Hamideh Sadeghzadeh
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahnaz Akbari
- Deputy of Treatment, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahshid Mehrjerdian
- Department of Pathology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Sheikh M, Roshandel G, McCormack V, Malekzadeh R. Current Status and Future Prospects for Esophageal Cancer. Cancers (Basel) 2023; 15:765. [PMID: 36765722 PMCID: PMC9913274 DOI: 10.3390/cancers15030765] [Citation(s) in RCA: 52] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/10/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Esophageal cancer (EC) is the ninth most common cancer and the sixth leading cause of cancer deaths worldwide. Esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) are the two main histological subtypes with distinct epidemiological and clinical features. While the global incidence of ESCC is declining, the incidence of EAC is increasing in many countries. Decades of epidemiologic research have identified distinct environmental exposures for ESCC and EAC subtypes. Recent advances in understanding the genomic aspects of EC have advanced our understanding of EC causes and led to using specific genomic alterations in EC tumors as biomarkers for early diagnosis, treatment, and prognosis of this cancer. Nevertheless, the prognosis of EC is still poor, with a five-year survival rate of less than 20%. Currently, there are significant challenges for early detection and secondary prevention for both ESCC and EAC subtypes, but Cytosponge™ is shifting this position for EAC. Primary prevention remains the preferred strategy for reducing the global burden of EC. In this review, we will summarize recent advances, current status, and future prospects of the studies related to epidemiology, time trends, environmental risk factors, prevention, early diagnosis, and treatment for both EC subtypes.
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Affiliation(s)
- Mahdi Sheikh
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 69007 Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan 49341-74515, Iran
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 69007 Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 14117-13135, Iran
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Dalirsani Z, Delavarian Z, Pakfetrat A, Akbarzade Mahlabani F, Taherizadeh M, Ghazi A. Evaluation of Risk Factors in Patients with Head and Neck Cancer: A Case Control Study. ADDICTION & HEALTH 2023; 15:1-7. [PMID: 37560078 PMCID: PMC10408740 DOI: 10.34172/ahj.2023.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/08/2022] [Indexed: 08/11/2023]
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) is one of the most common types of cancer worldwide. Since there are many factors that influence the development of cancer, identifying risk factors plays an important role in cancer prevention. The aim of this study was therefore to identify the risk factors for HNSCC in Mashhad, Iran. METHODS In this case-control study, 76 patients with HNSCC were included as the case and 91 healthy people as the control group. A checklist of risk factors was completed for each participant and the two groups were compared for the presence of risk factors. Chi-square, t test, and Mann-Whitney tests were used to compare the data. Odds ratios (ORs) for several factors have also been determined. FINDINGS The educational level and body mass index (BMI) of the patients in the case group were significantly lower than in the control group (P<0.001). Moreover, there were significant differences between the two groups in terms of risk factors such as tobacco smoking, the number of cigarettes smoked per day, and its duration (P=0.001, P<0.001, P=0.05), as well as the duration of hookah smoking, opium consumed per day and use of alcohol (P=0.023, P<0.001, P=0.015). CONCLUSION There was a direct relationship between HNSCC and risk factors such as cigarette smoking, number of cigarettes smoked per day, duration of cigarette consumption and hookah, opium consumed per day, and alcohol use. However, extensive studies with larger sample sizes are needed to better assess the impact of these factors and generalize the results.
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Affiliation(s)
- Zohreh Dalirsani
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Professor, Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Delavarian
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Professor, Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atessa Pakfetrat
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Professor, Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mahboobeh Taherizadeh
- Master student in Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ala Ghazi
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Assistant Professor, Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Nemati S, Saeedi E, Lotfi F, Nahvijou A, Mohebbi E, Ravankhah Z, Rezaeianzadeh A, Yaghoobi-Ashrafi M, Pirnejad H, Golpazir A, Dolatkhah R, Alvand S, Ahmadi-Tabatabaei SV, Cheraghi M, Weiderpass E, Bray F, Coleman MP, Etemadi A, Khosravi A, Najafi F, Mohagheghi MA, Roshandel G, Malekzadeh R, Zendehdel K. National surveillance of cancer survival in Iran (IRANCANSURV): Analysis of data of 15 cancer sites from nine population-based cancer registries. Int J Cancer 2022; 151:2128-2135. [PMID: 35869869 DOI: 10.1002/ijc.34224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 03/25/2024]
Abstract
Cancer survival is a key indicator for the national cancer control programs. However, survival data in the East Mediterranean region (EMR) are limited. We designed a national cancer survival study based on population-based cancer registries (PBCRs) from nine provinces in Iran. The current study reports 5-year net survival of 15 cancers in Iranian adults (15-99 years) during 2014 to 2015 in nine provinces of Iran. We used data linkages between the cancer registries and the causes of death registry and vital statistics and active follow-up approaches to ascertain the vital status of the patients. Five-year net survival was estimated through the relative survival analysis. We applied the international cancer survival standard weights for age standardization. Five-year survival was highest for prostate cancer (74.9%, 95% CI 73.0, 76.8), followed by breast (74.4%, 95% CI 72.50, 76.3), bladder (70.4%, 95% CI 69.0, 71.8) and cervix (65.2%, 95% CI 60.5, 69.6). Survival was below 25% for cancers of the pancreas, lung, liver, stomach and esophagus. Iranian cancer patients experience a relatively poor prognosis as compared to those in high-income countries. Implementation of early detection programs and improving the quality of care are required to improve the cancer survival among Iranian patients. Further studies are needed to monitor the outcomes of cancer patients in Iran and other EMR countries.
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Affiliation(s)
- Saeed Nemati
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Saeedi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Biostatistics Research Group, Department of Health Science, University of Leicester, Leicester, UK
| | - Fereshte Lotfi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Mohebbi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ravankhah
- Esfahan Cancer Registry, Esfahan University of Medical Sciences, Esfahan, Iran
| | | | | | - Habbiballah Pirnejad
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Arash Golpazir
- Kermanshah Cancer Registry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Dolatkhah
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saba Alvand
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Maria Cheraghi
- Cancer Registry Section, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Freddie Bray
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Michel P Coleman
- Cancer Survival Group, Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ardeshir Khosravi
- Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Farid Najafi
- Department of Epidemiology and Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Ali Mohagheghi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Prevalence of esophageal squamous dysplasia in relatives of patients with esophageal cancer in Southwestern Kenya. Cancer Epidemiol 2022; 78:102141. [PMID: 35299153 DOI: 10.1016/j.canep.2022.102141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 02/19/2022] [Accepted: 03/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Esophageal squamous cell carcinoma (ESCC) and its asymptomatic precursor lesion, esophageal squamous dysplasia (ESD), are common in East Africa. It is unknown whether family history of esophageal cancer is a risk factor for both ESD and ESCC in Africa, and whether family members of affected persons should be screened. METHODS We recruited 296 asymptomatic adult first-degree relatives of ESCC patients residing in southwestern Kenya. Participants completed questionnaires and underwent endoscopy with Lugol's iodine staining and biopsy to determine the prevalence of ESD. Prevalence comparisons were made with a prior population-based cohort from the same catchment area who also underwent Lugol's chromoendoscopy. RESULTS Mean age was 40.7 years, compared to 62.7 years in the prior population study. The overall prevalence of ESD/ESCC among first-degree relatives was 14.7%, comparable to the background population prevalence of 14.4%, and this comparability remained even after adjusting for the different age distributions of the studies. Post-primary education was the only measured variable that was associated with a decreased risk of ESD/ESCC (adjusted OR=0.31, 95% CI: 0.11, 0.83). There was heterogeneity in the ESD prevalence across families, even after adjustments for varying age and other measured factors. CONCLUSIONS The prevalence of esophageal squamous dysplasia among first-degree relatives of persons with ESCC was similar to that of the background population of southwestern Kenya; however, there was heterogeneity in ESD prevalence between families, suggesting other genetic or environmental factors may influence family prevalence. Further study of families with a high prevalence of ESD or ESCC is justified.
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Yano Y, Etemadi A, Abnet CC. Microbiome and Cancers of the Esophagus: A Review. Microorganisms 2021; 9:1764. [PMID: 34442842 PMCID: PMC8398938 DOI: 10.3390/microorganisms9081764] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 01/04/2023] Open
Abstract
Esophageal cancer (EC) is an aggressive malignant disease ranking amongst the leading causes of cancer deaths in the world. The two main histologic subtypes, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), have distinct geographic and temporal patterns and risk factor profiles. Despite decades of research, the factors underlying these geo-temporal patterns are still not fully understood. The human microbiome has recently been implicated in various health conditions and disease, and it is possible that the microbiome may play an important role in the etiology of EC. Although studies of the microbiome and EC are still in their early stages, we review our current understanding of the potential links between ESCC, EAC, and bacterial communities in the oral cavity and esophagus. We also provide a summary of the epidemiology of EC and highlight some key challenges and future directions.
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Affiliation(s)
- Yukiko Yano
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (A.E.); (C.C.A.)
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Yano Y, Abnet CC, Poustchi H, Roshandel G, Pourshams A, Islami F, Khoshnia M, Amiriani T, Norouzi A, Kamangar F, Boffetta P, Brennan P, Dawsey SM, Vogtmann E, Malekzadeh R, Etemadi A. Oral Health and Risk of Upper Gastrointestinal Cancers in a Large Prospective Study from a High-risk Region: Golestan Cohort Study. Cancer Prev Res (Phila) 2021; 14:709-718. [PMID: 33731409 PMCID: PMC8295188 DOI: 10.1158/1940-6207.capr-20-0577] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/05/2021] [Accepted: 03/15/2021] [Indexed: 12/23/2022]
Abstract
Tooth loss and periodontal disease have been associated with several cancers, and poor oral health may be an important risk factor for upper gastrointestinal (UGI, i.e., esophageal and gastric) cancers. We assessed the relationship between oral health and UGI cancers using a large prospective study of over 50,000 adults living in Golestan Province, Iran, a high-incidence area for these cancers. Hazard ratios (HRs) and 95% confidence intervals (CI) were estimated for the association between three different measures of oral health [frequency of tooth brushing; number of missing teeth; and the sum of decayed, missing, and filled teeth (DMFT)] and UGI cancers. During a median follow-up duration of 13 years, there were 794 incident UGI cancers (396 esophageal and 398 gastric cancers). Daily tooth brushing was associated with a decreased risk of developing both esophageal (HR = 0.670; 95% CI: 0.486-0.924) and gastric (HR = 0.741; 95% CI: 0.544-1.01) cancers (combined UGI cancer HR = 0.697; 95% CI: 0.558-0.871) compared with never brushing. Tooth loss in excess of the loess smoothed, age- and sex-specific median number of teeth lost was significantly associated with esophageal (HR = 1.64; 95% CI: 1.08-2.47) and gastric cancers (HR = 1.58; 95% CI: 1.05-2.38). There were some adverse associations between DMFT and UGI cancers but most were not statistically significant. These results suggest increased risk of developing UGI cancers among individuals with poor oral health, and those who do not perform regular oral hygiene. PREVENTION RELEVANCE: Poor oral health is associated with the risk of upper gastrointestinal cancers, and oral hygiene practices may help prevent these cancers.
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Affiliation(s)
- Yukiko Yano
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland.
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Akram Pourshams
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Islami
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Data Science Program, American Cancer Society, Atlanta, Georgia
| | - Masoud Khoshnia
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Taghi Amiriani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alireza Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Emily Vogtmann
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Reza Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland.
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Mmbaga EJ, Mushi BP, Deardorff K, Mgisha W, Akoko LO, Paciorek A, Hiatt RA, Buckle GC, Mwaiselage J, Zhang L, Van Loon K. A Case–Control Study to Evaluate Environmental and Lifestyle Risk Factors for Esophageal Cancer in Tanzania. Cancer Epidemiol Biomarkers Prev 2020; 30:305-316. [DOI: 10.1158/1055-9965.epi-20-0660] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/03/2020] [Accepted: 10/22/2020] [Indexed: 12/24/2022] Open
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10
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Feng H, Song G, Ma S, Ma Q, Li X, Wei W, Abnet C, Qiao Y, Wang G. The optimal starting age of endoscopic screening for esophageal squamous cell cancer in high prevalence areas in China. J Gastroenterol Hepatol 2020; 35:1761-1768. [PMID: 32367575 PMCID: PMC8406667 DOI: 10.1111/jgh.15090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/25/2020] [Accepted: 04/24/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND AIM This study aimed to evaluate effects of endoscopic screening method in different starting age groups and further confirm the optimum starting age for esophageal squamous cell cancer (ESCC) screening. METHODS This study received institutional review board approval, and 6825 residents aged 40 to 69 years in high prevalence communities were assigned to the screening group or the control (non-screening) group from Hebei, China. Cumulative mortalities during the 14-year period, relative risk for participants who underwent screening, and numbers needed to invite for screening to save one life were compared between the screening group and the control group of different starting age groups at 14-year follow-up. RESULTS The 14-year risks of ESCC mortality were one in 55, one in 17, and one in 9 for a person screened in the starting age group of 40, 50, and 60 years old. The cumulative mortalities of ESCC in screening groups were significantly lower than control groups in starting age groups of 40 years (1.42% vs 2.38%, P = 0.033) and 50 years (4.18% vs 7.13%, P = 0.005). Relative risks for participants who underwent screening were 0.60 and 0.59 for the starting age groups of 40 and 50 years. Numbers needed to invite for screening to save one life were 104 and 34 for participants in 40 years old group and 50 years old group, respectively. CONCLUSIONS In conclusion, people in high prevalence area of ESCC should have endoscopy screening once at their 50 years. Forty years will be preferably defined as the starting age for screening in areas with sufficient health resources.
