Clustering analysis of risk factors in high-incidence areas of esophageal cancer in Yanting county_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LUO Ruiwu ^1,2 , HUANG Heng ² , CHENG Hao ² , NI Siyu ² , FU Siyi ² , QIAN Qinchun ² , YANG Junjie ² , CHEN Xinlong ² , HUANG Hanyu ² , ZONG Zhengdong ² , ZHAO Yujuan ³ , QIN Yuhe ² , HE Chengcheng ² , WU Ye ² , WEN Hongying ⁴ ,  TIAN Dong ^1,4

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
2. Department of Clinical Medicine, North Sichuan Medical College, Nanchong, 637000, Sichuan, P. R. China;
3. School of Nursing, North Sichuan Medical College, Nanchong, 637000, Sichuan, P. R. China;
4. Department of Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, P. R. China;

Corresponding author：

TIAN Dong, Email: TianD_EATTS@nsmc.edu.cn

Keywords：

Esophageal cancer; high-incidence area; dietary habits; risk factors; clustering

DOI：

10.7507/1007-4848.202206023

Video：

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Objective To investigate the dietary patterns of rural residents in the high-incidence areas of esophageal cancer (EC), and to explore the clustering and influencing factors of risk factors associated with high-incidence characteristics. Methods A special structured questionnaire was applied to conduct a face-to-face survey on the dietary patterns of rural residents in Yanting county of Sichuan Province from July to August 2021. Univariate and multivariate logistic regression models were used to analyze the influencing factors of risk factor clustering for EC. Results There were 838 valid questionnaires in this study. A total of 90.8% of rural residents used clean water such as tap water. In the past one year, the people who ate fruits and vegetables, soybean products, onions and garlic in high frequency accounted for 69.5%, 32.8% and 74.5%, respectively; the people who ate kimchi, pickled vegetables, sauerkraut, barbecue, hot food and mildew food in low frequency accounted for 59.2%, 79.6%, 68.2%, 90.3%, 80.9% and 90.3%, respectively. The clustering of risk factors for EC was found in 73.3% of residents, and the aggregation of two risk factors was the most common mode (28.2%), among which tumor history and preserved food was the main clustering pattern (4.6%). The logistic regression model revealed that the gender, age, marital status and occupation were independent influencing factors for the risk factors clustering of EC (P<0.05). Conclusion A majority of rural residents in high-incidence areas of EC in Yanting county have good eating habits, but the clustering of some risk factors is still at a high level. Gender, age, marital status, and occupation are influencing factors of the risk factors clustering of EC.

Citation： LUO Ruiwu, HUANG Heng, CHENG Hao, NI Siyu, FU Siyi, QIAN Qinchun, YANG Junjie, CHEN Xinlong, HUANG Hanyu, ZONG Zhengdong, ZHAO Yujuan, QIN Yuhe, HE Chengcheng, WU Ye, WEN Hongying, TIAN Dong. Clustering analysis of risk factors in high-incidence areas of esophageal cancer in Yanting county. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(3): 385-391. doi: 10.7507/1007-4848.202206023 Copy

