Abstract:

The study conducted in Sebei sub- region, Eastern Uganda aimed at assessing the risk factors for esophageal cancer among adults aged 40 years and above in Sebei region and to share the findings with the relevant stakeholders for effective management and control strategies. Methodology: The study employed a descriptive, un- matched case control design using quantitative and qualitative approach. 138 respondents were sampled from patients who were both esophageal cancer cases and non- cases (controls). Data was collected using face to face administered pretested questionnaire. Descriptive and inferential (chi- square and logistic linear regression) was applied to analyse the socio- demographic and economic, behavioural, environmental and medical factors of the respondents. Findings: The study found out that only; alcohol consumption (AOR: 9.95 95%, CI: 2.59-36.08), p=0.001, tobacco use (AOR: 15.37 95%, CI: 3.40- 64.00) p=0.00 and H. Pylori infection (AOR: 7.91 95%, CI: 2.02-27.77), p=0.001 were significant risk factors. Other factors in the study were not significant risk factors (p>0.05). Conclusion: The study concluded that behavioural and medical factors were significant risk factors for esophageal cancer and that the lifestyle of adults aged 40 years and above had a significant impact on their esophageal cancer status. Recommendations: Cessation from alcohol consumption and tobacco use coupled with early testing and prompt treatment of H. Pylori infection can help avert the occurrence of esophageal cancer in the region.

Keywords: Risk Factors, Esophageal Cancer, Adults.

References:

[1].     Altieri, A., La Vecchia, C., Negri, E. (2003). Fluid intake and risk of bladder and other cancers. Eur J ClinNutr57 (Suppl 2): S59–S68.

[2].     Alavanja, M.C & Bonner, M.R. (2012). Occupational pesticide exposures and cancer risk: a review. J. Toxicol. Environ. Health B Crit. Rev. 15 (4), 238–263.

[3].     Bagnardi, V., Rota, M., Botteri, E., Tramacere, I., Islami, F., Fedirko, V, et al, (2013). Light alcohol drinking and cancer: a meta-analysis. Annals of Oncology 24: 301–308, 2013. doi:10.1093/annonc/mds337. Published online 21 August 2012

[4].     Baldi, I., Lebailly, P. (2007). Cancers and pesticides. Rev. Prat. 57 (11 Suppl.), 40–44.

[5].     Blot, W. J., Devesa, S. S., Kneller, R. W., et al. (1991). Rising incidence of Adenocarcinoma of the oesophagus and gastric cardia. JAMA 265.1297-9.

[6].     Boffetta, P., Hashibe, M., La Vecchia, C et al., (2006). The burden of cancer attributable to alcohol drinking. Int J Cancer 2006; 119: 884–887.

[7].     Brusselaers N, Ljung R, Mattsson F., et al. (2013). Education level and survival after Esophageal cancer surgery: a prospective population-based cohort study BMJ Open; 3:e003754. doi: 10.1136/bmjopen-2013-00375.

[8].     Chokunonga, E., Borok, M., Chirenje, Z., Nyakabau, A. and Parkin, D. (2013). Trends in the incidence of cancer in the black population of Harare, Zimbabwe 1991-2010. Int J Cancer.; 133:721-729.

[9].     Dar, N. A., Islami, F., Bhat, G. A, Shah, I. A., Makhdoomi, M. A., Iqbal, B. (2013). Poor oral hygiene and risk of esophageal squamous cell carcinoma in Kashmir. Brittish Journal of Cancr 109. 1367-1372. Doi: 10. 1038/bcj. 213.437.

[10]. De Martel, C., Ferlay, J., Franceschi, S., Vignat, J., Bray, F., Forman, D., et al. (2008). Global burden of cancers attributable to infections in; a review and synthetic analysis. Lancet Oncol.

[11]. Engel G. L. (1980). "The clinical application of the biopsychosocial model". American Journal of Psychiatry 137 (5): 535–544. PMID 7369396. doi: 10.1176/ajp.137.5.535.

[12]. Gerson,L . B. (2009) “Endoscopic mucosal resection for early esophageal cancer- Replacement for oesophagectomy?” Gastroenterology, vol.136, no.1, pp.359–360.

[13]. Gibson M. (2017). Epidemiology, pathobiology, and clinical manifestations of Esophageal cancer. UpToDate Website. Updated February 10, 2017. Accessed April 08, 2017.

[14]. Guo, P. Z. L. Huang, P., Yu, K. Li. (2012). Trends in cancer mortality in China: an update. Ann Oncol; 23 (10): 2755-2762. doi: 10.1093/annonc/mds069.

[15]. Handa, O., Naito, Y., Yoshikawa, T. (2011). Redox biology and gastric carcinogenesis: the role of Helicobacter pylori. Redox Rep; 16: 1-7 [PMID: 21605492 DOI: 10.1179/174329211X1296 8219310756].

[16]. Heineman, E., F., Lijinsky, W., Lee, W. J., Markin, R. S., Weisenburger, D. D., Ward M H. “Agricultural pesticide use and adenocarcinomas of the stomach and oesophagus,” Occupational and Environmental Medicine, vol.61, no.9, pp.743–749, 2004.

[17]. Herrera-Goepfert, R., Lizano, M., Akiba, S, et al (2009). Human papilloma virus and esophageal carcinoma in a Latin-American region. World J Gastroenterol, 15, 3142-7.