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Affiliation(s)
- Hao Feng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Department of Science and Technology Management, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | | | - Shanrui Ma
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Ma
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinqing Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenqiang Wei
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Christian Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Youlin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guoqing Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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11
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Alizadehasl A, Amin A, Maleki M, Noohi F, Ghavamzadeh A, Farrashi M. Cardio-oncology discipline: focus on the necessities in developing countries. ESC Heart Fail 2020; 7:2175-2183. [PMID: 32602665 PMCID: PMC7524122 DOI: 10.1002/ehf2.12838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/17/2020] [Accepted: 05/29/2020] [Indexed: 01/04/2023] Open
Abstract
Cardiovascular diseases constitute one of the main aetiologies of mortality among patients with cancer. Population ageing and cancer survival rate improvements have resulted in the coexistence of cardiovascular diseases and malignancies in an increasing number of patients. With the diversity in treatments and the introduction of new drug lines, multiple mechanisms of cardiovascular injury have been recognized in these patients. Cardio-oncology is an emerging entity introduced to provide a proper solution to the several challenges encountered in the management of patients with cancer and cardiac involvement. This review will assess the logical grounds for establishing a cardio-oncology unit, describe the main objectives and the detailed responsibilities in such systems, and outline the target population. Furthermore, the importance of research and appropriate data collection will be highlighted. Lastly, the special considerations and modifications required for setting up such centres in the developing countries are discussed.
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Affiliation(s)
- Azin Alizadehasl
- Cardio‐Oncology Research Center, Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran
| | - Ahmad Amin
- Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran
| | - Majid Maleki
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran
| | - Feridoun Noohi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran
| | - Ardeshir Ghavamzadeh
- Hematology, Oncology, and SCT Research CenterTehran University of Medical SciencesTehranIran
| | - Melody Farrashi
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran
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12
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Lu P, Gu J, Zhang N, Sun Y, Wang J. Risk factors for precancerous lesions of esophageal squamous cell carcinoma in high-risk areas of rural China: A population-based screening study. Medicine (Baltimore) 2020; 99:e21426. [PMID: 32756148 PMCID: PMC7402764 DOI: 10.1097/md.0000000000021426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Although many studies in China have found that environmental or lifestyle factors are major contributors to the etiology of esophageal cancer, most of the patients in the above studies are in the middle and late stages, the early-stage patients account for a small proportion. To clarify the risk/protective factors contributing to early lesions, we conducted the present cross-sectional study.A total of 2925 healthy controls and 402 patients with esophageal precancerous lesions were included in our study by endoscopic examination. Information on risk/protective factors was collected by personal interview, and unconditional logistic regression was used to determine adjusted odds ratios (AORs) by the maximum-likelihood method.Smoking >20 pack-years (AOR = 1.48), duration of drinking >30 years (AOR = 1.40), alcohol consumption >100 mL/d (AOR = 1.44), gastroesophageal reflux disease (AOR = 1.75), esophagitis (AOR = 1.25), a family history of esophageal cancer (AOR = 1.92), or stomach cancer (AOR = 1.92) were significant risk factors for esophageal precancerous lesions. There was a negative correlation between abdominal obesity and early esophageal cancer and precancerous lesions (AOR = 0.75). In addition, we found that there was a synergistic effect between a family history of esophageal cancer and drinking (AOR = 3.00) and smoking (AOR = 2.90).Lifestyle risk factors, genetic factors, and upper gastrointestinal diseases are associated with the development of esophageal precancerous lesions. These results highlight the need for primary prevention to reduce the future burden of cancer and other chronic diseases in high-risk areas of rural China.
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Affiliation(s)
- Peipei Lu
- School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan
| | - Jianhua Gu
- Office of National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer
- Department of Epidemiology Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Nan Zhang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan
| | - Yawen Sun
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan
| | - Jialin Wang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan
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13
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Roshandel G, Ferlay J, Semnani S, Fazel A, Naeimi-Tabiei M, Ashaari M, Amiriani T, Honarvar M, Sedaghat S, Hasanpour-Heidari S, Salamat F, Mansoury M, Ghasemi-Kebria F, Mirkarimi H, Jafari-Delouei N, Shokoohifar N, Vignat J, Weiderpass E, Malekzadeh R, Bray F. Recent cancer incidence trends and short-term predictions in Golestan, Iran 2004-2025. Cancer Epidemiol 2020; 67:101728. [PMID: 32554298 DOI: 10.1016/j.canep.2020.101728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND We examine recent trends in the major cancers occurring in the Golestan province, a high-risk region for upper gastrointestinal cancers in Northern Iran, and provide short-term cancer predictions of the future cancer burden. METHODS New cancer cases diagnosed in Golestan 2004-2016 were obtained from the Golestan population-based cancer registry (GPCR) database, and age-standardized rates by cancer site, year and sex calculated per 100,000 person-years. Using IARC's DepPred package we fitted time-linear age-period models to the available GPCR data to predict the cancer incidence burden in the year 2025. We calculated the contribution of demographic changes versus changes in risk to the overall changes in incidence from 2016 to 2025. RESULTS The number of new cancer cases (excluding non-melanoma skin cancers) in 2025 is predicted to increase by 61.3% from 2678 cases in 2016 to 4319 cases. While a 17.6% reduction in the number of esophageal cancer cases is predicted by 2025, the number of new cases for each of the remaining major cancers is predicted to increase over the next decade, including cancers of the stomach (a 36.1% increase from 2016 to 2025), colorectum (56.2%), lung (67.8%), female breast (93.2%), prostate (101.8%) and leukemia (96.1%). The changes in the population structure and risk contributed 37.8% and 23.5% respectively, to the overall increase in incidence. CONCLUSION Other than for the major upper gastrointestinal cancer types, the incidence rates of common cancers observed in the province are on the rise, reinforcing the need for continuous surveillance, as well as the design and implementation of effective cancer control programs.
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Affiliation(s)
- Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Jacques Ferlay
- Section for Cancer Surveillance, International Agency for Research in Cancer, Lyon, France
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolreza Fazel
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mohammad Ashaari
- Department of Pathology, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Taghi Amiriani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammadreza Honarvar
- Deputy of Research and Technology, Golestan University of Medical Sciences, Gorgan, Iran
| | - SeyedMehdi Sedaghat
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Susan Hasanpour-Heidari
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Faezeh Salamat
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohsen Mansoury
- Statistics and Information Technology Office, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Honeyehsadat Mirkarimi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nastaran Jafari-Delouei
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nesa Shokoohifar
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Jérôme Vignat
- Section for Cancer Surveillance, International Agency for Research in Cancer, Lyon, France
| | - Elisabete Weiderpass
- International Agency for Research in Cancer, World Health Organization, Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Freddie Bray
- Section for Cancer Surveillance, International Agency for Research in Cancer, Lyon, France.
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14
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Brown J, Stepien AJ, Willem P. Landscape of copy number aberrations in esophageal squamous cell carcinoma from a high endemic region of South Africa. BMC Cancer 2020; 20:281. [PMID: 32252688 PMCID: PMC7137242 DOI: 10.1186/s12885-020-06788-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 03/26/2020] [Indexed: 02/08/2023] Open
Abstract
Background Esophageal squamous cell carcinoma (ESCC) is an aggressive cancer with one of the highest world incidences in the Eastern Cape region of South Africa. Several genome wide studies have been performed on ESCC cohorts from Asian countries, North America, Malawi and other parts of the world but none have been conducted on ESCC tumors from South Africa to date, where the molecular pathology and etiology of this disease remains unclear. We report here tumor associated copy number changes observed in 51 ESCC patients’ samples from the Eastern Cape province of South Africa. Methods We extracted tumor DNA from 51 archived ESCC specimens and interrogated tumor associated DNA copy number changes using Affymetrix® 500 K SNP array technology. The Genomic Identification of Significant Targets in Cancer (GISTIC 2.0) algorithm was applied to identify significant focal regions of gains and losses. Gains of the top recurrent cancer genes were validated by fluorescence in situ hybridization and their protein expression assessed by immunohistochemistry. Results Twenty-three significant focal gains were identified across samples. Gains involving the CCND1, MYC, EGFR and JAG1 loci recapitulated those described in studies on Asian and Malawian cohorts. The two most significant gains involved the chromosomal sub-bands 3q28, encompassing the TPRG1 gene and 11q13.3 including the CTTN, PPFIA1and SHANK2 genes. There was no significant homozygous loss and the most recurrent hemizygous deletion involved the B3GAT1 gene on chromosome 11q25. Focal gains on 11q13.3 in 37% of cases (19/51), consistently involved CTTN and SHANK2 genes. Twelve of these cases (23,5%), had a broader region of gain that also included the CCND1, FGF19, FGF4 and FGF3 genes. SHANK2 and CTTN are co-amplified in several cancers, these proteins interact functionally together and are involved in cell motility. Immunohistochemistry confirmed both Shank2 (79%) and cortactin (69%) protein overexpression in samples with gains of these genes. In contrast, cyclin D1 (65%) was moderately expressed in samples with CCND1 DNA gain. Conclusions This study reports copy number changes in a South African ESCC cohort and highlights similarities and differences with cohorts from Asia and Malawi. Our results strongly suggest a role for CTTN and SHANK2 in the pathogenesis of ESCC in South Africa.
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Affiliation(s)
- Jacqueline Brown
- School of Pathology, Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg and the National Health Laboratory Services, Johannesburg, South Africa.
| | - Andrzej J Stepien
- Department of Anatomical Pathology, School of Medicine, Faculty of Health Science, Walter Sisulu University, National Health Laboratory Services/NMAH, Mthatha, South Africa
| | - Pascale Willem
- School of Pathology, Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg and the National Health Laboratory Services, Johannesburg, South Africa
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15
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Salamat F, Khandashpour M, Naeimi-Tabiei M, Ariannia A, Ashaari M, Sedaghat S, Ghasemi-Kebria F, Salamat F, Moghaddami A, Hasanpour-Heidari S, Hoseinpour R, Jafari-Delouei N, Ghayoriardahaei H, Gholami M, Fazel A, Roshandel G, Ferlay J, Weiderpass E. Increasing trends of lung cancer in Golestan province, Northern Iran (2004-2016). Cancer Epidemiol 2020; 65:101687. [PMID: 32087554 DOI: 10.1016/j.canep.2020.101687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/06/2020] [Accepted: 02/10/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION We aimed to present the time trends and geographical distribution of lung cancer in Golestan province, a high-risk area for pulmonary tuberculosis (TB) in Northern Iran (2004-2016). METHODS Data on incident primary lung cancers were obtained from the Golestan population-based cancer registry. The data were analyzed by CanReg-5 software to calculate the age-standardized incidence rates (ASRs). We used Joinpoint software for time trend analysis. Average annual percent changes were calculated. The contribution of population aging, population growth and risk to the overall changes in incidence of lung cancer were determined using partitioning analysis. RESULTS Overall, 1829 cases of lung cancer were registered by the GPCR during 2004-2016, of which 1274 (69.7%, ASR in 2016 = 21.3) were men and 555 (30.3%, ASR in 2016 = 11.4) were women. The results of Joinpoint regression suggested a significant increasing trend in incidence of lung cancer in Golestan province during 2004 and 2016 (AAPC = 3.74; p-value = 0.01) with more prominent increasing in rural population (AAPC = 4.93; p-value<0.01). The number of new cases of lung cancer increased by 131.6% (from 98 in 2004 to 227 in 2016), of which 34.1%, 22.3% and 75.3% were due to population size, population aging and risk, respectively. Hot points of lung cancer were found in western parts of the Golestan. CONCLUSION With high incidence rates and increasing trends of lung cancer, further studies are warranted to clarify the role of TB and other risk factors on its burden in this population.
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Affiliation(s)
- Faezeh Salamat
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahmoud Khandashpour
- Department of Internal medicine, Sayyad Shirazi hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Ali Ariannia
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Ashaari
- Department of Pathology, Sayyad Shirazi hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - SeyedMehdi Sedaghat
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Salamat
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abbas Moghaddami
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Susan Hasanpour-Heidari
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Reza Hoseinpour
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nastaran Jafari-Delouei
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hamid Ghayoriardahaei
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masoomeh Gholami
- Death registry unit, Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolreza Fazel
- Omid Cancer Research Center, Omid Preventive Medicine and Heath Promotion Center, Golestan University of Medical Sciences, Gorgan, Iran; Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran; Omid Cancer Research Center, Omid Preventive Medicine and Heath Promotion Center, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Jacques Ferlay
- Section for Cancer Surveillance, International Agency for Research in Cancer, Lyon, France
| | - Elisabete Weiderpass
- International Agency for Research in Cancer, World Health Organization, Lyon, France
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16
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Abstract
PURPOSE Even though Kurdistan, the western province of Iran, has a cancer surveillance system, a detailed analysis of incidence rate has not been yet performed. We describe Age Standardized Incidence Rates (ASRs) for esophageal cancer (EC) in Kurdistan Province of Iran in 2001-2015. METHODS Incidence cases of EC were obtained from a population-based cancer registry. We obtained ASRs and 95% confidence intervals (CI) per 100,000 populations for each calendar year group. RESULTS Between 2001 and 2015, 1362 incidence cases with EC were reported to the cancer registry. Annual ASRs in 2006-2010 were more than the other years in both men and women, respectively. Most ASRs were reported among women in Divandarreh (18.95, 95% CI 14.76, 23.92), Saqez (12.75, 95% CI 10.73, 15.01), Sanandaj (8.84, 95% CI 7.64, 10.17), and Qorveh (8.19, 95% CI 6.54, 10.12), and among men in Divandarreh (19.38, 95% CI 15.38, 24.06), Saqez (13.64, 95% CI 11.49, 16.05), Sanandaj (8.70, 95% CI 7.56, 9.96), and Marivan (7.93, 95% CI 6.26, 9.88). CONCLUSIONS It was concluded that EC in Divandarreh, Saqez, and Sanandaj has the highest ASRs, and these areas are considered as high-risk areas for this disease in the Iranian province of Kurdistan. Therefore, to understand the reasons of these problems, a considerable work is needed.
