Does family history of cancer modify the effects of lifestyle risk factors on esophageal cancer? a population‐based case–control study in China

Abstract

A population-based case-control study on esophageal cancer has been conducted since 2003 in Jiangsu Province, China. The aim of this analysis is to provide further evidence on the relationship between family history of cancer in first-degree relatives (FH-FDRs) and the risk of esophageal cancer, and to explore the joint effects for FH-FDR with major lifestyle risk factors. A total of 1,520 cases and 3,879 controls were recruited. Unconditional logistic regression was applied for evaluating independent association as well as potential interactions between FH-FDR and lifestyle risk factors on the risk of esophageal cancer. Population attributable fraction (PAF) was calculated to quantify the proportion of cases attributable to risk factors. Results showed that with a FH-FDR of any malignant tumor or esophageal cancer, there is a 1.64-and 2.22-fold risk of esophageal cancer, respectively. Association was increased when there was more than one affected FDR (OR 5 3.14) and younger age at diagnosis of relatives. Exposure of both FH-FDR and lifestyle risk factors strongly associated with esophageal cancer. Significant superadditivity interaction was found for FH-FDR with fast eating speed and diets low in fruits and vegetables. The estimation of PAF indicated that the majority of cases were attributed to lifestyle risk factors. In conclusion, it was found that FH-FDR significantly increases the risk of esophageal cancer and could modify the effect of certain lifestyle risk factors. If comprehensive lifestyle interventions are carried out within high-risk populations, there is a high probability of curbing occurrences of esophageal cancer.Esophageal cancer is one of the most common cancers worldwide, with $462,000 new cases and 386,000 deaths each year. China is an area with one of the highest incidences of esophageal cancer worldwide. Each year, about one-half of the cases of esophageal cancer that occur in the world are estimated to be in China. 1 According to the results of a national mortality retrospective survey conducted in 2006, esophageal cancer was the fourth leading cause of cancer death in China, with a national average age-standardized mortality of 15.2/100,000. 2 Squamous cell carcinoma of the esophagus remains the predominant histological subtype, representing more than 95% of total cases in the Chinese population. 3 The etiology of esophageal cancer shows that it is multifactorial. A number of studies have suggested that lifestyle factors are significant to the development of this disease. Tobacco smoking and alcohol consumption are responsible for a high fraction of esophageal cancer occurrence; more than 90% of cases could be attributed to these two factors in Western countries. 4 Dietary factors such as ingestion of hot foods and drinks, fast eating speed, nutrition deficiency and high intake of carcinogens from pickled vegetables have been suggested to contribute to most cases of esophageal cancer in high-risk areas such as China and Iran. 5,6 Moreover, genetics and other endogenous factors may also ...

Gastrointestinal cancer risk in patients with a family history of gastrointestinal cancer

“…Family members not only share genetic defects, but also similar environmental factors, such as dietary, smoking, alcohol drinking, and physical habits. Wu et al 24 reported that family history of EsoCa and similar lifestyles act synergistically in a population-based case-control study in China. Up to 3-fold higher risk was observed in individuals with a relative of EsoCa when they have lifestyle risk factors, such as smoking, alcohol, high-sodium diet, consuming very hot foods, and fast-eating speed.…”

“…Up to 3-fold higher risk was observed in individuals with a relative of EsoCa when they have lifestyle risk factors, such as smoking, alcohol, high-sodium diet, consuming very hot foods, and fast-eating speed. 24 Some gene variants associated with CRC development also showed different effects depending on environmental factors, such as intake of vitamin D, calcium, and selenium, as well as smoking habit. 14 These observations in-dicate that a comprehensive lifestyle intervention in these high-risk populations may reduce the incidence of GI cancers.…”

Analysis of TP53 Polymorphisms in North Indian Sporadic Esophageal Cancer Patients

“…In patients, 13.97% subjects were smokers, 29.41% were alcoholic while 11.77% were smokers and alcoholic. Several studies investigating the effects of smoking and alcohol intake on the risk of esophageal cancer have demonstrated that long duration, high consumption and the interaction of these habits may increase the risk of EC (Franceschi et al, 1990;Launoy et al, 1997;Zambon et al, 2000;Castellsague et al, 2004;Lee et al, 2005;Muwonge et al, 2008;Chen et al, 2010;Wu et al, 2011). About 81.62% of patients were from rural background with agriculture as family occupation and 50.74% of them were exposed to pesticides and other agriculture chemicals.…”

Proteomics and Esophageal Cancer

“…With 386000 annual death, eophageal cancer is the sixth leading cause of cancer death worldwide [12] [13]. The incidence of esophageal cancer is geographically diverse as a large variation could be observed for different parts of the world.…”