Life-style factors and medical conditions in relation to esophageal cancer by histologic type in a low-risk population.

A case-control study of esophageal cancer was conducted in Athens, Greece, during the 3-year period 1989-1991. Cases were 43 patients with incident esophageal squamous-cell carcinoma and 56 patients with incident esophageal adenocarcinoma hospitalized in any one of the 9 major hospitals in Athens, whereas controls were 200 injury patients admitted to the only Athens accident hospital. The data were analyzed by modeling through multiple logistic regression. Tobacco smoking and alcohol drinking were associated with both histologic types, but the odds ratios were generally lower than those observed in several other investigations. It may be that the high consumption of vegetables and fruits by the Greek population cushions the deleterious effect of tobacco, while the intake of ethanol in the form of wine during meals reduces the impact of this substance on the esophageal mucosa. A preference for very hot temperature for beverages and food was associated with significant elevation of the odds ratio to about 1.8 for esophageal cancer in general. There was non-significant evidence in our data to support earlier reports that aspirin intake may reduce the risk of cancer of the esophagus. Overall, we found no striking difference in the risk profile of the 2 histologic types of esophageal cancer.