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17
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Islami F, Poustchi H, Pourshams A, Khoshnia M, Gharavi A, Kamangar F, Dawsey SM, Abnet CC, Brennan P, Sheikh M, Sotoudeh M, Nikmanesh A, Merat S, Etemadi A, Nasseri Moghaddam S, Pharoah PD, Ponder BA, Day NE, Jamal A, Boffetta P, Malekzadeh R. A prospective study of tea drinking temperature and risk of esophageal squamous cell carcinoma. Int J Cancer 2020; 146:18-25. [PMID: 30891750 PMCID: PMC7477845 DOI: 10.1002/ijc.32220] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/16/2019] [Accepted: 02/05/2019] [Indexed: 02/02/2023]
Abstract
Previous studies have reported an association between hot tea drinking and risk of esophageal cancer, but no study has examined this association using prospectively and objectively measured tea drinking temperature. We examined the association of tea drinking temperature, measured both objectively and subjectively at study baseline, with future risk of esophageal squamous cell carcinoma (ESCC) in a prospective study. We measured tea drinking temperature using validated methods and collected data on several other tea drinking habits and potential confounders of interest at baseline in the Golestan Cohort Study, a population-based prospective study of 50,045 individuals aged 40-75 years, established in 2004-2008 in northeastern Iran. Study participants were followed-up for a median duration of 10.1 years (505,865 person-years). During 2004-2017, 317 new cases of ESCC were identified. The objectively measured tea temperature (HR 1.41, 95% CI 1.10-1.81; for ≥60°C vs. <60°C), reported preference for very hot tea drinking (HR 2.41, 95% CI 1.27-4.56; for "very hot" vs. "cold/lukewarm"), and reported shorter time from pouring tea to drinking (HR 1.51, 95% CI 1.01-2.26; for <2 vs. ≥6 min) were all associated with ESCC risk. In analysis of the combined effects of measured temperature and amount, compared to those who drank less than 700 ml of tea/day at <60°C, drinking 700 mL/day or more at a higher-temperature (≥60°C) was consistently associated with an about 90% increase in ESCC risk. Our results substantially strengthen the existing evidence supporting an association between hot beverage drinking and ESCC.
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Affiliation(s)
- F. Islami
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States
| | - H. Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Khoshnia
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Gastroenterology Research Center, Golestan University of Medical Science, Gorgan, Iran
| | - A. Gharavi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Gastroenterology Research Center, Golestan University of Medical Science, Gorgan, Iran
| | - F. Kamangar
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, United States
| | - S. M. Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - C. C. Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - P. Brennan
- International Agency for Research on Cancer, Lyon, France
| | - M. Sheikh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- International Agency for Research on Cancer, Lyon, France
| | - M. Sotoudeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Nikmanesh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - S. Merat
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Etemadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - S. Nasseri Moghaddam
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - P. D. Pharoah
- Department of Oncology, Strangeways Research Laboratory, University of Cambridge, Worts Causeway, Cambridge, United Kingdom
| | - B. A. Ponder
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
| | - N. E. Day
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - A. Jamal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States
| | - P. Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - R. Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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18
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Najafi F. Tobacco Smoking and Alcohol Drinking: Two Clinically Significant Risk Factors for Esophageal Squamous Cell Carcinoma. Gastroenterology 2019; 157:897. [PMID: 31228440 DOI: 10.1053/j.gastro.2019.04.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/25/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Farid Najafi
- Research Center for Environmental Determinants of Health and Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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19
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Abbaszadegan MR, Keyvani V, Moghbeli M. Genetic and molecular bases of esophageal Cancer among Iranians: an update. Diagn Pathol 2019; 14:97. [PMID: 31470870 PMCID: PMC6717340 DOI: 10.1186/s13000-019-0875-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/22/2019] [Indexed: 12/12/2022] Open
Abstract
Abstract Background Esophageal cancer is one of the leading causes of cancer related deaths among the Iranians. There is still a high ratio of mortality and low 5 years survival which are related to the late onset and diagnosis. Majority of patients refer for the treatment in advanced stages of tumor progression. Main body It is required to define an efficient local panel of diagnostic and prognostic markers for the Iranians. Indeed such efficient specific panel of markers will pave the way to decrease the mortality rate and increase the 5 years survival among the Iranian patients via the early diagnosis and targeted therapy. Conclusion in present review we have reported all of the molecular markers in different signaling pathways and cellular processes which have been assessed among the Iranian esophageal cancer patients until now.
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Affiliation(s)
| | - Vahideh Keyvani
- Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Meysam Moghbeli
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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20
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Gerayllo S, Morowatisharifabad MA, Jouybari L, Amirbeigy MK, Fallahzadeh H. Prevention behaviours of oesophageal cancer: Protocol for a mixed-method study. J Adv Nurs 2019; 75:3768-3773. [PMID: 31441532 DOI: 10.1111/jan.14178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/14/2019] [Accepted: 08/07/2019] [Indexed: 11/28/2022]
Abstract
AIM The aim was to implement an educational programme for the family members of patients with oesophageal cancer on prevention behaviours in Golestan province, north of Iran. DESIGN In this mixed-method research, qualitative and quantitative studies will be conducted. METHODS This study will be carried out using an exploratory mixed-method design in Golestan province, north of Iran in 2018-2019. The research will include three consecutive phases. At first, a qualitative study will be carried out to determine the preventive behaviour and measures of oesophageal cancer. In this phase, the participants will be selected using the purposive sampling method. Later, semi-structured interviews will be conducted with the relatives of patients with oesophageal cancer to collect the necessary qualitative data. The second phase will include a literature review based on the information collected from the first phase. Later, a researcher-made questionnaire will be designed based on the extended parallel process model. Furthermore, a comprehensive programme will be proposed about self-care of the patients with oesophageal cancer. In the third phase, a quantitative quasi-experimental research will be conducted over two groups of participants to measure the effectiveness of this programme. This research was approved by the Ethics Committee of Yazd Shahid Sadoughi University of Medical Sciences, Iran in November 2017. DISCUSSION Educational interventions should be designed purposefully according to the needs of the target group to improve their self-care behaviours. We also expect that this research can improve the individuals' access to high-quality preventive behaviours with regard to oesophageal cancer. TRIAL REGISTRATION The project was registered on the Iranian Registry of Clinical Trials, (registration number: IRCT20180725040588N1, date registered: 2th October 2018).
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Affiliation(s)
- Sakineh Gerayllo
- Social Determinants of Health Research Center, Department of Health Education and Promotion, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Leila Jouybari
- Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Hossein Fallahzadeh
- Department of Biostatistics and Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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21
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Yuan Q, Jiang Y, Fan Y, Ma Y, Lei H, Su J. Fumonisin B 1 Induces Oxidative Stress and Breaks Barrier Functions in Pig Iliac Endothelium Cells. Toxins (Basel) 2019; 11:toxins11070387. [PMID: 31269688 PMCID: PMC6669581 DOI: 10.3390/toxins11070387] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 12/15/2022] Open
Abstract
Fumonisins (Fums) are types of mycotoxin that widely contaminante feed material crops, and can trigger potential biological toxicities to humans and various animals. However, the toxicity of Fums on porcine blood vessels has not been fully explored. Fumonisin B1 (FB1) is the main component of Fums. Therefore, the aim of this study was to explore the effects of FB1 on the oxidative stress and tight junctions of the pig iliac endothelial cells (PIECs) in vitro. The results showed that FB1 reduced the viability of PIECs, increased the contents of lipid peroxidation product malondialdehyde (MDA), decreased the activities of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT) and thioredoxin reductase (TrxR), and decreased the level of glutathione (GSH). In addition, the barrier functions were destroyed, along with the down-regulations on Claudin 1, Occludin and ZO-1 and the increase of paracellular permeability. Thus, this research indicates that FB1 facilitates oxidative stress and breaks barrier functions to damage pig iliac endothelium cells.
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Affiliation(s)
- Qiaoling Yuan
- Department of Basic Veterinary Medicine, College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China
| | - Yancheng Jiang
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China
| | - Ying Fan
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China
| | - Yingfeng Ma
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China
| | - Hongyu Lei
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China.
| | - Jianming Su
- Department of Basic Veterinary Medicine, College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China.
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22
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Danaei G, Farzadfar F, Kelishadi R, Rashidian A, Rouhani OM, Ahmadnia S, Ahmadvand A, Arabi M, Ardalan A, Arhami M, Azizi MH, Bahadori M, Baumgartner J, Beheshtian A, Djalalinia S, Doshmangir L, Haghdoost AA, Haghshenas R, Hosseinpoor AR, Islami F, Kamangar F, Khalili D, Madani K, Masoumi-Asl H, Mazyaki A, Mirchi A, Moradi E, Nayernouri T, Niemeier D, Omidvari AH, Peykari N, Pishgar F, Qorbani M, Rahimi K, Rahimi-Movaghar A, Tehrani FR, Rezaei N, Shahraz S, Takian A, Tootee A, Ezzati M, Jamshidi HR, Larijani B, Majdzadeh R, Malekzadeh R. Iran in transition. Lancet 2019; 393:1984-2005. [PMID: 31043324 DOI: 10.1016/s0140-6736(18)33197-0] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 11/20/2018] [Accepted: 12/06/2018] [Indexed: 01/19/2023]
Abstract
Being the second-largest country in the Middle East, Iran has a long history of civilisation during which several dynasties have been overthrown and established and health-related structures have been reorganised. Iran has had the replacement of traditional practices with modern medical treatments, emergence of multiple pioneer scientists and physicians with great contributions to the advancement of science, environmental and ecological changes in addition to large-scale natural disasters, epidemics of multiple communicable diseases, and the shift towards non-communicable diseases in recent decades. Given the lessons learnt from political instabilities in the past centuries and the approaches undertaken to overcome health challenges at the time, Iran has emerged as it is today. Iran is now a country with a population exceeding 80 million, mainly inhabiting urban regions, and has an increasing burden of non-communicable diseases, including cardiovascular diseases, hypertension, diabetes, malignancies, mental disorders, substance abuse, and road injuries.
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Affiliation(s)
- Goodarz Danaei
- Department of Global Health and Population and Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Scientific Association for Public Health in Iran, Boston, MA, USA
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Rashidian
- Endocrinology and Metabolism Clinical Sciences Institute, Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran; Department of Information, Evidence and Research, Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
| | - Omid M Rouhani
- Department of Civil Engineering and Applied Mechanics, McGill University, Montreal, QC, Canada
| | - Shirin Ahmadnia
- Faculty of Social Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Alireza Ahmadvand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mandana Arabi
- Scientific Association for Public Health in Iran, Boston, MA, USA; Global Alliance for Improving Nutrition, New York, NY, USA
| | - Ali Ardalan
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Harvard Humanitarian Initiative, Cambridge, MA, USA
| | - Mohammad Arhami
- Department of Civil Engineering, Sharif University of Technology, Tehran, Iran
| | | | - Moslem Bahadori
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jill Baumgartner
- Institute for Health and Social Policy, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Arash Beheshtian
- Cornell Program in Infrastructure Policy, Cornell University, Ithaca, NY, USA
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Deputy of Research and Technology, Tehran, Iran
| | - Leila Doshmangir
- Health Services Management Research Center, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Hosseinpoor
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Farin Kamangar
- Scientific Association for Public Health in Iran, Boston, MA, USA; Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - Davood Khalili
- Scientific Association for Public Health in Iran, Boston, MA, USA; Prevention of Metabolic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kaveh Madani
- Department of Physical Geography, Stockholm University, Stockholm, Sweden; Centre for Environmental Policy, Imperial College London, London, UK
| | - Hossein Masoumi-Asl
- Center for Communicable Diseases Control, Tehran, Iran; Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mazyaki
- Department of Economics, Allameh Tabataba'i University, Tehran, Iran; Institute for Management and Planning Studies, Tehran, Iran
| | - Ali Mirchi
- Department of Biosystems and Agricultural Engineering, Oklahoma State University, Stillwater, OK, USA
| | - Ehsan Moradi
- Department of Civil Engineering and Applied Mechanics, McGill University, Montreal, QC, Canada
| | - Touraj Nayernouri
- Department of Neuroscience, School of Advanced Medical Technologies, Tehran University of Medical Sciences, Tehran, Iran
| | - Debbie Niemeier
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - Amir-Houshang Omidvari
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Niloofar Peykari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Ministry of Health and Medical Education, Tehran, Iran
| | - Farhad Pishgar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Kazem Rahimi
- Scientific Association for Public Health in Iran, Boston, MA, USA; The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Shahraz
- Scientific Association for Public Health in Iran, Boston, MA, USA; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Amirhossein Takian
- Department of Global Health and Public Policy, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Tootee
- Diabetes Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Ezzati
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Hamid Reza Jamshidi
- Research Institute for Endocrine Sciences, School of Medicine, Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Reza Majdzadeh
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran; Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran; Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Non-Communicable Disease Research Center, Shiraz University of Medical Science, Shiraz, Iran
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23
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Chetwood JD, Garg P, Finch P, Gordon M. Systematic review: the etiology of esophageal squamous cell carcinoma in low-income settings. Expert Rev Gastroenterol Hepatol 2019; 13:71-88. [PMID: 30791842 DOI: 10.1080/17474124.2019.1543024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Esophageal carcinoma causes over 380 000 deaths per year, ranking sixth worldwide in mortality amongst all malignancies. Globally, the squamous cell subtype is most common and accounts for 80% of esophageal cancers. Nonetheless, esophageal squamous cell carcinoma is much more poorly understood than esophageal adenocarcinoma, including what is driving such high prevalences, why it often presents in young patients, and shows such marked geographical delineations Areas covered: The current literature was searched for articles focusing on aetiopathogenesis of squamous cell esophageal carcinoma via a systematic review, particularly in low-resource settings. This was supplemented by papers of interest known to the authors. Expert commentary: Current putative mechanisms include polycyclic aromatic hydrocarbons, nitrosamines, acetaldehyde, cyclo-oxygenase-2 pathways, androgen and their receptor levels, as well as smoking & alcohol, micronutrient deficiencies and diet, mycotoxins, thermal damage, oral hygiene and microbiotal factors, inhaled smoke, viral infections such as HPV, and chronic irritative states. Etiology is likely multifactorial and varies geographically. Though smoking and alcohol play a predominant role in high-income settings, there is strong evidence that mycotoxins, diet and temperature effects may play an under-recognized role in low and middle-income settings.
