Association of smoking, alcohol drinking and dietary factors with esophageal cancer in high- and low-risk areas of Jiangsu Province, China

doi:10.3748/wjg.v12.i11.1686

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Esophageal Cancer

World J Gastroenterol. Mar 21, 2006; 12(11): 1686-1693
Published online Mar 21, 2006. doi: 10.3748/wjg.v12.i11.1686

Table 1 Characteristics among EC cases and controls in Dafeng and Ganyu ¹n (%)

Characteristics		Dafeng (high-risk)		Ganyu (low-risk)		P value²
Characteristics		Case (n=291)	Control (n=291)	Control (n=240)	Case (n=240)	P value²
Gender: Male		200 (68.7)	200 (68.7)	181 (75.4)	181 (75.4)	0.088
	Female	91 (31.3)	91 (31.3)	59 (24.6)	59 (24.6)
Age (yr) Mean±SD		64.8 ± 8.6	64.6 ± 8.9	65.4 ± 10.3	65.6 ± 10.4	0.088	0.002
	<50	14 (4.8)	17 (5.8 )	19 (7.9)	17 (7.1)
	50-59	61 (30.0)	59 (20.3)	48 (20.0)	51 (21.3)
	60-69	137(47.1)	137 (47.1)	78 (32.5)	76 (31.7)
	70-79	71 (24.4)	69 (23.7)	77 (32.1)	78 (32.5)
	≥80	8 (2.8)	9 (3.1)	18 (7.5)	18 (7.5)
Level of education
	Illiterate	156 (53.6)	130 (44.7)	138 (57.7)	164 (68.6)	<0.001
	Primary school	95 (32.7)	119 (40.9)	63 (26.4)	54 (22.6)
	Secondary school & above	40 (13.7)	42 (14.4)	38 (15.9)	21 (8.8 )
Past economic status(By separate cut-off points)
Median (CNY/yr)		1250	1500	1000	775	0.235
	1 (lowest)	97 (33.5)	55 (19.0)	38 (16.2)	47 (20.3)
	2	68 (23.5)	64 (22.1)	71 (30.2)	87 (37.5)
	3	73 (25.2)	96 (33.1)	71 (30.2)	59 (25.4)
	4 (highest)	52 (17.9)	75 (25.9)	55 (23.4)	39 (16.8)
Smoking status³
	Neversmoker	92 (31.6)	122 (41.9)	95 (39.6)	82 (34.2)		0.067
	Former-smoker	71 (24.4)	64 (22.0)	19 (7.9)	17 (7.1)
	Current smoker	128 (44.0)	105 (36.1)	126 (52.5)	141 (58.7)
Alcohol drinking status⁴
	Never drinker	175 (60.1)	181 (62.2)	143 (59.6)	131 (54.6)		0.076
	Former drinker	5 (1.7)	7 (2.4)	7 (2.9)	7 (2.9)
	Current drinker	111 (38.1)	103 (35.4)	90 (37.5)	102 (42.5)
Encountered misfortune in past10 yr:
	No	54 (18.6)	41 (14.2)	33 (14.0)	54 (23.3)	0.008
	Yes	237 (81.4)	248 (85.8)	203 (86.0)	178 (76.7)	0.008
History of family cancer
	No	112 (38.5)	86 (29.6)	16 (6.7)	29 (12.1)	<0.001
	Yes	179 (61.5)	205 (70.5)	224 (93.3)	211 (87.9)	<0.001
Body mass index
	<18.5	60 (20.8)	27 (9.3)	18 (7.6)	31 (13.4)	0.014
	18.5-23.9	182 (63.0)	192 (66.2)	161 (67.9)	155 (67.1)
	23.9-27.9	34 (11.8)	60 (20.7 )	46 (19.4)	28 (12.1)
	≥28	13 (4.5)	11 (3.8)	12 (5.1)	17 (7.4)

¹ Some strata do not match the total because of missing values;

² The P-value for comparing the distribution of factors between the two counties;

³ Never-smokers and ever-smokers were used for comparing the smoking habits between the two counties;

⁴ Because of the few numbers of former drinkers in both two counties, alcohol drinking status was categorized to never-drinkers and ever-drinkers for the comparison between the two counties and following analyses.

