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

1.	楊歡, 孫宛怡, 王建炳, 等. 中國食管癌病因學、篩查及早期診斷研究進展. 腫瘤防治研究, 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, 韓雪. 漢中地區人群上消化道三種腫瘤發生的危險因素分析. 臨床醫學研究與實踐, 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.	馮祥, 宋統球, 錢東福, 等. 江蘇省揚中市食管癌高危人群危險因素及其聚集性. 中華疾病控制雜志, 2021, 25(3): 317-322.
6.	顧曉平, 王銀存, 智恒奎, 等. 大豐市食管癌、胃癌發病危險因素及其聚集性病例對照研究. 中國公共衛生, 2016, 32(10): 1406-1409.
7.	李軍, 何永明, 李林, 等. 鹽亭縣2006—2015年食管癌和胃癌發病死亡趨勢分析. 中華腫瘤防治雜志, 2022, 29(11): 795-799.
8.	莫帥佳, 王喻, 田東, 等. 鹽亭縣和清鎮市農村居民對食管癌高危飲食生活方式及防治認知現狀調查. 中華胸部外科電子雜志, 2018, 5(2): 96-102.
9.	田東, 賀巧, 王洋, 等. 食管癌高發區農村居民飲食狀況及對食管癌認知調查. 川北醫學院學報, 2010, 25(5): 470-473.
10.	黃桁, 王喻, 姜凱元, 等. 食管癌高發區農村居民飲食狀況調查及防治分析. 現代腫瘤醫學, 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.	張高輝, 鹿子龍, 郭曉雷, 等. 2013年山東省18歲及以上居民飲酒現狀調查分析. 中華預防醫學雜志, 2017, 51(5): 450-452.
13.	何喬, 敬元華, 黃海容, 等. 四川省南部縣農村居民食管癌危險因素暴露水平及聚集分析. 中華腫瘤防治雜志, 2019, 26(22): 1675-1680.
14.	張瑞, 李賀, 李霓, 等. 基于中國城市大規模人群篩查隊列的上消化道癌危險因素巢式病例對照研究. 中國腫瘤, 2021, 30(5): 321-327.
15.	李賀, 曾紅梅, 鄒小農, 等. 基于三個非食管癌高發現場的食管鱗癌相關危險因素的探究. 中國腫瘤, 2019, 28(10): 726-730.
16.	梁瑋, 陳雅華, 鄭家垚. 早期食管癌的篩查策略: 基于海島的流行病學和內鏡篩查方案. 現代消化及介入診療, 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.	龍政, 劉威, 林琳, 等. 1990—2017年中國分省食管癌疾病負擔分析. 中國慢性病預防與控制, 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, 梅艷, 等. 食管癌高發地區居民食管癌認知情況及飲食偏好. 華南預防醫學, 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. 楊歡, 孫宛怡, 王建炳, 等. 中國食管癌病因學、篩查及早期診斷研究進展. 腫瘤防治研究, 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, 韓雪. 漢中地區人群上消化道三種腫瘤發生的危險因素分析. 臨床醫學研究與實踐, 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. 馮祥, 宋統球, 錢東福, 等. 江蘇省揚中市食管癌高危人群危險因素及其聚集性. 中華疾病控制雜志, 2021, 25(3): 317-322.
6. 顧曉平, 王銀存, 智恒奎, 等. 大豐市食管癌、胃癌發病危險因素及其聚集性病例對照研究. 中國公共衛生, 2016, 32(10): 1406-1409.
7. 李軍, 何永明, 李林, 等. 鹽亭縣2006—2015年食管癌和胃癌發病死亡趨勢分析. 中華腫瘤防治雜志, 2022, 29(11): 795-799.
8. 莫帥佳, 王喻, 田東, 等. 鹽亭縣和清鎮市農村居民對食管癌高危飲食生活方式及防治認知現狀調查. 中華胸部外科電子雜志, 2018, 5(2): 96-102.
9. 田東, 賀巧, 王洋, 等. 食管癌高發區農村居民飲食狀況及對食管癌認知調查. 川北醫學院學報, 2010, 25(5): 470-473.
10. 黃桁, 王喻, 姜凱元, 等. 食管癌高發區農村居民飲食狀況調查及防治分析. 現代腫瘤醫學, 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. 張高輝, 鹿子龍, 郭曉雷, 等. 2013年山東省18歲及以上居民飲酒現狀調查分析. 中華預防醫學雜志, 2017, 51(5): 450-452.
13. 何喬, 敬元華, 黃海容, 等. 四川省南部縣農村居民食管癌危險因素暴露水平及聚集分析. 中華腫瘤防治雜志, 2019, 26(22): 1675-1680.
14. 張瑞, 李賀, 李霓, 等. 基于中國城市大規模人群篩查隊列的上消化道癌危險因素巢式病例對照研究. 中國腫瘤, 2021, 30(5): 321-327.
15. 李賀, 曾紅梅, 鄒小農, 等. 基于三個非食管癌高發現場的食管鱗癌相關危險因素的探究. 中國腫瘤, 2019, 28(10): 726-730.
16. 梁瑋, 陳雅華, 鄭家垚. 早期食管癌的篩查策略: 基于海島的流行病學和內鏡篩查方案. 現代消化及介入診療, 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. 龍政, 劉威, 林琳, 等. 1990—2017年中國分省食管癌疾病負擔分析. 中國慢性病預防與控制, 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, 梅艷, 等. 食管癌高發地區居民食管癌認知情況及飲食偏好. 華南預防醫學, 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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