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Affiliation(s)
- John David Chetwood
- a Malawi Liverpool Wellcome Trust Clinical Research Programme , Blantyre , Malawi
| | - Priya Garg
- a Malawi Liverpool Wellcome Trust Clinical Research Programme , Blantyre , Malawi
| | | | - Melita Gordon
- a Malawi Liverpool Wellcome Trust Clinical Research Programme , Blantyre , Malawi.,b College of Medicine , Blantyre , Malawi.,c Institute of Infection and Global Health , University of Liverpool , Liverpool , UK
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24
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bay A, Ali S, Ghezelsofla M, Keramati H, Moradi B, Fakhri Y. Dataset on non-carcinogenic risk via nitrate and nitrite in the groundwater of Divandarreh County, Kurdistan province, Iran: A potential concern for drinking. Data Brief 2018; 20:1822-1828. [PMID: 30294630 PMCID: PMC6169444 DOI: 10.1016/j.dib.2018.09.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 12/15/2022] Open
Abstract
The presence of elevated nitrate (NO3-) and nitrite (NO2-) concentration in drinking water higher than the standard limits could endanger the health of consumers. For this data article, concentration of NO3- and NO2- was measured in 118 samples collected from 59 active rural wells in Divandarreh County and the non-carcinogenic risk in the adults and children was estimated by Monte Carlo simulation (MCS). The obtained data showed that the average concentration of NO3- and NO2- was ranges from 31.37 ± 18.87 mg/L and 1.45 ± 0.90 mg/L respectively. Based on acquired data, NO3- concentrations were 37 times higher than NO2- with significant p value of < 0.05. The average concentration of NO3- and NO2- was lower than the national standard with p value < 0.05. However, the concentration of NO3- and NO2- in 23.7% and 13.5% of wells was higher than the national standard of Iran. Total target hazard quotient (TTHQ) in the adults and children was 1.78 and 1.54, respectively. Although, the average concentration of NO3- and NO2- in drinking water was lower than the national standard limits, but the non-carcinogenic risk assessment showed that the children and adults are at a significant risk via nitrate and nitrite in the rural Divandarreh County (TTHQ > 1).
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Affiliation(s)
- Abotaleb bay
- Environmental Health Research Center, Golestan University of Medical Sciences, Golestan, Iran
| | - Shakir Ali
- Department of Geology, University of Delhi, 110007, India
| | - Mansoureh Ghezelsofla
- Master of Science in Environmental Science, Faculty of Science, Shahid Rajaee Teacher Training University, Tehran, Iran
| | - Hassan Keramati
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Bigard Moradi
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yadolah Fakhri
- Department of Environmental Health Engineering, School of Public Health, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding author.
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25
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Van Loon K, Mwachiro MM, Abnet CC, Akoko L, Assefa M, Burgert SL, Chasimpha S, Dzamalala C, Fleischer DE, Gopal S, Iyer PG, Kaimila B, Kayamba V, Kelly P, Leon ME, Mathew CG, Menya D, Middleton D, Mlombe Y, Mmbaga BT, Mmbaga E, Mulima G, Murphy G, Mushi B, Mwanga A, Mwasamwaja A, Parker MI, Pritchett N, Schüz J, Topazian MD, White RE, McCormack V, Dawsey SM. The African Esophageal Cancer Consortium: A Call to Action. J Glob Oncol 2018; 4:1-9. [PMID: 30241229 PMCID: PMC6223465 DOI: 10.1200/jgo.17.00163] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Esophageal cancer is the eighth most common cancer worldwide and the sixth most common cause of cancer-related death; however, worldwide incidence and mortality rates do not reflect the geographic variations in the occurrence of this disease. In recent years, increased attention has been focused on the high incidence of esophageal squamous cell carcinoma (ESCC) throughout the eastern corridor of Africa, extending from Ethiopia to South Africa. Nascent investigations are underway at a number of sites throughout the region in an effort to improve our understanding of the etiology behind the high incidence of ESCC in this region. In 2017, these sites established the African Esophageal Cancer Consortium. Here, we summarize the priorities of this newly established consortium: to implement coordinated multisite investigations into etiology and identify targets for primary prevention; to address the impact of the clinical burden of ESCC via capacity building and shared resources in treatment and palliative care; and to heighten awareness of ESCC among physicians, at-risk populations, policy makers, and funding agencies.
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Affiliation(s)
- Katherine Van Loon
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Michael M. Mwachiro
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Christian C. Abnet
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Larry Akoko
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Mathewos Assefa
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Stephen L. Burgert
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Steady Chasimpha
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Charles Dzamalala
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - David E. Fleischer
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Satish Gopal
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Prasad G. Iyer
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Bongani Kaimila
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Violet Kayamba
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Paul Kelly
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Maria E. Leon
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Christopher G. Mathew
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Diana Menya
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Daniel Middleton
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Yohannie Mlombe
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Blandina T. Mmbaga
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Elia Mmbaga
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Gift Mulima
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Gwen Murphy
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Beatrice Mushi
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Ally Mwanga
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Amos Mwasamwaja
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - M. Iqbal Parker
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Natalie Pritchett
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Joachim Schüz
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Mark D. Topazian
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Russell E. White
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Valerie McCormack
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
| | - Sanford M. Dawsey
- Katherine Van Loon, University of California, San Francisco, San Francisco, CA; Michael M. Mwachiro, Stephen L. Burgert, and Russell E. White, Tenwek Hospital, Bomet; Diana Menya, Moi University, Eldoret, Kenya; Christian C. Abnet, Gwen Murphy, Natalie Pritchett, and Sanford M. Dawsey, National Cancer Institute, Bethesda, MD; Larry Akoko, Elia Mmbaga, Beatrice Mushi, and Ally Mwanga, Muhimbili University of Health and Allied Sciences, Dar es Salaam; Blandina T. Mmbaga and Amos Mwasamwaja, Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Mathewos Assefa, Addis Ababa University, Addis Ababa, Ethiopia; Steady Chasimpha and Charles Dzamalala, Queen Elizabeth Central Hospital; Charles Dzamalala, Satish Gopal, Bongani Kaimila, and Yohannie Mlombe, University of Malawi College of Medicine, Blantyre; Gift Mulima, Kamuzu Central Hospital, Lilongwe, Malawi; David E. Fleischer, Mayo Clinic, Phoenix, AZ; Satish Gopal, University of North Carolina, Chapel Hill, NC; Prasad G. Iyer and Mark D. Topazian, Mayo Clinic, Rochester, MN; Violet Kayamba and Paul Kelly, University of Zambia, Lusaka, Zambia; Paul Kelly, Queen Mary University of London; Christopher G. Mathew, King’s College London, London, United Kingdom; Maria E. Leon, Daniel Middleton, Joachim Schüz, and Valerie McCormack, International Agency for Research on Cancer, Lyon, France; Christopher G. Mathew, University of the Witwatersrand, Johannesburg; and M. Iqbal Parker, University of Cape Town, Cape Town, South Africa
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Hashemian M, Murphy G, Etemadi A, Poustchi H, Sharafkhah M, Kamangar F, Pourshams A, Malekshah AF, Khoshnia M, Gharavi A, Hekmatdoost A, Brennan PJ, Boffetta P, Dawsey SM, Abnet CC, Malekzadeh R. Nut consumption and the risk of oesophageal squamous cell carcinoma in the Golestan Cohort Study. Br J Cancer 2018; 119:176-181. [PMID: 29950612 PMCID: PMC6048068 DOI: 10.1038/s41416-018-0148-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/21/2018] [Accepted: 05/23/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Nut consumption has been inversely associated with gastric cancer incidence in US-based studies, but not with oesophageal cancer. However, there is aetiologic heterogeneity, among oesophageal squamous cell carcinoma (ESCC) cases in low-risk vs. high-risk populations. The objective of this study was to evaluate the association between nut consumption and risk of ESCC in a high-risk population. METHODS The Golestan Cohort Study enroled 50,045 participants in Northeastern Iran, between 2004 and 2008. Intake of peanuts, walnuts and mixed nuts (including seeds) were assessed using a validated food frequency questionnaire at baseline. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals for subsequent ESCC adjusted for potential confounders. Non-consumers of nuts were used as the reference category and the consumers were categorised into tertiles. RESULTS We accrued 280 incident ESCC cases during 337,983 person-years of follow up. Individuals in the highest tertiles of total nut consumption, and mixed nut consumption were significantly associated with lower risk of developing ESCC compared to non-consumers (HR = 0.60, 95% CI = 0.39-0.93, p-trend = 0.02, and HR = 0.52, 95% CI = 0.32-0.84, p trend = 0.002, respectively). CONCLUSIONS We found a statistically significant inverse association between total nut consumption and the risk of ESCC in this high-risk population.
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Affiliation(s)
- Maryam Hashemian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Department of Nutrition and Biochemistry, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Gwen Murphy
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Arash Etemadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sharafkhah
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farin Kamangar
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- School of Computer, Mathematical, and Natural Sciences, Morgan State University, Morgan State University, Baltimore, MD, USA
| | - Akram Pourshams
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Fazeltabar Malekshah
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khoshnia
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolsamad Gharavi
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Paul J Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Tai WP, Nie GJ, Chen MJ, Yaz TY, Guli A, Wuxur A, Huang QQ, Lin ZG, Wu J. Hot food and beverage consumption and the risk of esophageal squamous cell carcinoma: A case-control study in a northwest area in China. Medicine (Baltimore) 2017; 96:e9325. [PMID: 29390400 PMCID: PMC5815812 DOI: 10.1097/md.0000000000009325] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This study was trying to investigate the association of hot food and beverage consumption and the risk of esophageal squamous cell carcinoma in Hotan, a northwest area of China with high risk of esophageal squmous cell carcinoma. METHODS A population-based case-control study was designed. For the study, 167 patients diagnosed with esophageal squamous cell carcinoma were selected from Hotan during 2014 to 2015, and 167 community-based controls were selected from the same area, matched with age and sex. Information involved of temperature of food and beverage intake was obtained by face-to-face interview. Logistic regression analyses were performed to investigate the association between temperature of food and beverage intake and the risk of esophageal squamous cell carcinoma. RESULTS The temperature of the food and beverage consumed by the esophageal squamous cell carcinoma patients was significantly higher than the controls. High temperature of tea, water, and food intake significantly increased the risk of esophageal squamous cell carcinoma by more than 2-fold, with adjusted odds ratio 2.23 (1.45-2.90), 2.13 (1.53-2.66), and 2.98 (1.89-4.12). CONCLUSIONS Intake of food and beverage with high temperature was positively associated with the incidence of esophageal squamous cell carcinoma in Northwestern China.
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Affiliation(s)
- Wei-Ping Tai
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing
- The Digestive Endoscopy Center, Hotan District People's Hospital, Xinjiang Autonomous Region, China
| | - Guo-Ji Nie
- The Digestive Endoscopy Center, Hotan District People's Hospital, Xinjiang Autonomous Region, China
| | - Meng-Jie Chen
- The Digestive Endoscopy Center, Hotan District People's Hospital, Xinjiang Autonomous Region, China
| | - Tajigul Yiminni Yaz
- The Digestive Endoscopy Center, Hotan District People's Hospital, Xinjiang Autonomous Region, China
| | - Arzi Guli
- The Digestive Endoscopy Center, Hotan District People's Hospital, Xinjiang Autonomous Region, China
| | - Arzigul Wuxur
- The Digestive Endoscopy Center, Hotan District People's Hospital, Xinjiang Autonomous Region, China
| | - Qing-Qing Huang
- The Digestive Endoscopy Center, Hotan District People's Hospital, Xinjiang Autonomous Region, China
| | - Zhi-Gang Lin
- The Digestive Endoscopy Center, Hotan District People's Hospital, Xinjiang Autonomous Region, China
| | - Jing Wu
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing
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Hashemian M, Murphy G, Etemadi A, Poustchi H, Brockman JD, Kamangar F, Pourshams A, Khoshnia M, Gharavi A, Dawsey SM, Brennan PJ, Boffetta P, Hekmatdoost A, Malekzadeh R, Abnet CC. Toenail mineral concentration and risk of esophageal squamous cell carcinoma, results from the Golestan Cohort Study. Cancer Med 2017; 6:3052-3059. [PMID: 29125237 PMCID: PMC5727321 DOI: 10.1002/cam4.1247] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/13/2017] [Accepted: 10/05/2017] [Indexed: 12/18/2022] Open
Abstract
Studies conducted in China linked selenium deficiency to higher risk of esophageal squamous cell carcinoma (ESCC), but this has not been widely tested outside that selenium-deficient region. The aim of this study was to investigate the association between selenium and other mineral concentrations in toenails and risk of ESCC in a region with high incidence rates. In this nested case-control study, we identified 222 cases of ESCC from the Golestan Cohort Study, Iran, which has followed up 50,045 participants since enrollment (2004-2008). We randomly selected one control for each case matched by age and sex, using incidence density sampling. We used toenail samples collected at baseline to measure the concentration of selenium, zinc, chromium, mercury, and scandium using instrumental neutron activation analysis. Multivariate adjusted logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals. Median nail selenium, zinc, chromium, and mercury levels were 1.01, 74.59, 0.77, and 0.018 μg/g in cases and 1.02, 75.71, 0.71, and 0.023 μg/g in controls, respectively. The adjusted odds ratios comparing each fourth quartile of mineral status versus the first quartile were as follows: selenium = 0.78 (95% CI, 0.41-1.49); zinc=0.80 (95% CI, 0.42-1.53); chromium = 0.91 (95% CI, 0.46-1.80); and mercury=0.61 (95% CI, 0.27-1.38), and all trend tests were non-significant. The nail selenium concentration in our controls reflects relatively high selenium status. No evidence of association between selenium or chromium concentrations in toenails and the risk of ESCC was detected in this population.