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2.	Ye XY, Lai YT, Song WP, et al. The research progress on the association between dietary habits and esophageal cancer: A narrative review. Ann Palliat Med, 2021, 10(6): 6948-6956.
3.	王珣, 韩雪. 汉中地区人群上消化道三种肿瘤发生的危险因素分析. 临床医学研究与实践, 2021, 6(30): 4-6.
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5.	冯祥, 宋统球, 钱东福, 等. 江苏省扬中市食管癌高危人群危险因素及其聚集性. 中华疾病控制杂志, 2021, 25(3): 317-322.
6.	顾晓平, 王银存, 智恒奎, 等. 大丰市食管癌、胃癌发病危险因素及其聚集性病例对照研究. 中国公共卫生, 2016, 32(10): 1406-1409.
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8.	莫帅佳, 王喻, 田东, 等. 盐亭县和清镇市农村居民对食管癌高危饮食生活方式及防治认知现状调查. 中华胸部外科电子杂志, 2018, 5(2): 96-102.
9.	田东, 贺巧, 王洋, 等. 食管癌高发区农村居民饮食状况及对食管癌认知调查. 川北医学院学报, 2010, 25(5): 470-473.
10.	黄桁, 王喻, 姜凯元, 等. 食管癌高发区农村居民饮食状况调查及防治分析. 现代肿瘤医学, 2018, 26(22): 3667-3670.
11.	Tian D, Mo SJ, Han LK, et al. Investigation of dietary factors and esophageal cancer knowledge: Comparison of rural residents in high- and low-incidence areas. Sci Rep, 2018, 8(1): 4914.
12.	张高辉, 鹿子龙, 郭晓雷, 等. 2013年山东省18岁及以上居民饮酒现状调查分析. 中华预防医学杂志, 2017, 51(5): 450-452.
13.	何乔, 敬元华, 黄海容, 等. 四川省南部县农村居民食管癌危险因素暴露水平及聚集分析. 中华肿瘤防治杂志, 2019, 26(22): 1675-1680.
14.	张瑞, 李贺, 李霓, 等. 基于中国城市大规模人群筛查队列的上消化道癌危险因素巢式病例对照研究. 中国肿瘤, 2021, 30(5): 321-327.
15.	李贺, 曾红梅, 邹小农, 等. 基于三个非食管癌高发现场的食管鳞癌相关危险因素的探究. 中国肿瘤, 2019, 28(10): 726-730.
16.	梁玮, 陈雅华, 郑家垚. 早期食管癌的筛查策略: 基于海岛的流行病学和内镜筛查方案. 现代消化及介入诊疗, 2021, 26(2): 149-154.
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18.	龙政, 刘威, 林琳, 等. 1990—2017年中国分省食管癌疾病负担分析. 中国慢性病预防与控制, 2021, 29(8): 571-575.
19.	Vingeliene S, Chan DSM, Vieira AR, et al. An update of the WCRF/AICR systematic literature review and meta-analysis on dietary and anthropometric factors and esophageal cancer risk. Ann Oncol, 2017, 28(10): 2409-2419.
20.	Yan B, Zhang L, Shao Z. Consumption of processed and pickled food and esophageal cancer risk: A systematic review and meta-analysis. Bull Cancer, 2018, 105(11): 992-1002.
21.	Dobo KL, Kenyon MO, Dirat O, et al. Practical and science-based strategy for establishing acceptable intakes for drug product N-nitrosamine impurities. Chem Res Toxicol, 2022, 35(3): 475-489.
22.	Zhao L, Li YC, Wu JP, et al. Increased risk of esophageal squamous cell carcinoma associated with frequent and long-term consumption of salted meat and salted fat. J Int Med Res, 2019, 47(8): 3841-3849.
23.	Deybasso HA, Roba KT, Belachew T. Perceived role of hot food in the pathogenesis of oesophageal cancer: A qualitative study in the Arsi Zone, Oromia, Central Ethiopia. J Nutr Sci, 2021, 10: e1.
24.	Oze I, Charvat H, Matsuo K, et al. Revisit of an unanswered question by pooled analysis of eight cohort studies in Japan: Does cigarette smoking and alcohol drinking have interaction for the risk of esophageal cancer? Cancer Med, 2019, 8(14): 6414-6425.
25.	Lu P, Gu J, Zhang N, et al. 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(31): e21426.
26.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
27.	徐蓉生, 段云, 梅艳, 等. 食管癌高发地区居民食管癌认知情况及饮食偏好. 华南预防医学, 2019, 45(4): 305-308.
28.	Pakzad R, Mohammadian-Hafshejani A, Khosravi B, et al. The incidence and mortality of esophageal cancer and their relationship to development in Asia. Ann Transl Med, 2016, 4(2): 29.

