Yuan Lingzhi, Shen Peijun, Zheng Shaopeng, Wu Dongwen, Li Xinmeng, Cai Ting, Yao Yao, Song Yunhe, Wang Fen
Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Hunan Key Laboratory of Non-resolving Inflammation and Cancer, Central South University, Changsha, Hunan, China.
Front Oncol. 2023 Jan 24;13:1077598. doi: 10.3389/fonc.2023.1077598. eCollection 2023.
Esophageal cancer remains a public health problem in many countries, especially developing countries. The early lifestyle preventive measures mentioned in the treatment guidelines for esophageal cancer are very limited. We aimed to evaluate the risk factors for esophageal cancer in a high-incidence area in China and to provide evidence for clinical intervention in esophageal cancer prevention.
Symptom and lifestyle/habit questionnaires including 19 items were designed. The correlation between the occurrence of esophageal cancer and living habits was analyzed retrospectively through questionnaire survey. A total of 708 subjects (365 esophageal cancer, 343 non-esophageal cancer) enrolled from two hospitals in central China (Linzhou Esophageal Cancer Hospital and The Third Xiangya Hospital of Central South University) completed symptom and lifestyle/habit questionnaires. We used conditional logistic regression to estimate the odds ratio (OR) with consideration of 95% confidence interval (CI).
The composition ratio analysis showed that the top five lifestyle factors related to esophageal cancer were eating too fast, drinking, hot drinks, smoking and overeating. Univariate analysis showed that 15 factors, including male sex, smoking, drinking, eating too fast, overeating, hot drinks, greasy food, acidic food, hard food, strong tea, coffee, bedtime immediately after meals, eating food before bedtime, difficult defecation, and an overtight belt, were associated with esophageal cancer (all P <0.05). Logistic multivariate regression analysis showed, drinking (OR 3.609, 95%CI 2.223-5.859; P=0.000); hot drinks (OR 2.672, 95%CI 1.786-3.997; P=0.000); overeating (OR 2.110, 95%CI 1.411-3.154; P=0.000); eating too fast (OR 1.879, 95%CI 1.274-2.772; P=0.001); strong tea (OR 1.882, 95%CI 1.171~3.023; P=0.009); hard food (OR 1.723, 95%CI 1.113-2.667; P=0.015); smoking (OR 1.686, 95%CI 1.045-2.720; P=0.032), which were significantly associated with the development of esophageal cancer.
The unhealthy lifestyles of patients in high-incidence areas of esophageal cancer in central China are significantly associated with the incidence of esophageal cancer. Lifestyle changes that address these factors, especially overeating and eating too fast, which are rarely studied or discussed despite being common, may improve esophageal cancer management and treatment outcomes. The present results may be used as a reference for preventive education and treatment.
食管癌在许多国家，尤其是发展中国家，仍然是一个公共卫生问题。食管癌治疗指南中提到的早期生活方式预防措施非常有限。我们旨在评估中国一个高发地区食管癌的危险因素，并为食管癌预防的临床干预提供证据。
设计了包含19项内容的症状及生活方式/习惯问卷。通过问卷调查回顾性分析食管癌发生与生活习惯之间的相关性。从中国中部的两家医院（林州食管癌医院和中南大学湘雅三医院）招募了708名受试者（365例食管癌患者，343例非食管癌患者），他们完成了症状及生活方式/习惯问卷。我们使用条件逻辑回归来估计比值比（OR），并考虑95%置信区间（CI）。
构成比分析显示，与食管癌相关的前五位生活方式因素为进食过快、饮酒、喝热饮、吸烟和暴饮暴食。单因素分析显示，15个因素与食管癌相关，包括男性、吸烟、饮酒、进食过快、暴饮暴食、喝热饮、油腻食物、酸性食物、硬质食物、浓茶、咖啡、饭后立即睡觉、睡前吃东西、排便困难和腰带过紧（所有P<0.05）。逻辑多因素回归分析显示，饮酒（OR 3.609，95%CI 2.223 - 5.859；P = 0.000）；喝热饮（OR 2.672，95%CI 1.786 - 3.997；P = 0.000）；暴饮暴食（OR 2.110，95%CI 1.411 - 3.154；P = 0.000）；进食过快（OR 1.879，95%CI 1.274 - 2.772；P = 0.001）；浓茶（OR 1.882，95%CI 1.171 - 3.023；P = 0.009）；硬质食物（OR 1.723，95%CI 1.113 - 2.667；P = 0.015）；吸烟（OR 1.686，95%CI 1.045 - 2.720；P = 0.032），这些因素与食管癌的发生显著相关。
中国中部食管癌高发地区患者的不健康生活方式与食管癌发病率显著相关。针对这些因素改变生活方式，尤其是针对暴饮暴食和进食过快这两个虽常见但很少被研究或讨论的因素，可能会改善食管癌的管理和治疗效果。本研究结果可作为预防教育和治疗的参考。
