Esophageal cancer in Kashmir — an assessment

  • Maqsood Siddiqi
  • R. Preussmann
Guest Editorial

Conclusion

Kashmir, with its culturally distinct population with uniform and stable dietary habits, provides an interesting field area for studying the relevance of diet in human esophageal carcinogenesis. In the absence of several features of life-style normally associated with increased incidence of the disease, the local food habits appear to be critical factors in the etiology of this cancer in Kashmir. Evidence from our preliminary studies shows a considerable dietary exposure to preformed N-nitroso compounds in the local population. In addition, the potential endogenous formation of N-nitroso compounds, caused by high precursor contents in certain foodstuffs, enhances the relevance of these compounds as possible risk factors for esophageal and other gastrointestinal cancers in this region. The quantitative assessment of total human exposure to N-nitroso compounds and their exact significance to the high cancer incidence in Kashmir requires carefully planned environmental monitoring and prospective epidemiological studies.

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References

  1. Bartsch H, Montesano R (1984) Relevance of nitrosamines to human cancer. Carcinogenesis 5:1381–1393Google Scholar
  2. Bartsch H, Ohshima H, Nair J (1986) Modifiers of endogenous nitrosamine synthesis and metabolism. In: Shankel DM, Hartman PE, Kada T, Hollander A (eds) Antimutagenesis and anticarcinogenesis mechanisms. Plenum, New York, pp 87–101Google Scholar
  3. Bhatia PL, Bhide SV (1983) Risk factors in oesophageal cancer. Indian J Cancer 20:43–48Google Scholar
  4. Burrell RJW (1962) Esophageal cancer among Bantu in Traskei J Natl Cancer Inst 28:495–514Google Scholar
  5. Chen J, Ohshima H, Yang H, Li J, Cambell TC, Peto R, Bartsch H (1987) A correlation study on urinary excretion of N-nitroso compounds and cancer mortality in China: interim results. In: Bartsch H, O'Neill I, Schulte-Hermann R (eds) The relevance of N-nitroso compounds to human cancer: exposure and mechanisms. IARC Scientific Publication no. 84, IARC. Lyon, pp 503–506Google Scholar
  6. Cook-Muzaffari PJ, Azordegan F, Day NE et al. (1979) Oesophageal cancer studies in the Caspian Littoral of Iran: results of a case-control study. Br J Cancer 39:293–309Google Scholar
  7. Coordinating group for research on etiology of esophageal cancer in North China (1975) The epidemiology and etiology of esophageal cancer in North China. A preliminary report. Chin Med J 1:167–183Google Scholar
  8. Correa P (1987) Modulation of gastric carcinogenesis: updated model based on intragastric nitrosation. In: Bartsch H, O'Neill I, Schulte-Hermann R (eds) The relevance of N-nitroso compounds to human cancer: exposure and mechanisms. IARC Scientific Publications no. 84, IARC, Lyon, pp 485–491Google Scholar
  9. Crespi M, Munoz N, Grassi A, Shen Qiong, Wang Kuo Jing, Lin Jing Jien (1984) Precursor lesions of esophageal cancer in a lowrisk population in China: comparison with high-risk populations. Int J Cancer 34:599–602Google Scholar
  10. Day NE, Munoz N (1984) Esophagus. In: Schottenfeld D, Fraumeni I (eds) Cancer epidemiology and prevention. Saunders Philadelphia, pp 596–623Google Scholar
  11. Doll R (1977) Strategy for detection of cancer hazards to man. Nature 265:496–589Google Scholar
  12. Doll R (1978) Geographical variation in cancer incidence: a clue to causation. World J Surg 2:595–602Google Scholar
  13. Dowlatshahi K, Mobarhan S (1984) Diet and environment in the etiology of esophageal carcinoma. In: Levin B, Riddel RH (eds) Frontiers in gastrointestinal cancer. Elservier Amsterdam, pp 1–17Google Scholar