1. 杨欢, 孙宛怡, 王建炳, 等. 中国食管癌病因学、筛查及早期诊断研究进展. 肿瘤防治研究, 2022, 49(3): 169-175.
2. Ye XY, Lai YT, Song WP, et al. The research progress on the association between dietary habits and esophageal cancer: A narrative review. Ann Palliat Med, 2021, 10(6): 6948-6956.
3. 王珣, 韩雪. 汉中地区人群上消化道三种肿瘤发生的危险因素分析. 临床医学研究与实践, 2021, 6(30): 4-6.
4. GBD 2017 Oesophageal Cancer Collaborators. The global, regional, and national burden of oesophageal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol, 2020, 5(6): 582-597.
5. 冯祥, 宋统球, 钱东福, 等. 江苏省扬中市食管癌高危人群危险因素及其聚集性. 中华疾病控制杂志, 2021, 25(3): 317-322.
6. 顾晓平, 王银存, 智恒奎, 等. 大丰市食管癌、胃癌发病危险因素及其聚集性病例对照研究. 中国公共卫生, 2016, 32(10): 1406-1409.
7. 李军, 何永明, 李林, 等. 盐亭县2006—2015年食管癌和胃癌发病死亡趋势分析. 中华肿瘤防治杂志, 2022, 29(11): 795-799.
8. 莫帅佳, 王喻, 田东, 等. 盐亭县和清镇市农村居民对食管癌高危饮食生活方式及防治认知现状调查. 中华胸部外科电子杂志, 2018, 5(2): 96-102.
9. 田东, 贺巧, 王洋, 等. 食管癌高发区农村居民饮食状况及对食管癌认知调查. 川北医学院学报, 2010, 25(5): 470-473.
10. 黄桁, 王喻, 姜凯元, 等. 食管癌高发区农村居民饮食状况调查及防治分析. 现代肿瘤医学, 2018, 26(22): 3667-3670.
11. Tian D, Mo SJ, Han LK, et al. Investigation of dietary factors and esophageal cancer knowledge: Comparison of rural residents in high- and low-incidence areas. Sci Rep, 2018, 8(1): 4914.
12. 张高辉, 鹿子龙, 郭晓雷, 等. 2013年山东省18岁及以上居民饮酒现状调查分析. 中华预防医学杂志, 2017, 51(5): 450-452.
13. 何乔, 敬元华, 黄海容, 等. 四川省南部县农村居民食管癌危险因素暴露水平及聚集分析. 中华肿瘤防治杂志, 2019, 26(22): 1675-1680.
14. 张瑞, 李贺, 李霓, 等. 基于中国城市大规模人群筛查队列的上消化道癌危险因素巢式病例对照研究. 中国肿瘤, 2021, 30(5): 321-327.
15. 李贺, 曾红梅, 邹小农, 等. 基于三个非食管癌高发现场的食管鳞癌相关危险因素的探究. 中国肿瘤, 2019, 28(10): 726-730.
16. 梁玮, 陈雅华, 郑家垚. 早期食管癌的筛查策略: 基于海岛的流行病学和内镜筛查方案. 现代消化及介入诊疗, 2021, 26(2): 149-154.
17. Liu M, Liu Z, Cai H, et al. A model to identify individuals at high risk for esophageal squamous cell carcinoma and precancerous lesions in regions of high prevalence in China. Clin Gastroenterol Hepatol, 2017, 15(10): 1538-1546.
18. 龙政, 刘威, 林琳, 等. 1990—2017年中国分省食管癌疾病负担分析. 中国慢性病预防与控制, 2021, 29(8): 571-575.
19. Vingeliene S, Chan DSM, Vieira AR, et al. An update of the WCRF/AICR systematic literature review and meta-analysis on dietary and anthropometric factors and esophageal cancer risk. Ann Oncol, 2017, 28(10): 2409-2419.
20. Yan B, Zhang L, Shao Z. Consumption of processed and pickled food and esophageal cancer risk: A systematic review and meta-analysis. Bull Cancer, 2018, 105(11): 992-1002.
21. Dobo KL, Kenyon MO, Dirat O, et al. Practical and science-based strategy for establishing acceptable intakes for drug product N-nitrosamine impurities. Chem Res Toxicol, 2022, 35(3): 475-489.
22. Zhao L, Li YC, Wu JP, et al. Increased risk of esophageal squamous cell carcinoma associated with frequent and long-term consumption of salted meat and salted fat. J Int Med Res, 2019, 47(8): 3841-3849.
23. Deybasso HA, Roba KT, Belachew T. Perceived role of hot food in the pathogenesis of oesophageal cancer: A qualitative study in the Arsi Zone, Oromia, Central Ethiopia. J Nutr Sci, 2021, 10: e1.
24. Oze I, Charvat H, Matsuo K, et al. Revisit of an unanswered question by pooled analysis of eight cohort studies in Japan: Does cigarette smoking and alcohol drinking have interaction for the risk of esophageal cancer? Cancer Med, 2019, 8(14): 6414-6425.
25. Lu P, Gu J, Zhang N, et al. 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(31): e21426.
26. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
27. 徐蓉生, 段云, 梅艳, 等. 食管癌高发地区居民食管癌认知情况及饮食偏好. 华南预防医学, 2019, 45(4): 305-308.
28. Pakzad R, Mohammadian-Hafshejani A, Khosravi B, et al. The incidence and mortality of esophageal cancer and their relationship to development in Asia. Ann Transl Med, 2016, 4(2): 29.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clustering analysis of risk factors in high-incidence areas of esophageal cancer in Yanting county

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