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Affiliation(s)
- Maryam Hashemian
- Digestive Oncology Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
- Metabolic Epidemiology BranchDivision of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMaryland
- Departments of Nutrition and BiochemistryFaculty of MedicineSabzevar University of Medical SciencesSabzevarIran
| | - Gwen Murphy
- Metabolic Epidemiology BranchDivision of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMaryland
| | - Arash Etemadi
- Digestive Oncology Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
- Metabolic Epidemiology BranchDivision of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMaryland
| | - Hossein Poustchi
- Digestive Oncology Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
- Liver and Pancreatobiliary Diseases Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
| | - John D. Brockman
- Research Reactor CentreUniversity of Missouri‐ColumbiaColumbiaMissouri
| | - Farin Kamangar
- Digestive Disease Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
- School of Computer, Mathematical, and Natural SciencesMorgan State UniversityMorgan State UniversityBaltimoreMaryland
| | - Akram Pourshams
- Liver and Pancreatobiliary Diseases Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
| | - Masoud Khoshnia
- Digestive Disease Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
- Golestan Research Center of Gastroenterology and HepatologyGolestan University of Medical SciencesGorganIran
| | - Abdolsamad Gharavi
- Digestive Disease Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
- Golestan Research Center of Gastroenterology and HepatologyGolestan University of Medical SciencesGorganIran
| | - Sanford M. Dawsey
- Metabolic Epidemiology BranchDivision of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMaryland
| | | | - Paolo. Boffetta
- Tisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew YorkNew York
| | - Azita Hekmatdoost
- Departments of Clinical Nutrition and DieteticsFaculty of Nutrition and Food TechnologyNational Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran
| | - Reza Malekzadeh
- Digestive Oncology Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
- Digestive Disease Research CenterDigestive Diseases Research InstituteTehran University of Medical SciencesTehranIran
| | - Christian C. Abnet
- Metabolic Epidemiology BranchDivision of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMaryland
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Protective Effect of Dietary Calcium Intake on Esophageal Cancer Risk: A Meta-Analysis of Observational Studies. Nutrients 2017; 9:nu9050510. [PMID: 28524093 PMCID: PMC5452240 DOI: 10.3390/nu9050510] [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: 03/15/2017] [Revised: 04/27/2017] [Accepted: 05/10/2017] [Indexed: 12/12/2022] Open
Abstract
Although several epidemiological studies have investigated the association between dietary calcium intake and the risk of esophageal cancer, the results are inconsistent. This study aimed to make a comprehensive evaluation regarding the association between calcium intake and risk of esophageal cancer through a meta-analysis approach. We searched for all relevant articles from the inception to April 2017, using PUBMED, EMBASE, and Web of Knowledge. The pooled odds ratio (ORs) with the 95% confidence interval (95% CI) for the highest versus the lowest categories of calcium intake was calculated using a Mantel–Haenszel fixed-effect model. In total, 15 articles reporting 17 studies including 3396 esophageal cancer cases and 346,815 controls were selected for the meta-analysis. By comparing the highest vs. the lowest levels of dietary calcium intake, we found that dietary calcium intake was inversely associated with the risk of esophageal cancer (OR = 0.80, 95% CI: 0.71–0.91, I2 = 33.6%). The subgroup analysis indicated that the protective function of dietary calcium intake were observed in esophageal squamous cell cancer, but not in esophageal adenocarcinoma in the studies conducted in Asia, but not those in Europe and America. In conclusion, our results suggest that higher dietary calcium intake is associated with a lower risk of esophageal cancer—especially esophageal squamous cell cancer—in Asian populations, though more data from prospective cohort studies are needed.
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30
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Mmbaga EJ, Deardorff KV, Mushi B, Mgisha W, Merritt M, Hiatt RA, Mwaiselage J, Zhang L, Van Loon K. Characteristics of Esophageal Cancer Cases in Tanzania. J Glob Oncol 2017; 4:1-10. [PMID: 30241222 PMCID: PMC6180793 DOI: 10.1200/jgo.2016.006619] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Age-standardized incidence rates for esophageal cancer (EC) in East Africa
have been reported as disproportionately high compared with the worldwide
incidence of nine per 100,000 population. This study aimed to characterize
EC cases seen at Muhimbili National Hospital and Ocean Road Cancer Institute
in Dar es Salaam, Tanzania. Methods Demographic, clinical, and treatment variables were abstracted from charts of
patients who received care for a diagnosis of EC at one or both institutions
between 2011 and 2013. Categorical data were summarized as frequency counts
and percentages. Continuous data were presented as medians and ranges. To
compare men and women, Pearson’s χ2 and two-sample
t tests were applied. Results Seven hundred thirty-eight unique cases of EC were identified, of whom 68%
were men and the median age was 60 years (range, 19 to 95 years). Notably,
93 cases (13%) were ≤ 40 years old at diagnosis. Squamous cell
carcinoma was the dominant histology, comprising 90% of cases with
documented histopathology. However, 34% of cases with a diagnosis of EC were
not pathologically confirmed. The stage was documented as locoregional in 4%
of cases, locally advanced in 20% of cases, metastatic in 14% of cases, and
unknown in 63% of cases. Of 430 patients who received treatment at Ocean
Road Cancer Institute, 76% were treated with radiation, 44% were treated
with chemotherapy, 3% underwent a cancer-related surgical procedure, and 10%
of cases received no cancer-directed therapy. The median overall survival
for all patients was 6.9 months (95% CI, 5.0 to 12.8), regardless of stage
at presentation. Conclusion Between 2011 and 2013, cases of EC represented a large clinical burden at
both institutions.
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Affiliation(s)
- Elia J Mmbaga
- Elia J. Mmbaga, Beatrice Mushi, and William Mgisha, Muhimbili University of Health and Allied Sciences; Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania; Katrina V. Deardorff, Megan Merritt, Robert A. Hiatt, Li Zhang, and Katherine Van Loon, University of California, San Francisco, San Francisco, CA
| | - Katrina V Deardorff
- Elia J. Mmbaga, Beatrice Mushi, and William Mgisha, Muhimbili University of Health and Allied Sciences; Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania; Katrina V. Deardorff, Megan Merritt, Robert A. Hiatt, Li Zhang, and Katherine Van Loon, University of California, San Francisco, San Francisco, CA
| | - Beatrice Mushi
- Elia J. Mmbaga, Beatrice Mushi, and William Mgisha, Muhimbili University of Health and Allied Sciences; Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania; Katrina V. Deardorff, Megan Merritt, Robert A. Hiatt, Li Zhang, and Katherine Van Loon, University of California, San Francisco, San Francisco, CA
| | - William Mgisha
- Elia J. Mmbaga, Beatrice Mushi, and William Mgisha, Muhimbili University of Health and Allied Sciences; Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania; Katrina V. Deardorff, Megan Merritt, Robert A. Hiatt, Li Zhang, and Katherine Van Loon, University of California, San Francisco, San Francisco, CA
| | - Megan Merritt
- Elia J. Mmbaga, Beatrice Mushi, and William Mgisha, Muhimbili University of Health and Allied Sciences; Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania; Katrina V. Deardorff, Megan Merritt, Robert A. Hiatt, Li Zhang, and Katherine Van Loon, University of California, San Francisco, San Francisco, CA
| | - Robert A Hiatt
- Elia J. Mmbaga, Beatrice Mushi, and William Mgisha, Muhimbili University of Health and Allied Sciences; Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania; Katrina V. Deardorff, Megan Merritt, Robert A. Hiatt, Li Zhang, and Katherine Van Loon, University of California, San Francisco, San Francisco, CA
| | - Julius Mwaiselage
- Elia J. Mmbaga, Beatrice Mushi, and William Mgisha, Muhimbili University of Health and Allied Sciences; Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania; Katrina V. Deardorff, Megan Merritt, Robert A. Hiatt, Li Zhang, and Katherine Van Loon, University of California, San Francisco, San Francisco, CA
| | - Li Zhang
- Elia J. Mmbaga, Beatrice Mushi, and William Mgisha, Muhimbili University of Health and Allied Sciences; Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania; Katrina V. Deardorff, Megan Merritt, Robert A. Hiatt, Li Zhang, and Katherine Van Loon, University of California, San Francisco, San Francisco, CA
| | - Katherine Van Loon
- Elia J. Mmbaga, Beatrice Mushi, and William Mgisha, Muhimbili University of Health and Allied Sciences; Julius Mwaiselage, Ocean Road Cancer Institute, Dar es Salaam, Tanzania; Katrina V. Deardorff, Megan Merritt, Robert A. Hiatt, Li Zhang, and Katherine Van Loon, University of California, San Francisco, San Francisco, CA
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Gholipour M, Islami F, Roshandel G, Khoshnia M, Badakhshan A, Moradi A, Malekzadeh R. Esophageal Cancer in Golestan Province, Iran: A Review of Genetic Susceptibility and Environmental Risk Factors. Middle East J Dig Dis 2016; 8:249-266. [PMID: 27957288 PMCID: PMC5145292 DOI: 10.15171/mejdd.2016.34] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 10/15/2016] [Indexed: 12/12/2022] Open
Abstract
Esophageal squamous cell carcinoma (ESCC) is an aggressive tumor that is typically diagnosed only when the tumor has gained remarkable size, extended to peripheral tissues, and led to dysphagia. Five-year survival of advanced cancer is still very poor (19%), even with improved surgical techniques and adjuvant chemoradiation therapy. Therefore, early detection and prevention are the most important strategies to reduce the burden of ESCC. Our review will focus on the studies conducted in Golestan province, an area with a high prevalence of ESCC in northern Iran. We review three aspects of the research literature on ESCC: epidemiological features, environmental factors (including substance abuse, environmental contaminants, dietary factors, and human papillomavirus [HPV]), and molecular factors (including oncogenes, tumor suppressor genes, cell cycle regulatory proteins, and other relevant biomarkers). Epidemiological and experimental data suggest that some chemicals and lifestyle factors, including polycyclic aromatic hydrocarbons (PAHs), cigarette smoking, opium use, and hot tea drinking are associated with the development of ESCC in Golestan. HPV infects the esophageal epithelium, but so far, no firm evidence of its involvement in esophageal carcinogenesis has been provided. Some of these factors, notably hot tea drinking, may render the esophageal mucosa more susceptible to injury by other carcinogens. There are few studies at molecular level on ESCC in Golestan. Increasing awareness about the known risk factors of ESCC could potentially reduce the burden of ESCC in the region. Further studies on risk factors, identifying high risk populations, and early detection are needed.
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Affiliation(s)
- Mahin Gholipour
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Farhad Islami
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
- The Tisch Cancer Institute and Institute for Transitional Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masoud Khoshnia
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abbas Badakhshan
- Health Care Management Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolvahab Moradi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Di Pardo BJ, Bronson NW, Diggs BS, Thomas CR, Hunter JG, Dolan JP. The Global Burden of Esophageal Cancer: A Disability-Adjusted Life-Year Approach. World J Surg 2016; 40:395-401. [PMID: 26630937 DOI: 10.1007/s00268-015-3356-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Esophageal cancer is the eighth most common cancer worldwide and the sixth leading cause of cancer-related deaths. As a significant cause of morbidity and mortality, its burden on society has yet to be fully characterized. The aim of this study is to examine its global burden through estimation of the disability-adjusted life years (DALYs) attributable to it. METHODS Global incidence and mortality estimates for esophageal cancer were obtained from the International Agency for Research on Cancer GLOBOCAN 2008 database. DALYs were calculated, using methodology established by the World Health Organization. RESULTS In 2008, 3,955,919 DALYs were attributed to esophageal cancer, at a global rate of 0.58 DALYs per 1000 people annually. Years of life lost (YLL) accounted for 96.8 % of DALYs, while years lived with disability (YLD) accounted for 3.2 %. 83.8 % of the global DALYs occurred in less-developed countries, with most accrued in Eastern Asia, comprising 50.9 % of the total. The highest rate of DALY accrual was in Southern Africa, at 1.62 DALYs per 1000 people annually. CONCLUSIONS A substantial number of years of life were lost or affected by esophageal cancer worldwide in 2008, with the burden resting disproportionately on less-developed countries. Geographically, the greatest burden is in Eastern Asia. The vast majority of DALYs were due to YLL, rather than YLD, indicating the need to focus resources on disease prevention and early detection. Our findings provide an additional basis upon which to formulate global priorities for interventions that affect DALY reduction in esophageal cancer.
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Affiliation(s)
- Benjamin J Di Pardo
- Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA
| | - Nathan W Bronson
- Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA
| | - Brian S Diggs
- Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA
| | - Charles R Thomas
- Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - John G Hunter
- Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA
| | - James P Dolan
- Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA.