Table 2 OR¹ and 95% CI of socioeconomic status in EC of Dafeng and Ganyu

Socioeconomic status		Dafeng (high-risk)	Ganyu (low-risk)
Level of education
	Illiterate	1.00 (Referent)	1.00 (Referent)
	Primary school	0.54 (0.35-0.84)	0.58 (0.33-1.03)
	Secondary school & above	0.74 (0.39-1.41)	0.42 (0.21-0.83)
	P value for trend	0.08	0.008
Past economic status
	1 (lowest)	1.00 (Referent)	1.00 (Referent)
	2	0.67 (0.43-1.06)	1.03 (0.61-1.75)
	3	0.44 (0.28-0.68)	0.76 (0.44-1.31)
	4 (highest)	0.39 (0.23-0.65)	0.73 (0.41-1.28)
	P value for trend	<0.001	0.024
Encountered misfortune in past 10 yr
	No	1.00 (Referent)	1.00 (Referent)
	Yes	1.26 (0.80-1.98)	1.64 (0.98-2.73)
History of family cancer
	No	1.00 (Referent)	1.00 (Referent)
	Yes	1.53 (1.06-2.19)	2.07 (1.03-4.17)
Body mass index
	<18.5	1.00 (Referent)	1.00 (Referent)
	18.5-23.9	0.45 (0.26-0.76)	0.50 (0.28-0.90)
	23.9-27.9	0.26 (0.13-0.50)	0.36 (0.17-0.75)
	≥28	0.49 (0.18-1.33)	0.80 (0.33-1.98)
	P value for trend	0.002	0.376

¹ Matched by age and gender, further adjusted for education level and past economic status (quartile).

Table 3 OR¹ and 95% CI of tobacco smoking in EC of Dafeng and Ganyu

Tobacco smoking		Dafeng (high-risk)	Ganyu (low-risk)
Smoking status²
	Former smoker	1.93 (0.91-4.08)	1.28 (0.28-5.83)
	Current smoker	2.42 (1.28-4.56)	2.36 (0.89-6.26)
	P value for trend	0.005	0.07
Duration of smoking (yr)2
	<20	2.02 (0.93-4.38)	1.60 (0.31-7.90)
	20-34	2.32 (1.15-4.67)	2.25 (0.80-6.35)
	≥35	1.80 (0.62-5.24)	0.98 (0.29-3.24)
	P value for trend	0.016	0.249
Duration of smoking (yr)²
	1-29	1.61 (0.67-3.86)	1.44 (0.46-4.42)
	30-49	2.65 (1.28-5.49)	2.04 (0.60-6.92)
	≥20	2.04 (0.78-5.35)	1.98 (0.43-9.11)
	P value for trend	0.009	0.194
Amount of smoking (Cig/d)²
	1-9	1.36 (0.50-3.74)	1.12 (0.27-4.68)
	10-19	2.21 (1.01-4.80)	1.56 (0.42-5.78)
	≥20	2.04 (1.00-4.18)	0.91 (0.32-2.61)
	P value for trend	0.015	0.915
Total consumption of cigarettes²
	1 (lowest)	1.40 (0.61-3.21)	0.96 (032-2.82)
	2	2.55 (1.06-6.14)	3.50 (0.37-32.8)
	3	1.88 (0.79-4.49)	1.94 (0.25-14.7)
	4 (highest)	1.81 (0.57-5.74)	0.74 (0.19-2.81)
	P value for trend	0.029	0.959

¹ Matched by age and gender, further adjusted for level of education, past economic status (group) and alcohol drinking;

² Never-smokers were used as the reference group.

Table 4 OR¹ and 95% CI of alcohol drinking in EC of Dafeng and Ganyu

Alcohol drinking		Dafeng (high-risk)	Ganyu (low-risk)
Alcohol drinking
	Never	1.00 (Referent)	1.00 (Referent)
	Ever	1.01 (0.70-1.46)	1.71 (1.02-2.88)
	P value	0.964	0.043
Age of first drink²
	<20	0.83 (0.44-1.58)	2.59 (1.03-6.50)
	20-34	1.23 (0.79-1.91)	1.95 (1.08-3.53)
	≥35	0.81 (0.48-1.35)	1.18 (0.56-2.47)
	P value for trend	0.815	0.012
Duration of drinking (yr)²
	1-24	0.96 (0.56-1.59)	1.28 (0.58-2.79)
	25-34	0.89 (0.48-1.64)	1.48 (0.75-2.94)
	35-44	1.57 (0.92-2.70)	1.47 (0.71-3.01)
	≥45	0.77 (0.43-1.40)	1.88 (0.95-3.75)
P value for trend		0.834	0.061
Alcohol consumption 10 years ago² (pure ethanol mL/wk)
	1-249	0.87 (0.49-1.54)	0.79 (0.36-1.74)
	250-499	1.06 (0.60-1.89)	0.61 (0.30-1.25)
	500-749	0.97 (0.52-1.79)	1.63 (0.77-3.43)
	≥750	1.10 (0.63-1.93)	1.27 (0.71-2.28)
	P value for trend	0.74	0.223

¹ Matched by age and gender, further adjusted for level of education, past economic status (group) and tobacco smoking;

² Never-drinkers were used as the reference group.