[18]. Hu, H.M, Kuo, C.H., Lee, C.H., Wu, I.C., Lee, K.W., Lee, J.M., Goan, Y.G, Chou, S.H, Kao, E.L, Wu, M.T., Wu, D.C. (2009). Polymorphism in COX-2 modifies the inverse association between Helicobacter pylori sero positivity and esophageal squamous cell carcinoma risk in Taiwan: a case control study. BMC Gastroenterol; 9: 37 (PMID: 19463183 DOI: 10.1186/1471-230X-9-37).

[19]. Islami, F, & Kamangar, F. (2008). Helicobacter pylori and esophageal cancer risk: a meta- analysis. Cancer Prev Res (Phila); 1: 329-338 [PMID: 19138977 DOI: 10.1158/1940-6207. CAPR 08.

[20]. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA: A Cancer Journal for Clinicians 2010; 60(5):277–300.

[21]. Kipsengeret, K. K., Mbaria, J. M., Muchemi, G. M., Kitala, P. M, & Laititia, W. K. (2016). Occupational exposure to pesticide and associated health problems in Kenya’s floriculture industry. 1 (1). 1-10. Available at http://www.prudentjournals.org/PRJMMS.

[22]. Kirtika, P., Mwangi, A., Simeon, M., Radheka, P., Wakhisi, J. 2013. Esophageal Cancer, the Topmost Cancer at MTRH in the Rift Valley, Kenya, and Its Potential Risk Factors: Hindawi Publishing Corporation ISRN Oncology Volume, Article ID 503249, 9pages. Accessed on 13^th/03/2017 from http://dx.doi.org/10.1155/2013/503249.

[23]. Koros, K. K., James, M., Mbaria., Gerald, M., Muchemi., Philiph, M., Kitala. & Laititia, W. K. (2016) Occupational exposure to pesticide and associated health problems in Kenya’s floriculture industry. Vol. 1 Issue 1, pp: (1-10), September. Accessed on 16^th march 2017: http://www. Prudentjournals.org/PRJMMS.

[24]. Lagergren, J., Gunnar, A., Mats, T., Sven, D., Erik, B., Juho, H. Marital Status, Education, and Income in Relation to the Risk of Esophageal and Gastric Cancer by Histological Type and Site. Cancer: 122.207- 12. Doi: 10. 1002/cnc29731.

[25]. Lambert, R.; Hainaut, P. (2007). Epidemiology of oesophago-gastric cancer. Best Pract. Res. Clin. Gastroenterol., 21, 921–945.

[26]. Iijima K, Koike T, Abe Y, Yamagishi H, Ara N, Asanuma K, et al. Gastric hyposecretion in esophageal squamous-cell carcinomas. Dig Dis Sci. 2010; 55:1349–55.

[27]. Maxwell, D., Parkin, B., Ferlay, J. and Jema, A. (2014). American Association for cancer Research. DOI: 10.1158/1055-9965.EPI-14-0281. Accessed from cebp.aacrjournals.org on 6^th February 2017.

[28]. Melhado, R E., Derek, A & Tucker, O. (2010). The Changing Face of Esophageal Cancer Cancers, 2, 1379- 1404; doi: 10.3390/cancers2031379 ISSN 2072-6694 Accessed on www.mdpi.com/journal/cancers.

[29]. Mostafalou, S & Abdollahi, M., 2012c. Current concerns on genotoxicity of pesticides. Int.J. Pharmacol. 8 (6), 473–474.

[30]. Paige, M., Kevin, D. S., Yu, Y. and Naimi T S. (2013). Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States. American Journal of Public Health: Vol. 103, No. 4, pp. 641-648. Doi: 10.2105/AJPH.2012.301199.

[31]. Parkin, D.M. (2008). The role of cancer registries in cancer control. Int J ClinOncol; 13:102-11.

[32]. Soroush, S., Saba, S., Sadegh, R. and Mahin.A. (2012-2014). Study of Risk Factors for esophageal Cancer in Khorramabad City From. doi: 10.17795/jjcdc- 33229.

[33]. Stefani, D. E., Muñoz, N., Esteve, J., Vasallo, A., Victora, C.G., Teuchmann, S. (1990). Mate drinking, alcohol, tobacco, diet, and esophageal cancer in Uruguay. Cancer Res, 50: 426431.

[34]. Talukdar, F.R., Ghosh, S. K., Laskar, R.S., Mondal, R. (2013). Epigenetic, Genetic and Environmental Interactions in Esophageal Squamous Cell Carcinoma from Northeast India. PLoS ONE 8(4): e60996. doi: 10.1371/journal.pone.0060996.Editor: Zhihua Liu, Chinese Academy of Medical Sciences, China. Published online 2016 April 26.

[35]. Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet-Tieulent, J. and Jemal, A. (2015). Global cancer statistics, 2012. CA: A Cancer Journal for Clinicians, 65: 87–108. doi:10.3322/caac.21262.

[36]. Wei, M. M., Wei-Hui, Z., Zhi-Qiang, L. Epidemiologic Risk Factors for Esophageal Cancer Development. Asian Pacific J Cancer Prev, 12, 2461-2466.

[37]. Weichenthal, S., Moase, C., Chan, P., 2010. A review of pesticide exposure and Cancer incidence in the Agricultural Health Study cohort. Environ. Health Perspect. 118 (8), 1117–1125.

[38]. World Health Organization. (2010). Health system response and capacity: Policies, strategies and action Plans by country. Available from: http://apps.who.int/gho/data/node.main.A907? lang¼en.