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33
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Golalipour G, Semnani S, Safaie B, Rajaie S, Sedaghat SM, Kamalinia HR, Aarabi M, Roshandel G. Predictors of survival in oesophageal cancer patients in a high-risk area in Northern Iran: the role of health services utilisation. Eur J Cancer Care (Engl) 2016; 26. [PMID: 27430738 DOI: 10.1111/ecc.12549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/27/2022]
Abstract
We aimed to determine predictors of survival in oesophageal cancer (EC) patients in a high-risk area. This study was conducted on EC patients diagnosed in 2007-2008 in Golestan province, Iran. Diagnostic (DU) and Therapeutic (TU) services utilisation indices were determined. DU and TU indices of 1 were considered as good utilisation. EC-specific survival rates were calculated. Multivariate Cox-regression model was used to calculate adjusted hazard ratios (AHRs). Two hundred and twenty-three EC subjects were enrolled. The median survival time was 10.47 months and the 5-year survival rate was 11%. Cox-regression analysis suggested that stage of tumour (AHRregional = 3.75, 95% confidence interval [CI]: 2.34-6.00; AHRmetastasis = 12.21, 95% CI: 7.42-20.08) and TU (AHR = 1.78, 95% CI: 1.25-2.52) were the strongest variables related to EC survival. The median survival time in patients with good and poor TU were 14.37 and 8.53 months respectively (p < .01). There was no significant relationship between DU and EC survival. We found relatively low survival rates in our EC patients when compared with developed countries. Our results also suggested an increasing trend for EC survival rate during recent years. Good TU could predict higher survival rates. Patients' access to therapeutic services may be considered as an important indicator in decision-making for controlling EC.
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Affiliation(s)
- G Golalipour
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - S Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - B Safaie
- Department of Pathology, Golestan University of Medical Sciences, Gorgan, Iran
| | - S Rajaie
- Department of Surgery, Golestan University of Medical Sciences, Gorgan, Iran
| | - S M Sedaghat
- Department of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - H R Kamalinia
- Department of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - M Aarabi
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - G Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
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34
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Doucet-O'Hare TT, Sharma R, Rodić N, Anders RA, Burns KH, Kazazian HH. Somatically Acquired LINE-1 Insertions in Normal Esophagus Undergo Clonal Expansion in Esophageal Squamous Cell Carcinoma. Hum Mutat 2016; 37:942-54. [PMID: 27319353 DOI: 10.1002/humu.23027] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/01/2016] [Indexed: 12/16/2022]
Abstract
Squamous cell carcinoma of the esophagus (SCC) is the most common form of esophageal cancer in the world and is typically diagnosed at an advanced stage when successful treatment is challenging. Understanding the mutational profile of this cancer may identify new treatment strategies. Because somatic retrotransposition has been shown in tumors of the gastrointestinal system, we focused on LINE-1 (L1) mobilization as a source of genetic instability in this cancer. We hypothesized that retrotransposition is ongoing in SCC patients. The expression of L1 encoded proteins is necessary for retrotransposition to occur; therefore, we evaluated the expression of L1 open reading frame 1 protein (ORF1p). Using immunohistochemistry, we detected ORF1p expression in all four SCC cases evaluated. Using L1-seq, we identified and validated 74 somatic insertions in eight tumors of the nine evaluated. Of these, 12 insertions appeared to be somatic, not genetically inherited, and sub-clonal (i.e., present in less than one copy per genome equivalent) in the adjacent normal esophagus (NE), while clonal in the tumor. Our results indicate that L1 retrotransposition is active in SCC of the esophagus and that insertion events are present in histologically NE that expands clonally in the subsequent tumor.
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Affiliation(s)
- Tara T Doucet-O'Hare
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Predoctoral Training Program in Human Genetics, McKusick-Nathans Institute of Genetic Medicine, Baltimore, Maryland.,National Institutes of Health: National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Reema Sharma
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nemanja Rodić
- Dermatology Department, Yale School of Medicine, New Haven, Connecticut
| | - Robert A Anders
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kathleen H Burns
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Haig H Kazazian
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Cao W, Han J, Yuan Y, Xu Z, Yang S, He W. Drinking water: a risk factor for high incidence of esophageal cancer in Anyang, China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2016; 38:773-782. [PMID: 26399884 DOI: 10.1007/s10653-015-9760-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 08/12/2015] [Indexed: 06/05/2023]
Abstract
Anyang is known to be a high-incidence area of esophageal cancer (EC) in China. Among a long list of risk factors, the quality of drinking water was evaluated. We have selected 3806 individuals and collected 550 drinking water samples correspondent with this not-matched case-control survey. There are 531 EC patients included based on Population Cancer Registry from 92 townships, of which 3275 controls with long-lived aged over 90 years and free from EC are used as controls in the same regions. Our result suggests that the quality of drinking water is a highly associated risk factor for EC. The residential ecological environment and the quality of water resource positively link with each other. The analysis of water samples also demonstrated that the concentrations of methyl ethylamine, morpholine, N-methylbenzylamine, nitrate and chloride in water from springs and rivers are higher than those in well and tap water (P = 0.001). Micronuclei formation tests show that well water and tap water in these regions have no mutagenicity.
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Affiliation(s)
- Wenbo Cao
- Basic Medicine College, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Jianying Han
- Anyang Center for Disease Control and Prevention (CDC), Anyang, 455000, Henan, China.
| | - Yi Yuan
- Basic Medicine College, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Zhixiang Xu
- Basic Medicine College, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Shengli Yang
- Basic Medicine College, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Weixin He
- Anyang Center for Disease Control and Prevention (CDC), Anyang, 455000, Henan, China
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36
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Golozar A, Etemadi A, Kamangar F, Malekshah AF, Islami F, Nasrollahzadeh D, Abedi-Ardekani B, Khosnia M, Pourshams A, Semnani S, Marjani HA, Shakeri R, Sotoudeh M, Brennan P, Taylor P, Boffetta P, Abnet C, Dawsey S, Malekzadeh R. Food preparation methods, drinking water source, and esophageal squamous cell carcinoma in the high-risk area of Golestan, Northeast Iran. Eur J Cancer Prev 2016; 25:123-9. [PMID: 25851181 PMCID: PMC5759050 DOI: 10.1097/cej.0000000000000156] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cooking practices and water sources have been associated with an increased risk of cancer, mainly through exposure to carcinogens such as heterocyclic amines, polycyclic aromatic hydrocarbons, and nitrates. Using data from the Golestan case-control study, carried out between 2003 and 2007 in a high-risk region for esophageal squamous cell carcinoma (ESCC), we sought to investigate the association between food preparation and drinking water sources and ESCC. Information on food preparation methods, sources of drinking water, and dietary habits was gathered from 300 cases and 571 controls matched individually for age, sex, and neighborhood using a structured questionnaire and a semiquantitative food frequency questionnaire. Multivariate conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for potential confounders and other known risk factors including socioeconomic status and smoking. More than 95% of the participants reported eating meat, mostly red meat. Red meat consumption above the 75th percentile increased the odds of ESCC by 2.82-fold (95% CI: 1.21-6.57). Fish intake was associated with a significant 68% decrease in ESCC odds (26%, 86%). Among meat eaters, ORs (95% CI) for frying meat (red or white) and fish were 3.34 (1.32-8.45) and 2.62 (1.24-5.5). Drinking unpiped water increased ESCC odds by 4.25 times (2.23-8.11). The OR for each 10-year increase in the duration of drinking unpiped water was 1.47 (1.22-1.78). Our results suggest roles for red meat intake, drinking water source, and food preparation methods in ESCC, even after adjusting for a large number of potential confounders.
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Affiliation(s)
- Asieh Golozar
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Arash Etemadi
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Farin Kamangar
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
| | - Akbar Fazeltabar Malekshah
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Islami
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- The Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, USA
| | - Dariush Nasrollahzadeh
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Medical epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Behnoosh Abedi-Ardekani
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- International Agency for Research on Cancer, Lyon, France
| | - Masoud Khosnia
- Golestan Research Center of Gastroenterology and Hepatology, Gorgan University of Medical Sciences, Gorgan, Iran
| | - Akram Pourshams
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Gorgan University of Medical Sciences, Gorgan, Iran
| | - Haji Amin Marjani
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Gorgan University of Medical Sciences, Gorgan, Iran
| | - Ramin Shakeri
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Sotoudeh
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Philip Taylor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, USA
- International Prevention Research Institute, Lyon, France
| | - Christian Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Sanford Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Reza Malekzadeh
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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37
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Yang CS, Chen X, Tu S. Etiology and Prevention of Esophageal Cancer. Gastrointest Tumors 2016; 3:3-16. [PMID: 27722152 DOI: 10.1159/000443155] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 12/07/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Esophageal cancer (EC) occurs commonly, especially in Asia, and is the sixth leading cause of cancer deaths worldwide. Recently, great progress has been made in research on the etiology and prevention of EC. SUMMARY The major risk factors for esophageal squamous cell carcinoma (ESCC) are tobacco smoking and alcohol drinking, which act synergistically. Dietary parameters, including dietary carcinogens and insufficiency of micronutrients, could also be important risk factors in certain areas. A common etiological factor for both EC and some other cancers are low levels of intake of fruits and vegetables. With improvements in diet and drinking water in developing countries, the incidence of ESCC decreased. However, in economically well-developed countries, the incidence of esophageal adenocarcinoma (EAC) has markedly increased in the past 40 years. The major etiological factor for EAC is gastroesophageal reflux, which is also an etiological factor for gastric cardia adenocarcinoma (GCA). In certain areas of China, the occurrence of GCA is closely related to ESCC. Susceptibility genes for EC are starting to be discovered, and this may help to identify high-risk groups that have more need for preventive measures. Mitigation of the risk factors, early detection and treatment of precancerous lesions are effective approaches for prevention. Smoking cessation, avoidance of excessive alcohol, meat and caloric consumption, increasing physical activity and frequent consumption of vegetables and fruits are prudent lifestyle modifications for the prevention of EC as well as other diseases. KEY MESSAGE The etiology of EC includes tobacco smoking, alcohol drinking, low levels of intake of fruits and vegetables as well as gastroesophageal reflux and susceptibility genes. PRACTICAL IMPLICATIONS A healthy lifestyle including smoking cessation, increasing physical activity, consumption of vegetables as well as reduction of alcohol intake and caloric consumption are major approaches to the prevention of EC.
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Affiliation(s)
- Chung S Yang
- Department of Chemical Biology, Susan Lehman Cullman Laboratory for Cancer Research, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, N.J, USA
| | - Xiaoxin Chen
- Julius L. Chambers Biomedical/Biotechnology Research Institute, North Carolina Central University, Durham, N.C, USA; Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA
| | - Shuiping Tu
- Department of Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
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Rafiq R, Shah IA, Bhat GA, Lone MM, Islami F, Boffetta P, Dar NA. Secondhand Smoking and the Risk of Esophageal Squamous Cell Carcinoma in a High Incidence Region, Kashmir, India: A Case-control-observational Study. Medicine (Baltimore) 2016; 95:e2340. [PMID: 26735535 PMCID: PMC4706255 DOI: 10.1097/md.0000000000002340] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Studies have associated secondhand smoking (SHS) with cancers of the lung, larynx, and pharynx. Only a few studies have examined the association between SHS and esophageal squamous cell carcinoma (ESCC) and the findings are inconclusive. We aimed to investigate the association between SHS and risk of ESCC in a case-control study in Kashmir, where the incidence of ESCC is high. We recruited 703 histopathologically confirmed ESCC cases and 1664 hospital-based controls individually matched to the cases for age, sex, and district of residence. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using conditional logistic regression models. Among never-tobacco users, the ORs for the association between SHS and ESCC risk were above unity with ever exposure to SHS (OR = 1.32; 95% CI, 0.43-4.02) and exposure to SHS for > 14 h/wk (median value) (OR = 2.69; 95% CI, 0.75-20.65). In the analysis of data from all participants, the OR (95% CI) for the association between SHS and ESCC was (OR = 1.02; 95% CI, 0.53-1.93) for SHS ≤ 14 h/wk and (OR = 1.91; 95% CI, 0.75-4.89) for SHS >14 h/wk in the models adjusted for tobacco use and several other potential confounding factors. We found an indication of increased risk of ESCC associated with exposure to SHS. Studies with larger numbers of SHS-exposed never tobacco users are required to further examine this association.
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Affiliation(s)
- Rumaisa Rafiq
- From the Department of Biochemistry, University of Kashmir, Hazratbal (RR, IAS, GAB, NAD); Department of Radiation Oncology, SK Institute of Medical Sciences, Soura, Srinagar, JK, India (MML); Surveillance and Health Services Research, American Cancer Society, Atlanta, GA (FI); Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran (FI); and The Tisch Cancer Institute and Institute for Transitional Epidemiology, Mount Sinai School of Medicine, New York, NY (PB)
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Anvari K, Aledavood SA, Toussi MS, Forghani MN, Mohtashami S, Rajabi MT, Shandiz FH, Nosrati F, Nowferesti G, Salek R. A clinical trial of neoadjuvant concurrent chemoradiotherapy followed by resection for esophageal carcinoma. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2015; 20:751-6. [PMID: 26664422 PMCID: PMC4652308 DOI: 10.4103/1735-1995.168377] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background: Esophageal carcinoma is a common malignancy in the North East of Iran. Combined modality treatments have been adopted to improve survival in patients with esophageal carcinoma. In this trial, we evaluated the efficacy and toxicity of a preoperative concurrent chemoradiotherapy protocol in the patients with locally advanced esophageal carcinoma. Materials and Methods: Between 2006 and 2011, eligible patients with locally advanced esophageal carcinoma underwent concurrent radiotherapy and chemotherapy and 3-4 weeks later, esophagectomy. Pathologic response, overall survival rate, toxicity, and feasibility were evaluated. Results: One hundred ninety-seven patients with a median age of 59 (range: 27-70) entered the protocol. One hundred ninety-four cases (98.5%) had esophageal squamous cell carcinoma. Grades 3-4 of toxicity in patients undergoing neoadjuvant chemoradotherapy were as follows: Neutropenia in 21% and esophagitis in 2.5% of cases. There were 11 (5.6%) early death probably due to the treatment-related toxicities. One hundred twenty-seven patients underwent surgery with postsurgical mortality of 11%. In these cases, the complete pathological response was shown in 38 cases (29.9%) with a 5-year overall survival rates of 48.2% and median overall survival of 44 months (95% confidence interval, 24.46-63.54). Conclusion: The pathological response rate and the overall survival rate are promising in patients who completed the protocol as receiving at least one cycle of chemotherapy. However, the treatment toxicities were relatively high.
