Vikash Sewram1, Freddy Sitas2, Dianne O'Connell3, Jonny Myers4. 1. African Cancer Institute, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Division of Community Health, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa. Electronic address: vsewram@sun.ac.za. 2. Cancer Research Division, Cancer Council New South Wales, P.O. Box 572, Kings Cross, NSW 1340, Australia; Sydney School of Public Health, University of Sydney, Camperdown, Australia; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia. 3. Cancer Research Division, Cancer Council New South Wales, P.O. Box 572, Kings Cross, NSW 1340, Australia; Sydney School of Public Health, University of Sydney, Camperdown, Australia; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia; School of Medicine and Public Health, University of Newcastle, Australia. 4. Centre for Occupational and Environmental Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, South Africa.
Abstract
BACKGROUND: The Eastern Cape Province of South Africa, which includes the former Transkei has high rates of squamous cell oesophageal cancer (OC), thought to be caused mainly by nutritional deficiencies and fungal contamination of staple maize. A hospital-based case-control study was conducted at three of the major referral hospitals in this region to measure, among other suspected risk factors, the relative importance of tobacco smoking and alcohol consumption for the disease in this population. METHODS: Incident cases (n=670) of OC and controls (n=1188) were interviewed using a structured questionnaire which included questions on tobacco and alcohol-related consumption. Odds ratios (ORs) with 95% confidence intervals for each of the risk factors were calculated using unconditional multiple logistic regression models. RESULTS: A monotonic dose-response was observed across the categories of each tobacco-related variable in both sexes. Males and females currently smoking a total of >14g of tobacco per day were observed to have over 4-times the odds of developing OC (males OR=4.36, 95% CI 2.24-8.48; females OR=4.56, 95% CI 1.46-14.30), with pipe smoking showing the strongest effect. Similar trends were observed for the alcohol-related variables. The quantity of ethanol consumed was the most important factor in OC development rather than any individual type of alcoholic beverage, especially in smokers. Males and females consuming >53g of ethanol per day had approximately 5-times greater odds in comparison to non-drinkers (males OR=4.72, 95% CI 2.64-8.41; females OR=5.24, 95% CI 3.34-8.23) and 8.5 greater odds in those who smoked >14g tobacco daily. The attributable fractions for smoking and alcohol consumption were 58% and 48% respectively, 64% for both factors combined. CONCLUSION: Tobacco and alcohol use are major risk factors for OC development in this region. IMPACT: This study provides evidence for further reinforcement of cessation of smoking and alcohol consumption to curb OC development.
BACKGROUND: The Eastern Cape Province of South Africa, which includes the former Transkei has high rates of squamous cell oesophageal cancer (OC), thought to be caused mainly by nutritional deficiencies and fungal contamination of staple maize. A hospital-based case-control study was conducted at three of the major referral hospitals in this region to measure, among other suspected risk factors, the relative importance of tobacco smoking and alcohol consumption for the disease in this population. METHODS: Incident cases (n=670) of OC and controls (n=1188) were interviewed using a structured questionnaire which included questions on tobacco and alcohol-related consumption. Odds ratios (ORs) with 95% confidence intervals for each of the risk factors were calculated using unconditional multiple logistic regression models. RESULTS: A monotonic dose-response was observed across the categories of each tobacco-related variable in both sexes. Males and females currently smoking a total of >14g of tobacco per day were observed to have over 4-times the odds of developing OC (males OR=4.36, 95% CI 2.24-8.48; females OR=4.56, 95% CI 1.46-14.30), with pipe smoking showing the strongest effect. Similar trends were observed for the alcohol-related variables. The quantity of ethanol consumed was the most important factor in OC development rather than any individual type of alcoholic beverage, especially in smokers. Males and females consuming >53g of ethanol per day had approximately 5-times greater odds in comparison to non-drinkers (males OR=4.72, 95% CI 2.64-8.41; females OR=5.24, 95% CI 3.34-8.23) and 8.5 greater odds in those who smoked >14g tobacco daily. The attributable fractions for smoking and alcohol consumption were 58% and 48% respectively, 64% for both factors combined. CONCLUSION:Tobacco and alcohol use are major risk factors for OC development in this region. IMPACT: This study provides evidence for further reinforcement of cessation of smoking and alcohol consumption to curb OC development.
Authors: Diana Menya; Nicholas Kigen; Margaret Oduor; Stephen Karuru Maina; Fatma Some; David Chumba; Paul Ayuo; Odipo Osano; Daniel Rs Middleton; Joachim Schüz; Valerie A McCormack Journal: Int J Cancer Date: 2018-11-12 Impact factor: 7.396
Authors: Sridharan Manavalan; Bruk Getachew; Kebreten F Manaye; Syed J Khundmiri; Antonei B Csoka; Raechel McKinley; Andrea Tamas; Dora Reglodi; Yousef Tizabi Journal: Neurotox Res Date: 2017-03-24 Impact factor: 3.911
Authors: V A McCormack; D Menya; M O Munishi; C Dzamalala; N Gasmelseed; M Leon Roux; M Assefa; O Osano; M Watts; A O Mwasamwaja; B T Mmbaga; G Murphy; C C Abnet; S M Dawsey; J Schüz Journal: Int J Cancer Date: 2016-08-24 Impact factor: 7.396
Authors: Maria E Leon; Mathewos Assefa; Endale Kassa; Abate Bane; Tufa Gemechu; Yared Tilahun; Nigatu Endalafer; Gilles Ferro; Kurt Straif; Elizabeth Ward; Abraham Aseffa; Joachim Schüz; Ahmedin Jemal Journal: PLoS One Date: 2017-06-08 Impact factor: 3.240
Authors: Akwi W Asombang; Nathaniel Chishinga; Alick Nkhoma; Jackson Chipaila; Bright Nsokolo; Martha Manda-Mapalo; Joao Filipe G Montiero; Lewis Banda; Kulwinder S Dua Journal: World J Gastroenterol Date: 2019-08-21 Impact factor: 5.742
Authors: Katherine Van Loon; Michael M Mwachiro; Christian C Abnet; Larry Akoko; Mathewos Assefa; Stephen L Burgert; Steady Chasimpha; Charles Dzamalala; David E Fleischer; Satish Gopal; Prasad G Iyer; Bongani Kaimila; Violet Kayamba; Paul Kelly; Maria E Leon; Christopher G Mathew; Diana Menya; Daniel Middleton; Yohannie Mlombe; Blandina T Mmbaga; Elia Mmbaga; Gift Mulima; Gwen Murphy; Beatrice Mushi; Ally Mwanga; Amos Mwasamwaja; M Iqbal Parker; Natalie Pritchett; Joachim Schüz; Mark D Topazian; Russell E White; Valerie McCormack; Sanford M Dawsey Journal: J Glob Oncol Date: 2018-09