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

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.