  14. Druckrey H, Preussmann R, Schmähl D, Ivankovic S (1967) Organotrope carcinogene Wirkung bei 65 verschiedenen N-nitroso-Verbindungen an BD-Ratten. Z Krebsforsch 69:103–201Google Scholar
  15. Durrani HA (1982) The presentation of gastric cancer in Kashmir native: a study of 850 cases. Am J Gastroentrol 77:700 (meet abstr)Google Scholar
  16. Fong LLY, Sivak A, Newberne PM (1977) Zinc and copper concentration in tissues from cancer patients and animals. In: Hemphill DD (ed) Trace substances in environmental health—XI. A symposium, Columbia University of Missouri, pp 184–191Google Scholar
  17. Ghadirian P (1987) Thermal irritation and esophageal cancer in Northern Iran. Cancer 60:1909–1914Google Scholar
  18. Hecker E, Lutz D, Weber J, Goerttler K, Morton JF (1983) Multistage tumor development in the human esophagus — the first identification of cocarcinogens of the tumor promoter type as principal carcinogenic risk factors in a local life style cancer. In: 13th International Cancer Congress, Part B, Biology of Cancer (1). Alan R. Liss, New York, pp 219–238Google Scholar
  19. Hicks RM, Ismail MM, Walters CL, Beecham PT, Rabie MT, el-Alamy MA (1982) Association of bacteriurea and urinary nitrosamine formation with Schistoma haematobium infection in the Qalyub area of Egypt. Trans R Soc Trop Med Hyg 76:519–527Google Scholar
  20. Higginson J, Muir CS (1979) Environmental carcinogenesis: misconception and limitations to cancer control. J Natl Cancer Inst 63:1291–1298Google Scholar
  21. Hoffmann D, Hecht SS (1985) Nicotine-derived N-nitrosamines and tobacco-related cancer: current status and future directions. Cancer Res 45:935–944Google Scholar
  22. Hormozdiari H, Day NE, Aramesh B et al. (1975) Dietary factors and esophageal cancer in the Caspian littoral of Iran. Cancer Res 35:3493–3498Google Scholar
  23. Hsia C-C, Tsao IY (1978) Fungal invasions in esophageal tissues and its possible relation to esophageal carcinoma. Natl Med J China 58:392–396Google Scholar
  24. Joint Iran-International Agency for Research on Cancer Study Group (1977) Esophageal cancer studies in the Caspian Littoral of Iran: results of population studies — a prodrome. J Natl Cancer Inst 59:1127–1137Google Scholar
  25. Li MH, Li P, Li PJ (1980) Research on esophageal cancer in China. Adv Cancer Res 33:174–249Google Scholar
  26. Lu SH, Lin P (1982) Recent research on the etiology of esophageal cancer in China. J Gastroenterol 20:361–367Google Scholar
  27. Mahboobi E, Kmet J, Cook PJ et al. (1973) Oesophageal cancer studies in Caspian Littoral of Iran: the Caspian registry. Br J Cancer 28:197–208Google Scholar
  28. Maqbool M, Ahad A (1976) Carcinoma of esophagus in Kashmir. Indian J Otolaryngol 28:118–122Google Scholar
  29. Martinez I (1969) Factors associated with cancer of esophagus, mouth and pharynx in Porto Rico. J Natl Can Inst 42:1069–1094Google Scholar
  30. Mattoo AR, Kaul HK (1974) Incidence of malignant neoplasm in Kashmir. J Indian Med Assoc 62:309–311Google Scholar
  31. Minocha R, Dani M, Siddiqi M (1986) Evaluation of carcinogenicity of infusions from green tea leaves by microsomal degranulation technique. Ind J Exp Biol 24:224–228Google Scholar
  32. Munoz N, Crespi M (1986) Precancerous lesions of the oesophagus and their risk factors. Gann monograph on cancer research 31:27–33Google Scholar
  33. Munoz N, Crespi M, Grassi A, Wang Guo-Qing, Shen Qiong, Li Zhang Cai (1982) Precursor lesions of esophageal cancer in high risk populations in Iran and China. Lancet I:876–879Google Scholar
  34. Narang APS, Verma A, Sanyal B, Qadri A, Mattoo RL (1987) Evaluation of serum copper and seruloplasmin in prognosis of gastrointestinal tract cancers. Trace Elem Med 4:25–27Google Scholar