Table 5 OR and 95% CI of dietary habits, food consumption in EC of Dafeng and Ganyu

Dietary factor	County	Category				P value for trend
Dietary factor	County	1 (lowest)	2	3	4 (highest)	P value for trend
Food temperature¹	Dafeng	1	0.51 (0.24-1.09)	-	-	0.08
(1-Normal; 2- Hot)	Ganyu	1	1.14 (0.55-2.41)	-	-	0.714
Eating speed¹	Dafeng	1	4.01 (1.87-8.62)	-	-	<0.001
(1-Normal; 2-Fast)	Ganyu	1	3.09 (1.24-7.70)	-	-	0.015
Self reported grain fungi pollution¹	Dafeng	1	2.27 (0.79-6.54)	-	-	0.131
(1-Likely; 2-Not likely)	Ganyu	1	1.18 (0.45-3.11)	-	-	0.741
Fresh garlic/wk²³	Dafeng	1	0.64 (0.26-1.60)	-	-	0.337
Fresh garlic/wk²³	Ganyu	1	1.17 (0.57-2.41)	-	-	0.664
Staple foods¹	Dafeng	1	0.45 (0.19-1.10)	0.54 (0.21-1.38)	0.73 (0.26-2.04)	0.474
Staple foods¹	Ganyu	1	0.98 (0.10-9.77)	0.45 (0.05-4.38)	0.54 (0.05-4.34)	0.324
Meat⁴	Dafeng	1	0.73 (0.29-1.85)	1.66 (0.68-4.10)	1.93 (0.64-5.77)	0.16
Meat⁴	Ganyu	1	0.54 (0.12-2.42)	1.17 (0.28-4.92)	0.65 (0.11-3.67)	0.305
Fish and seafood products⁴	Dafeng	1	1.14 (0.64-2.03)	2.11 (1.12-3.96)	1.91 (1.00-3.64)	0.023
Fish and seafood products⁴	Ganyu	1	0.98 (0.42-2.28)	0.64 (0.28-1.44)	1.04 (0.46-2.33)	0.794
Eggs⁴	Dafeng	1	0.53 (0.20-1.44)	1.23 (0.54-2.80)	1.99 (0.72-5.49)	0.146
Eggs⁴	Ganyu	1	0.69 (0.28-1.73)	0.30 (0.10-1.10)	0.95 (0.41-2.22)	0.936
Soybean⁴⁵	Dafeng	1	1.81 (0.88-3.74)	-	-	0.11
Soybean⁴⁵	Ganyu	1	1.31 (0.37-4.59)	-	-	0.677
Preserved foods⁴	Dafeng	1	0.26(0.09-0.75)	0.49 (0.16-1.46)	0.94 (0.37-2.36)	0.635
Preserved foods⁴	Ganyu	1	1.05 (0.37-2.97)	0.56 (0.21-1.48)	1.21 (0.46-3.20)	0.932
Vegetables⁴	Dafeng	1	1.26 (0.50-3.16)	0.94 (0.39-2.30)	1.37 (0.49-3.83)	0.72
Vegetables⁴	Ganyu	1	0.34 (0.08-1.54)	0.80 (0.20-3.18)	0.76 (0.15-3.72)	0.889
Fruits²	Dafeng	1	1.02 (0.42-2.47)	0.42 (0.16-1.12)	1.23 (0.51-2. 98)	0.802
Fruits²	Ganyu	1	1.61 (0.68-3.80)	1.13 (0.43-2.95)	1.17 (0.41-3.37)	0.746

¹ Matched by age and gender, further adjusted for level of education, past economic status (group), smoking, alcohol drinking, BMI group, cancer family history, eating speed, food temperature and self-reported grain fungi pollution;

² Matched by age and gender, further adjusted for education level, past economic status (group), smoking, alcohol drinking, BMI group, eating speed and family history of cancer;

³ Less than 3 times per week=1, 3 times per week and above=2;

⁴ Matched by age and gender, further adjusted for level of education, past economic status (group), smoking, alcohol drinking, BMI group, cancer family history, eating speed and food temperature;

⁵ Categorized by median among controls.

Citation: Wu M, Zhao JK, Hu XS, Wang PH, Qin Y, Lu YC, Yang J, Liu AM, Wu DL, Zhang ZF, Frans KJ, Veer PV. Association of smoking, alcohol drinking and dietary factors with esophageal cancer in high- and low-risk areas of Jiangsu Province, China. World J Gastroenterol 2006; 12(11): 1686-1693
URL: https://www.wjgnet.com/1007-9327/full/v12/i11/1686.htm
DOI: https://dx.doi.org/10.3748/wjg.v12.i11.1686