Dietary, smoking, and drinking habits, as well as sociopsychological factors and familial history, were investigated in a case-control study on the etiology of esophageal cancer (EC) in two areas of Shanxi (Yangcheng and Linfen), north central China. Data were analyzed from 326 cases and 396 controls. We identified several factors associated with high or low risk; some were common across the areas and others were area-specific. Consumption of millet gruel was associated positively with EC, in a dose-response relationship. An increase in EC risk was seen for consumption of millet soup with noodles, and also with certain sociopsychological factors, in both areas. A large increase in risk was found with consumption of boiled vegetables in Linfen, with a dose-response relationship. EC risk tended to become greater with the increasing intake of moldy foods and of pickled vegetable juice. A positive association between EC risk and family history of EC was observed only in Yangcheng. Soybean consumption was found to be associated with reduced risk. Dental hygiene (brushing teeth) was associated with reduced risk in Linfen. There was a suggestion of increased risk associated with heavy tobacco smoking, but it was not significant in either area. Alcohol consumption had a marginally significant association with risk in the high risk area, but not in Linfen.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Wynder EL, Bross IJ. A study of etiological factors in cancer of the esophagus. Cancer 1961; 14: 389–413.
Kmet J, Mahboubi E. Esophageal cancer in the Caspian littoral of Iran: Initial studies. Science 1972; 175: 846–53.
National Cancer Control Office. Data of Cancer Mortality in China. Beijing, PR China: Ministry of Public Health, 1980.
Yang C-s. Research on esophageal cancer in China: a review. Cancer Res 1980; 40: 2633–44.
Yao F-y. Research on causes of esophageal cancer. Chin J Epidemiol 1986; 2: 70–3.
Lu J-b, Qin Y-h. Correlation between high salt intake and mortality rates for oesophageal and gastric cancer in Henan Province, China. Int J Epidemiol 1987; 16: 171–6.
Li J-y, Ershow AG, Chen Z-j, et al. A case-control study of cancer of the esophagus and gastric cardia in Linxian. Int J Cancer 1989; 43: 755–61.
Schlesselman JJ, Case-Control Studies-Design, Conduct, Analysis. Oxford, UK: Oxford University Press, 1982.
Breslow NE, Day NE. Statistical Methods in Cancer Research Vol 1 The Analysis of Case-Control Studies. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32.
SAS Institute. SUGI Supplemental Library User's Guide. Cary, NC, USA: SAD Institute Inc., 1983.
Hopkins RA, Postlethwait RW. Caustic burns and carcinoma of the esophagus. Ann Surg 1981; 194: 146–8.
Yang C-s, Miao J, Yang W, et al. Diet and vitamin nutrition of the high esophageal cancer risk population in Linxian, China. Nutr Cancer 1982; 4: 154–64.
Thurnham DI, Zheng S-f, Munoz N, et al. Comparison of riboflavin, vitamin A, and zinc status of Chinese population at high and low risk for esophageal cancer. Nutr Cancer 1985; 7: 131–43.
Palmer S. Dietary considerations for risk reduction. Cancer 1986; 58: 1949–53.
Tagashira Y, Sasaba T, Nakachi K, et al. Epidemiology of esophageal cancer in Saitama, Japan: A case-control study. Jpn J Public Health 1987; 34: 589–97 (in Japanese with English summary).
Graham S, Marshall J, Haughey B, et al. Nutritional epidemiology of cancer of the esophagus. Am J Epidemiol 1990; 131: 454–67.
Neuberger JS, Lynch HT. Cancer of the esophagus: A model of causation. Med Hypotheses 1982; 9: 337–42.
Messina M, Barnes S. The role of soy products in reducing risk of cancer. JNCI 1991; 83: 541–6.
Benjamin H, Storkson J, Nagahara A, et al. Inhibition of benzo(a)pyrene-induced mouse forestomach neoplasia by dietary soy sauce. Cancer Res 1991; 51: 2940–2.
Odashima S. Advances in chemical carcinogenesis by N-nitroso compounds. J Food Hyg Soc Jpn 1974; 15: 419–33 (in Japanese).
Lu S-h, Oshima H, Fu H-m, et al. Urinary excretion of N-nitrosamino acids and nitrate by inhabitants of high-and low-risk areas for esophageal cancer in northern China: endogenous formation of nitrosoproline and its inhibition by vitamin C. Cancer Res 1986; 46: 1485–91.
National Research Council. Diet, Nutrition, and Cancer. Washington, DC: Commission of Life Sciences, National Academy of Sciences, National Research Council, 1982.
Pour P, Ghadirian P. Familial cancer of the esophagus in Iran. Cancer 1974; 33: 1649–52.
Li G-h, He L-j. A survey of familial aggregation of esophageal cancer in Yangcheng County, Shanxi Province. Chin Med J 1985; 98: 749–52.
Tyuns AJ. Oesophageal cancer in non-smoking drinkers and in non-drinking smokers. Int J Cancer 1983; 32: 443–4.
Brown LM, Blot WJ, Schuman SH, et al. Environmental factors and high risk of esophageal cancer among men in coastal South Carolina. JNCI 1988; 80: 1620–5.
La Vecchia CL, Negri E. The role of alcohol in oesophageal cancer in non-smokers, and of tobacco in non-drinkers. Int J Cancer 1986; 58: 784–5.
Ziegler RG. Alcohol-nutrient interactions in cancer etiology. Cancer 1986; 58: 1942–48.
Saracci R. The interactions of tobacco smoking and other agents in cancer etiology. Epidemiol Rev 1987; 9: 175–93.
Nakachi K, Imai K, Hoshiyama Y, et al. The joint effects of two factors in the aetiology of oesophageal cancer in Japan. J Epidemiol Community Health 1988; 42: 355–64.
Additional information
Drs Y-P Wang, Han, Su, Y-L Wang, and Zhu are in the Shanxi Cancer Institute, PR China. Drs Sasaba, Nakachi, and Hoshiyama are with the Division of Epidemiology at Saitama Cancer Center Research Institute, Japan. Dr Tagashira is in the Saitama Cancer Center Research Institute, Japan. Address correspondence to Dr Sasaba, Ina, Saitama 362, Japan.
Rights and permissions
About this article
Cite this article
Wang, YP., Han, XY., Su, W. et al. Esophageal cancer in Shanxi Province, People's Republic of China: a case-control study in high and moderate risk areas. Cancer Causes Control 3, 107–113 (1992). https://doi.org/10.1007/BF00051650
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00051650