Perceived role of hot food in the pathogenesis of oesophageal cancer: a qualitative study in the Arsi Zone, Oromia, Central Ethiopia

Abstract

Observational studies in Ethiopia have identified a positive association between hot wheat porridge consumption and oesophageal carcinoma. However, a single dietary intake cannot be a sufficient predictor of cancer among populations that have diverse dietary practices. The present study was carried out to explore the community's perspectives on the role of hot foods in the pathogenesis of oesophageal cancer in Ethiopia. Focus group discussions were conducted from May to August 2019 among purposefully selected 112 participants. Data were collected by using open-ended questions; memo writing, audio recordings and photo pictures. All tape-recorded interviews were transcribed verbatim and inductively coded using Atlas.ti Version 7.0.71 software. Finally, the analysis was performed according to the standard thematic framework analysis techniques. The finding showed that hot foods (porridge, coffee and soup) consumption patterns were perceived as the principal dietary risk of oesophageal cancer. Cooking in unventilated rooms, monotonous cereal-based foods, poor vegetable, and fruit intake, not taking milk with porridge, eating fast, swallowing large bolus of hot porridge and exposure to carcinogens in foods were regarded as predisposing dietary practices to oesophageal carcinoma. Socio-demographic, economic and cultural backgrounds were reported as the underlying risk factors associated with oesophageal cancer. There was a strong perception within the community that oesophageal cancer is linked to several but sequentially interlinked dietary and related practices. Cumulative thermal injuries from the consumptions of hot food could be the immediate dietary risk factors associated with increased risk of oesophageal cancer.

Consumption of porridge at Carcinogenic Temperature and Associated Factors in Esophageal Cancer Endemic Area in Ethiopia

“…However, in further analysis, only wheat porridge had a signi cant positive association with the consumption of porridge at a probably carcinogenic temperature compared to maize porridge. The nding supports a qualitative study in the area that demonstrated the perceived heat retention ability of wheat porridge compared to porridge cooked from barley and maize [20]. The probable explanation could be porridges cooked from different grains may display disparities in the convective and/or evaporative heat loss mechanisms.…”

“…The practice of consuming porridge at a carcinogenic temperature was higher than the proportion of households who consumed very hot foods in Iran [7] but lower than the study result in Kenya [16]. On the other hand, the nding supports a qualitative study that reported preferences for very hot porridge by the majority of households living in the study areas [20].…”

“…A 10% non-response rate was added giving a total of 309 utensils of porridge for measurements. Finally, 301 consented households were recruited for the study for the reason that porridge is consumed in a shared manner from a single serving utensil [20].…”

“…The types of porridge, cooking, and serving vessels vary across the ethnic and religious backgrounds of the populations in the Zone. Traditionally, the wooden bowl(Qorii) is used as a porridge serving utensil [20]. The source populations were households that lived in the selected districts.…”

“…Arsi Zone is one of the hot spot areas in Africa`s EC cancer corridor (17) where EC is highly predominant among farmers living in rural areas [18,19]. The consumption of a self-reported "hot porridge" was reported as a major dietary risk factor for an increased incidence of esophageal cancer in the area [18][19][20].…”