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Open Access 01-12-2021 | Esophagitis | Research

Risk factors for esophageal squamous cell carcinoma and its histological precursor lesions in China: a multicenter cross-sectional study

Authors: Chen Niu, Yong Liu, Jialin Wang, Yuqin Liu, Shaokai Zhang, Yongzhen Zhang, Liwei Zhang, Deli Zhao, Fugang Liu, Lina Chao, Xinzheng Wang, Chunli Zhang, Guohui Song, Zhiyi Zhang, Youpeng Li, Zheng Yan, Yongxiu Wen, Yinyin Ge, Zhaoping Zang, Wei Feng, Haiping Zhang, Lixin Tao, Rena Nakyeyune, Yi Shen, Yi Shao, Xiuhua Guo, Toni Miles, Aiming Yang, Fen Liu, Guiqi Wang

Published in: BMC Cancer | Issue 1/2021

Abstract

Background

Despite research efforts, the causative factors that contribute to esophageal squamous cell carcinoma (ESCC) in high-risk areas have not yet been understood. In this study, we, therefore, aimed to describe the risk factors associated with ESCC and its precursor lesions.

Methods

We performed an endoscopic examination of 44,857 individuals aged 40–69 years from five high incidence regions of China in 2017–2018. Participants were classified as 4 groups of normal control, esophagitis, low-grade intraepithelial neoplasia (LGIN) and high-grade intraepithelial neoplasia/esophageal squamous cell carcinoma (HGIN/ESCC) using an unconditional logistic regression determine risk factors.

Results

We identified 4890 esophagitis, 1874 LGIN and 437 HGIN/ESCC cases. Crude odds ratios (ORs) and adjusted odds ratios were calculated using unconditional logistic regression. Drinking well and surface water, salty diet, and positive family history of cancer were the common risk factors for esophagitis, LGIN and HGIN/ESCC. History of chronic hepatitis/cirrhosis was the greatest risk factor of esophagitis (adjusted OR 2.96, 95%CI 2.52–3.47) and HGIN/ESCC (adjusted OR 1.91, 95%CI 1.03–3.22). Pesticide exposure (adjusted OR 1.20, 95%CI 1.05–1.37) was essential risk factor of LGIN.

Conclusions

Among individuals aged 40–69 years in high incidence regions of upper gastrointestinal cancer, the results provided important epidemiological evidence for the prevention of different precancerous lesions of ESCC.

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Title: Risk factors for esophageal squamous cell carcinoma and its histological precursor lesions in China: a multicenter cross-sectional study
Authors: Chen Niu
Yong Liu
Jialin Wang
Yuqin Liu
Shaokai Zhang
Yongzhen Zhang
Liwei Zhang
Deli Zhao
Fugang Liu
Lina Chao
Xinzheng Wang
Chunli Zhang
Guohui Song
Zhiyi Zhang
Youpeng Li
Zheng Yan
Yongxiu Wen
Yinyin Ge
Zhaoping Zang
Wei Feng
Haiping Zhang
Lixin Tao
Rena Nakyeyune
Yi Shen
Yi Shao
Xiuhua Guo
Toni Miles
Aiming Yang
Fen Liu
Guiqi Wang
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Esophagitis
Published in: BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-021-08764-x

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