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Affiliation(s)
- Kazem Anvari
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Amir Aledavood
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Seilanian Toussi
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Naser Forghani
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samira Mohtashami
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Taghi Rajabi
- Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Homaee Shandiz
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Nosrati
- Omid Hospital, Radiation Oncology Specialist, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gholamhossein Nowferesti
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roham Salek
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Bray F, Ferlay J, Laversanne M, Brewster DH, Gombe Mbalawa C, Kohler B, Piñeros M, Steliarova-Foucher E, Swaminathan R, Antoni S, Soerjomataram I, Forman D. Cancer Incidence in Five Continents: Inclusion criteria, highlights from Volume X and the global status of cancer registration. Int J Cancer 2015; 137:2060-71. [PMID: 26135522 DOI: 10.1002/ijc.29670] [Citation(s) in RCA: 277] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 06/24/2015] [Indexed: 11/10/2022]
Abstract
Cancer Incidence in Five Continents (CI5), a longstanding collaboration between the International Agency for Research on Cancer and the International Association of Cancer Registries, serves as a unique source of cancer incidence data from high-quality population-based cancer registries around the world. The recent publication of Volume X comprises cancer incidence data from 290 registries covering 424 populations in 68 countries for the registration period 2003-2007. In this article, we assess the status of population-based cancer registries worldwide, describe the techniques used in CI5 to evaluate their quality and highlight the notable variation in the incidence rates of selected cancers contained within Volume X of CI5. We also discuss the Global Initiative for Cancer Registry Development as an international partnership that aims to reduce the disparities in availability of cancer incidence data for cancer control action, particularly in economically transitioning countries, already experiencing a rapid rise in the number of cancer patients annually.
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Affiliation(s)
- F Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - J Ferlay
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - M Laversanne
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - D H Brewster
- Scottish Cancer Registry, NHS National Services Scotland, Edinburgh, United Kingdom
| | | | - B Kohler
- North American Association of Central Cancer Registries, USA
| | - M Piñeros
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
- Instituto Nacional de Cancerología, Colombia
| | - E Steliarova-Foucher
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | | | - S Antoni
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - I Soerjomataram
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - D Forman
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
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Chen H, Nie S, Zhu Y, Lu M. Teeth loss, teeth brushing and esophageal carcinoma: a systematic review and meta-analysis. Sci Rep 2015; 5:15203. [PMID: 26462879 PMCID: PMC4604458 DOI: 10.1038/srep15203] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 09/21/2015] [Indexed: 12/24/2022] Open
Abstract
Esophageal carcinoma (EC) is a serious malignancy, and its epidemiologic etiology is not fully explained. We performed this review to investigate the association between teeth loss and teeth brushing and the risk of EC. A systematic search was conducted to identify all relevant studies. The Q test and I(2) statistic were used to examine between-study heterogeneity. Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were considered by fixed or random effects models. Furthermore, we conducted subgroup analyses based on study design, the studies' geographic regions and case type of origin. Modified Egger linear regression test was used to estimate publication bias. Ten articles were included. Pooled analyses indicated that teeth loss was associated with an increased risk of EC for Asians (OR, 1.52; 95% CI: 1.30, 1.78), and high frequency of teeth brushing was associated with a lower incidence of EC (OR, 0.62; 95%CI: 0.43, 0.89). Subgroup analyses showed consistent results and no publication bias existed. Teeth loss and teeth brushing play potential roles in the progressing of EC. People should take care of their oral health in daily life. And large well-designed researches are needed to fully describe the association between teeth health and EC risk.
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Affiliation(s)
- Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan 250012, China.,Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China
| | - Shuping Nie
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan 250012, China.,Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China
| | - Yuhui Zhu
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan 250012, China.,Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China
| | - Ming Lu
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan 250012, China.,Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China
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Rastaghi S, Jafari-Koshki T, Mahaki B. Application of Bayesian Multilevel Space-Time Models to Study Relative Risk of Esophageal Cancer in Iran 2005-2007 at a County Level. Asian Pac J Cancer Prev 2015; 16:5787-92. [PMID: 26320452 DOI: 10.7314/apjcp.2015.16.14.5787] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reported age standardized incidence rates for esophageal cancer in Iran are 0.88 and 6.15 for females and males, at fifth and the eighth ranks, respectively, of cancers overall. The present study aimed to map relative risk using more realistic and less problematic methods than common estimators. MATERIALS AND METHODS In this ecological investigation, the studied population consisted of all esophageal cancer patients in Iran from 2005 to 2007. The Bayesian multilevel space-time model with three levels of county, province, and time was used to measure the relative risk of esophageal cancer. Analyses were conducted using R package INLA. RESULTS The total number of registered patients was 7,160. According to the results, the three-level model with adjustment for risk factors of physical activity and smoking had the best fit among all models .The overall temporal trend was significantly increasing. At county level, Ahar, Marand, Salmas, Bojnoord, Saghez, Sarakhs, Shahroud and Torbatejam had the highest relative risks. Physical activity was found to have significant direct association with risk of developing esophageal cancer. CONCLUSIONS Given to great variation across geographical areas, many different factors affect the incidence of esophageal cancer. Conducting further studies at the individual level in areas with high incidence could provide more detailed information on risk factors of esophageal cancer.
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Affiliation(s)
- Sedigheh Rastaghi
- Department of Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran E-mail :
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Hashemian M, Poustchi H, Abnet CC, Boffetta P, Dawsey SM, Brennan PJ, Pharoah P, Etemadi A, Kamangar F, Sharafkhah M, Hekmatdoost A, Malekzadeh R. Dietary intake of minerals and risk of esophageal squamous cell carcinoma: results from the Golestan Cohort Study. Am J Clin Nutr 2015; 102:102-8. [PMID: 26016858 PMCID: PMC4480669 DOI: 10.3945/ajcn.115.107847] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 04/07/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Dietary factors have been hypothesized to affect the risk of esophageal cancer via different mechanisms, but the intake of minerals is understudied and the evidence is conflicting. OBJECTIVE The objective was to evaluate the associations of dietary intake of minerals with risk of esophageal squamous cell carcinoma (ESCC). DESIGN We used data from the Golestan Cohort Study, which was launched in a high-risk region for esophageal cancer in Iran. Participants were enrolled in 2004-2008 and were followed to 2014. Intakes of minerals were assessed with a validated food-frequency questionnaire. A Cox proportional hazards model was used to estimate HRs and 95% CIs of ESCC for dietary intakes of selected minerals. RESULTS We identified 201 ESCC cases among 47,405 subjects. Calcium intake was significantly inversely associated with the risk of ESCC (HR per 100-mg/d increase: 0.88; 95% CI: 0.81, 0.96; P = 0.005; quartile 4 vs. quartile 1 HR: 0.49; 95% CI: 0.29, 0.82; P-trend = 0.013). Zinc intake was also inversely associated with ESCC, but the quartile association did not reach significance (HR per 1-mg/d increase: 0.87; 95% CI: 0.77, 0.98; P = 0.027; quartile 4 vs. quartile 1 HR: 0.56; 95% CI: 0.28, 1.12; P-trend = 0.097). The relations between dietary intakes of selenium, magnesium, and copper and risk of ESCC were nonlinear (P-nonlinear trend = 0.001, 0.016, and 0.029, respectively). There was no relation between dietary intake of manganese and the risk of ESCC. CONCLUSION The results suggest that higher intakes of calcium and zinc are associated with a lower risk of ESCC in a high-risk region of Iran.
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Affiliation(s)
| | | | - Christian C Abnet
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | - Sanford M Dawsey
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Paul J Brennan
- International Agency for Research on Cancer, Lyon, France; and
| | - Paul Pharoah
- Cancer Research UK, Department of Oncology, Cambridge University, Cambridge, United Kingdom
| | - Arash Etemadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Farin Kamangar
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | - Azita Hekmatdoost
- Departments of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran;
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Bhat GA, Shah IA, Rafiq R, Nabi S, Iqbal B, Lone MM, Islami F, Boffetta P, Dar NA. Family history of cancer and the risk of squamous cell carcinoma of oesophagus: a case-control study in Kashmir, India. Br J Cancer 2015; 113:524-32. [PMID: 26125444 PMCID: PMC4522628 DOI: 10.1038/bjc.2015.218] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/11/2015] [Accepted: 05/21/2015] [Indexed: 02/06/2023] Open
Abstract
Background: Only a few studies have examined the association between family history of cancer (FHC) and the risk of oesophageal squamous cell carcinoma (ESCC) in high incidence areas of ESCC. We conducted a case–control study to evaluate the relationship between FHC and ESCC risk in Kashmir, India, with analysis of detailed epidemiological data and information on multiple gene polymorphisms. Methods: We collected detailed information on FHC and a number of socio-demographic and lifestyle factors, and also obtained blood samples for genetic analysis from 703 histopathologically confirmed ESCC cases and 1664 individually matched controls. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). Results: Participants who had FHC showed a strong association with ESCC risk, and the risk was stronger when first-degree relatives (FDRs) had FHC (OR=6.8; 95% CI=4.6–9.9). Having a sibling with a cancer showed the strongest association (OR=10.8; 95% CI=6.0–19.3), but having a child with a cancer was not associated with ESCC risk. A history of any cancer in the spouse was also associated with ESCC risk (OR=4.1; 95% CI=1.6–10.2). Those with two or more relatives with FHC were at a higher risk of ESCC. After restricting FHC to familial ESCC only, the above associations were strengthened, except when spouses were affected with ESCC (OR=2.5; 95% CI=0.7–8.9). When we examined the associations between several single-nucleotide polymorphisms and ESCC in those with and without FHC, the associations of variant genotypes in cytochrome P450 (CYP) 2C19 and CYP2D6 and the wild genotype of CYP2E1 with ESCC were much stronger in those with FHC. The FHC had an additive interaction with several risk factors of ESCC in this population. Conclusion: Our results showed that FHC was strongly associated with ESCC risk in Kashmir. It seems both genetic factors and shared environment are involved in this association.
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Affiliation(s)
- G A Bhat
- Department of Biochemistry, University of Kashmir, Srinagar 190006, India
| | - I A Shah
- Department of Biochemistry, University of Kashmir, Srinagar 190006, India
| | - R Rafiq
- Department of Biochemistry, University of Kashmir, Srinagar 190006, India
| | - S Nabi
- Department of Biochemistry, University of Kashmir, Srinagar 190006, India
| | - B Iqbal
- Department of Biochemistry, University of Kashmir, Srinagar 190006, India
| | - M M Lone
- Departments of Radiation Oncology, SK Institute of Medical Sciences, Soura Srinagar, 190011 India
| | - F Islami
- 1] Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA [2] Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, 14117 Iran
| | - P Boffetta
- Tisch Cancer Institute and Institute for Transitional Epidemiology, Mount Sinai School of Medicine, New York, NY, USA
| | - N A Dar
- Department of Biochemistry, University of Kashmir, Srinagar 190006, India
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Eichelberger L, Murphy G, Etemadi A, Abnet CC, Islami F, Shakeri R, Malekzadeh R, Dawsey SM. Risk of gastric cancer by water source: evidence from the Golestan case-control study. PLoS One 2015; 10:e0128491. [PMID: 26023788 PMCID: PMC4449025 DOI: 10.1371/journal.pone.0128491] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 04/27/2015] [Indexed: 02/07/2023] Open
Abstract
Background Gastric cancer (GC) is the world’s fifth most common cancer, and the third leading cause of cancer-related death. Over 70% of incident cases and deaths occur in developing countries. We explored whether disparities in access to improved drinking water sources were associated with GC risk in the Golestan Gastric Cancer Case Control Study. Methods and Findings 306 cases and 605 controls were matched on age, gender, and place of residence. We conducted unconditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CI), adjusted for age, gender, ethnicity, marital status, education, head of household education, place of birth and residence, homeownership, home size, wealth score, vegetable consumption, and H. pylori seropositivity. Fully-adjusted ORs were 0.23 (95% CI: 0.05–1.04) for chlorinated well water, 4.58 (95% CI: 2.07–10.16) for unchlorinated well water, 4.26 (95% CI: 1.81–10.04) for surface water, 1.11 (95% CI: 0.61–2.03) for water from cisterns, and 1.79 (95% CI: 1.20–2.69) for all unpiped sources, compared to in-home piped water. Comparing unchlorinated water to chlorinated water, we found over a two-fold increased GC risk (OR 2.37, 95% CI: 1.56–3.61). Conclusions Unpiped and unchlorinated drinking water sources, particularly wells and surface water, were significantly associated with the risk of GC.
