Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20852, USA.
Cancer Epidemiol. 2011 Dec;35(6):e91-9. doi: 10.1016/j.canep.2011.06.006. Epub 2011 Aug 16.
Smoking and alcohol consumption explain little of the risk for upper-gastrointestinal (UGI) cancer in China, where over half of all cases in the world occur.
We evaluated questionnaire-based risk factors for UGI cancers in a case-control study from Shanxi Province, China, including 600 esophageal squamous cell carcinomas (ESCCs), 599 gastric cardia adenocarcinomas (GCAs), 316 gastric noncardia adenocarcinomas (GNCAs), and 1514 age- and gender-matched controls.
Ever smoking and ever use of any alcohol were not associated with risk of UGI cancer; only modest associations were observed between ESCC risk and highest cumulative smoking exposure, as well as GNCA risk and beer drinking. While several associations were noted for socioeconomic and some dietary variables with one or two UGI cancers, the strongest and most consistent relations for all three individual UGI cancers were observed for consumption of scalding hot foods (risk increased 150-219% for daily vs. never users) and fresh vegetables and fruits (risk decreased 48-70% for vegetables and 46-68% for fruits, respectively, for high vs. low quartiles).
This study confirms the minor role of tobacco and alcohol in UGI cancers in this region, and highlights thermal damage as a leading etiologic factor.
在中国，吸烟和饮酒对上消化道（UGI）癌症的风险解释有限，而全球超过一半的病例发生在中国。
我们在中国山西省进行了一项基于问卷调查的 UGI 癌症风险因素的病例对照研究，包括 600 例食管鳞癌（ESCC）、599 例贲门腺癌（GCAs）、316 例胃非贲门腺癌（GNCAs）和 1514 名年龄和性别匹配的对照。
曾经吸烟和饮酒与 UGI 癌症风险无关；仅观察到 ESCC 风险与最高累积吸烟暴露以及 GNCA 风险与啤酒饮用之间存在适度关联。虽然一些社会经济和某些饮食变量与一种或两种 UGI 癌症有关，但所有三种单独的 UGI 癌症的最强和最一致的关系是食用滚烫的食物（每日食用者的风险比从不食用者增加 150-219%）和新鲜蔬菜和水果（蔬菜食用量最高与最低四分位数相比，风险降低 48-70%；水果食用量最高与最低四分位数相比，风险降低 46-68%）。
本研究证实了烟草和酒精在该地区 UGI 癌症中的作用较小，并强调了热损伤是主要的病因因素。