  35. O'Neill CH, Hodges GM, Riddle PN, Jordan PW et al. (1980) A fine fibrous silica contaminant of flour in the high esophageal cancer area of North-East Iran. Int J Cancer 26:617–628Google Scholar
  36. Pera M, Cardesa A, Pera C, Mohr U (1987) Nutritional aspects of oesophageal carcinogenesis (Review). Anticancer Res 7:301–308Google Scholar
  37. Perkin DM (1986) Cancer occurrence in developing countries. IARC Scientific Publication no 75. IARC, Lyon, pp 203–222Google Scholar
  38. Peto R, Doll R, Buckley JD, Sporn MB (1981) Can dietary betacarotene materially reduce human cancer rates? Nature 290:201–208Google Scholar
  39. Preston-Martin S (1987) N-nitroso compounds as a cause of human cancer. In: Bartsch H, O'Neill I, Schulte-Hermann R (eds) The relevance of N-nitroso compounds to human cancer: exposure and mechanisms. IARC Scientific Publication no 84, IARC, Lyon, pp 477–484Google Scholar
  40. Preussmann R (1987) Chemical factors in the pathogenesis of esophageal carcinoma. In: Wagner G, Zhang You Hi (eds) Cancer of liver, esophagus and nasopharynx, Springer. Berlin Heidelberg New York, pp 119–123Google Scholar
  41. Preussmann R, Stewart BW (1984) N-Nitroso compounds. In: Searle CE (ed) Chemical carcinogens. ACS Monograph 182, ACS, Washington, pp 643–828Google Scholar
  42. Preussmann R, Tricker AR (1988) N-Nitroso compounds and their precursors in the human environment. In: Hill M (ed) Nitrosamines toxicology and microbiology. Ellis Harwood, Chichester pp 88–11Google Scholar
  43. Siddiqi M, Tricker AR, Preussmann R (1988a) The occurrence of preformed N-nitroso compounds in food samples from a high risk area of esophageal cancer in Kashmir, India. Cancer Lett 39:37–43Google Scholar
  44. Siddiqi M, Tricker AR, Preussmann R (1988b) Formation of N-nitroso compounds under simulated gastric conditions from Kashmir foodstuffs. Cancer Lett 39:259–265Google Scholar
  45. Thurnham DI, Zheng Su-Fang, Munoz N et al. (1985) Comparison of riboflavin, vitamin A, and zinc status of Chinese populations at high and low risk for esophageal cancer. Nutr Cancer 7:131–143Google Scholar
  46. Tricker AR, Siddiqi M, Preussmann R (1988) Occurrence of volatile N-nitrosamines in dried chillies. Cancer Lett 38:271–273Google Scholar
  47. Tuyns AJ, Masse LMF (1973) Mortality from cancer of the esophagus in Brittany. Int J Epidemiol 2:241–245Google Scholar
  48. Tuyns AJ, Bequignot G, Abbatucci JS (1979) Oesophageal cancer and alcohol consumption: importance of types of beverage. Int J Cancer 23:443–447Google Scholar
  49. Tuyns AJ, Riboli E, Doornbos G (1985) Nutrition and cancer of esophagus. In: Jossens JV et al. (eds) Diet and human carcinogenesis. Elsevier, Amsterdam, pp 71–79Google Scholar
  50. Van Rensburg SJ (1981) Epidemiologic and dietary evidence for a specific nutritional predisposition to esophageal cancer. J Natl Cancer Inst 67:243–251Google Scholar
  51. Waterhouse J, Shanmugaratnam K, Muir C, Powell J (1982) Cancer incidence in five continents, vol IV. IARC Scientific Publication no 42. IARC, Lyon, pp 390–397Google Scholar
  52. Weber J, Hecker E (1978) Cocarcinogens of the diterpenes ester type from Croton falvens L. and esophageal cancer in Curacao. Experientia 34:679–682Google Scholar
  53. Yang CHS (1980) Research on esophageal cancer in China: a review. Cancer Res 40:2633–2644Google Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • Maqsood Siddiqi
    • 1
  • R. Preussmann
    • 2
  1. 1.Department of BiochemistryUniversity of KashmirSrinagarIndia
  2. 2.Institute for Toxicology and ChemotherapyGerman Cancer Research CentreHeidelbergGermany

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