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Affiliation(s)
- Laura Eichelberger
- Department of Anthropology, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, United States of America; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr., Bethesda, MD, 20892, United States of America
| | - Gwen Murphy
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr., Bethesda, MD, 20892, United States of America
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr., Bethesda, MD, 20892, United States of America; Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr., Bethesda, MD, 20892, United States of America
| | - Farhad Islami
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Surveillance and Health Services Research, American Cancer Society, 250 Williams St., Atlanta, GA, 30303, United States of America
| | - Ramin Shakeri
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr., Bethesda, MD, 20892, United States of America
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Cheng ML, Zhang L, Borok M, Chokunonga E, Dzamamala C, Korir A, Wabinga HR, Hiatt RA, Parkin DM, Van Loon K. The incidence of oesophageal cancer in Eastern Africa: identification of a new geographic hot spot? Cancer Epidemiol 2015; 39:143-9. [PMID: 25662402 PMCID: PMC4470609 DOI: 10.1016/j.canep.2015.01.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 01/06/2015] [Accepted: 01/08/2015] [Indexed: 12/15/2022]
Abstract
The incidence of oesophageal cancer (OC) varies geographically, with more than 80% of cases and deaths worldwide occurring in developing countries. The aim of this study is to characterize the disease burden of OC in four urban populations in Eastern Africa, which may represent a previously undescribed high-incidence area. Data on all cases of OC diagnosed between 2004 and 2008 were obtained from four population-based cancer registries in: Blantyre, Malawi; Harare, Zimbabwe; Kampala, Uganda; and Nairobi, Kenya. Age-standardized incidence rates (ASRs) were calculated for each population, and descriptive statistics for incident cases were determined. In Blantyre, 351 male (59%) and 239 (41%) female cases were reported, with ASRs of 47.2 and 30.3. In Harare, 213 male (61%) and 134 (39%) female cases were reported, with ASRs of 33.4 and 25.3, respectively. In Kampala, 196 male (59%) and 137 female (41%) cases were reported, with ASRs of 36.7 and 24.8. In Nairobi, 323 male (57%) and 239 female (43%) cases were reported, with ASRs of 22.6 and 21.6. Median age at diagnosis was significantly different among the four populations, ranging from 50 years in Blantyre to 65 years in Harare (p<0.0001). Except in Nairobi, incidence among males was significantly higher than among females (p<0.01). Squamous cell OC was the predominant histologic subtype at all sites. ASRs at all four sites were remarkably higher than the mean worldwide ASR. Investigation to evaluate potential etiologic effects of dietary, lifestyle, environmental, and other factors impacting the incidence in this region is needed.
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Affiliation(s)
- Michael L Cheng
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States
| | - Li Zhang
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States
| | | | | | | | - Anne Korir
- Nairobi Cancer Registry, Kenya Medical Research Institute, Nairobi, Kenya
| | - Henry R Wabinga
- Kampala Cancer Registry, Makerere University, Kampala, Uganda
| | - Robert A Hiatt
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States
| | | | - Katherine Van Loon
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States.
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Roshandel G, Khoshnia M, Sotoudeh M, Merat S, Etemadi A, Nickmanesh A, Norouzi A, Pourshams A, Poustchi H, Semnani S, Ghasemi-Kebria F, Noorbakhsh R, Abnet C, Dawsey SM, Malekzadeh R. Endoscopic screening for precancerous lesions of the esophagus in a high risk area in Northern Iran. ARCHIVES OF IRANIAN MEDICINE 2015; 17:246-52. [PMID: 24724600 DOI: 014174/aim.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Esophageal squamous cell carcinoma (ESCC) is a major health problem in many developing countries including Iran. ESCC has a very poor prognosis, largely due to late diagnosis. As a first step in developing an early detection and treatment program, we conducted a population-based endoscopic screening for ESCC and its precursor lesion, esophageal squamous dysplasia (ESD) in asymptomatic adults from Golestan Province, northern Iran, a high-risk area for ESCC, to evaluate the feasibility of such a program and to document the prevalence and risk factor correlates of ESD. METHODS This cross-sectional study was conducted among participants of the Golestan Cohort Study (GCS), a population-based cohort of 50,000 adults in eastern Golestan Province. Randomly selected GCS participants were invited by telephone. Those who accepted were referred to a central endoscopy clinic. Eligible subjects were consented and then asked to fill in a brief questionnaire. Detailed information about selected risk factors was obtained from the GCS main database. Endoscopic examination with Lugol's iodine staining was performed, biopsies were taken from unstained lesions as well as the normally stained mucosa of the esophagus, and the biopsies were diagnosed by expert pathologists according to previously described criteria. RESULTS In total, 1906 GCS subjects were invited, of whom only 302 subjects (15.8%) were successfully enrolled. Esophagitis (29.5%) and ESD (6.0%) were the most common pathological diagnoses. Turkmen ethnicity (adjusted OR = 8.61; 95%CI: 2.48-29.83), being older than the median age (OR = 7.7; 95% CI: 1.99-29.87), and using deep frying cooking methods (OR = 4.65; 95%CI: 1.19-18.22) were the strongest predictors for ESD. There were significant relationships between esophagitis and smoking (p-value<0.001), drinking hot tea (P value = 0.02) and lack of education (P value = 0.004). CONCLUSION We observed a low rate for participation in endoscopic screening. Overall prevalence of ESD was 6.0%. Developing non-endoscopic primary screening methods and screening individuals with one or more risk factors may improve these rates.
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Affiliation(s)
- Gholamreza Roshandel
- 1)Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2)Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan,
| | - Masoud Khoshnia
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masoud Sotoudeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Merat
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- 1)Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 3)Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Arash Nickmanesh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Roya Noorbakhsh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Christian Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Lee YL, Hu HY, Yang NP, Chou P, Chu D. Dental prophylaxis decreases the risk of esophageal cancer in males; a nationwide population-based study in Taiwan. PLoS One 2014; 9:e109444. [PMID: 25279666 PMCID: PMC4184879 DOI: 10.1371/journal.pone.0109444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 09/08/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Periodontal disease (PD) is one of the most common chronic inflammatory diseases. Esophageal cancer (EC) is also a common cause of death due to cancer among males. Systemic inflammatory processes have been shown to increase the risk of cancer. We conducted a retrospective cohort study to investigate the association between PD and EC. METHODS A total of 718,409 subjects were recruited from the Taiwan National Health Insurance Research Database (NHIRD) and followed from January 1, 2000 to December 31, 2010. Of these, 519,831 subjects were diagnosed with PD and were grouped according to the most advanced treatment they received: dental prophylaxis, intensive treatment, or no treatment. The IRs of EC were compared among groups. RESULTS A total of 682 patients developed EC, resulting in an overall IR of 0.11 case-number per 1000 person-years (‰/y). The dental prophylaxis group had a significantly lower IR of EC (0.06‰/y) than other groups (p<0.001). Multivariable Cox regression analysis further revealed that male subjects [hazard ratio (HR) = 10.04, 95% confidence interval (CI) = 7.58-13.30], as well as a history of esophageal ulcers (HR = 7.10, 95% CI = 5.03-10.01), alcohol abuse (HR = 5.46, 95% CI = 2.26-13.18), or esophageal reflux (HR = 1.86, 95% CI = 1.02-3.52), were factors associated with a higher risk of EC. And the dental prophylaxis group showed a significantly lower risk for EC (HR = 0.53, 95% CI = 0.44-0.65). Further subgroup analysis showed that the dental prophylaxis group among males had a significant lower risk (HR = 0.54, 95% CI = 0.44-0.66) for EC, while that of the females did not has statistically significant difference. CONCLUSION For this cohort, subjects received dental prophylaxis reduced the risk of EC compared to all PD and no PD groups among males.
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Affiliation(s)
- Ya-Ling Lee
- Department of Dentistry, Taipei City Hospital, Taipei, Taiwan
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Hsiao-Yun Hu
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Nan-Ping Yang
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Pesus Chou
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Dachen Chu
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan
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49
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Roshandel G, Merat S, Sotoudeh M, Khoshnia M, Poustchi H, Lao-Sirieix P, Malhotra S, O'Donovan M, Etemadi A, Nickmanesh A, Pourshams A, Norouzi A, Debiram I, Semnani S, Abnet CC, Dawsey SM, Fitzgerald RC, Malekzadeh R. Pilot study of cytological testing for oesophageal squamous cell dysplasia in a high-risk area in Northern Iran. Br J Cancer 2014; 111:2235-41. [PMID: 25247319 PMCID: PMC4264437 DOI: 10.1038/bjc.2014.506] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 07/31/2014] [Accepted: 08/18/2014] [Indexed: 11/09/2022] Open
Abstract
Background: Oesophageal squamous cell carcinoma (ESCC) is a fatal disease with 5-year survival rates of <5% in Northern Iran. Oesophageal squamous dysplasia (ESD) is the precursor histologic lesion of ESCC. This pilot study was conducted to assess the feasibility, safety, and acceptability of non-endoscopic cytological examination of the oesophagus and to provide initial data on the accuracy of cytological atypia for identifying patients with ESD in this very-high-risk area. Methods: Randomly selected asymptomatic participants of the Golestan Cohort Study were recruited. A cytological specimen was taken using a capsule sponge device and evaluated for atypical cells. Sections of the cytological specimen were also stained for p53 protein. Patient acceptability was assessed using a visual analogue scale. The cytological diagnosis was compared with a chromoendoscopic examination using Lugol's solution. Results: Three hundred and forty-four subjects (43% male, mean (s.d.) age 55.6 (7.9) years) were referred to the study clinic. Three hundred and twelve met eligibility criteria and consented, of which 301 subjects (96.5%) completed both cytological and endoscopic examinations. There were no complications. Most of the participants (279; 92.7%) were satisfied with the examination. The sensitivity and specificity of the cytological examination for identifying subjects with high-grade ESD were 100 and 97%, respectively. We found an accuracy of 100% (95% CI=99–100%) for a combination of cytological examination and p53 staining to detect high-grade ESD. Conclusions: The capsule sponge methodology seems to be a feasible, safe, and acceptable method for diagnosing precancerous lesions of the oesophagus in this population, with promising initial accuracy data for the detection of high-grade ESD.
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Affiliation(s)
- G Roshandel
- 1] Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran [2] Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan 4917774979, Iran
| | - S Merat
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - M Sotoudeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - M Khoshnia
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan 4917774979, Iran
| | - H Poustchi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - P Lao-Sirieix
- MRC Cancer Cell, Hutchison-MRC Research Centre, University of Cambridge, Cambridge CB2 0XZ, UK
| | - S Malhotra
- MRC Cancer Cell, Hutchison-MRC Research Centre, University of Cambridge, Cambridge CB2 0XZ, UK
| | - M O'Donovan
- MRC Cancer Cell, Hutchison-MRC Research Centre, University of Cambridge, Cambridge CB2 0XZ, UK
| | - A Etemadi
- 1] Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran [2] Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20895, USA
| | - A Nickmanesh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - A Pourshams
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - A Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan 4917774979, Iran
| | - I Debiram
- MRC Cancer Cell, Hutchison-MRC Research Centre, University of Cambridge, Cambridge CB2 0XZ, UK
| | - S Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan 4917774979, Iran
| | - C C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20895, USA
| | - S M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20895, USA
| | - R C Fitzgerald
- MRC Cancer Cell, Hutchison-MRC Research Centre, University of Cambridge, Cambridge CB2 0XZ, UK
| | - R Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran
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Golozar A, Beaty TH, Gravitt PE, Ruczinski I, Qiao YL, Fan JH, Ding T, Tang ZZ, Etemadi A, Hu N, Hyland PL, Wang L, Wang C, Dawsey SM, Freedman ND, Abnet CC, Goldstein AM, Taylor PR. Oesophageal squamous cell carcinoma in high-risk Chinese populations: Possible role for vascular epithelial growth factor A. Eur J Cancer 2014; 50:2855-65. [PMID: 25172294 DOI: 10.1016/j.ejca.2014.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 07/24/2014] [Accepted: 07/29/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND Mechanisms involved in wound healing play some role in carcinogenesis in multiple organs, likely by creating a chronic inflammatory milieu. This study sought to assess the role of genetic markers in selected inflammation-related genes involved in wound healing (interleukin (IL)-1a, IL-1b, IL-1 Receptor type I (IL-1Ra), IL-1 Receptor type II (IL-1Rb), tumour necrosis factor (TNF)-α, tumour necrosis factor receptor superfamily member (TNFRSF)1A, nuclear factor kappa beta (NF-kB)1, NF-kB2, inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-2, hypoxia induced factor (HIF)-1α, vascular endothelial growth factor (VEGF)A and P-53) in risk to oesophageal squamous cell carcinoma (OSCC). METHODS We genotyped 125 tag single nucleotide polymorphism (SNP)s in 410 cases and 377 age and sex matched disease-free individuals from Nutritional Intervention Trial (NIT) cohort, and 546 cases and 556 controls individually matched for age, sex and neighbourhood from Shanxi case-control study, both conducted in high-risk areas of north-central China (1985-2007). Cox proportional-hazard models and conditional logistic regression models were used for SNPs analyses for NIT and Shanxi, respectively. Fisher's inverse test statistics were used to obtain gene-level significance. RESULTS Multiple SNPs were significantly associated with OSCC in both studies, however, none retained their significance after a conservative Bonferroni adjustment. Empiric p-values for tag SNPs in VEGFA in NIT were highly concentrated in the lower tail of the distribution, suggesting this gene may be influencing risk. Permutation tests confirmed the significance of this pattern. At the gene level, VEGFA yielded an empiric significance (P=0.027) in NIT. We also observed some evidence for interaction between environmental factors and some VEGFA tag SNPs. CONCLUSION Our finding adds further evidence for a potential role for markers in the VEGFA gene in the development and progression of early precancerous lesions of oesophagus.
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Affiliation(s)
- Asieh Golozar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Terri H Beaty
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Patti E Gravitt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ingo Ruczinski
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - You-Lin Qiao
- Department of Epidemiology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jin-Hu Fan
- Department of Epidemiology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Ti Ding
- Shanxi Cancer Hospital, Taiyuan, Shanxi, People's Republic of China
| | - Ze-Zhong Tang
- Shanxi Cancer Hospital, Taiyuan, Shanxi, People's Republic of China
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Nan Hu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Paula L Hyland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Lemin Wang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Chaoyu Wang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Alisa M Goldstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Philip R Taylor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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