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Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies

Geophagia, the intentional practice of consuming soil, occurs across the African esophageal cancer corridor, particularly during pregnancy. We investigated whether this practice is linked to endemic esophageal squamous cell carcinoma (ESCC) in this region. We conducted ESCC case‐control studies in T...

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Autores principales: Narh, Clement T., Dzamalala, Charles P., Mmbaga, Blandina T., Menya, Diana, Mlombe, Yohannie, Finch, Peter, Nyakunga, Gissela, Schüz, Joachim, McCormack, Valerie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411422/
https://www.ncbi.nlm.nih.gov/pubmed/34004024
http://dx.doi.org/10.1002/ijc.33688
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author Narh, Clement T.
Dzamalala, Charles P.
Mmbaga, Blandina T.
Menya, Diana
Mlombe, Yohannie
Finch, Peter
Nyakunga, Gissela
Schüz, Joachim
McCormack, Valerie
author_facet Narh, Clement T.
Dzamalala, Charles P.
Mmbaga, Blandina T.
Menya, Diana
Mlombe, Yohannie
Finch, Peter
Nyakunga, Gissela
Schüz, Joachim
McCormack, Valerie
author_sort Narh, Clement T.
collection PubMed
description Geophagia, the intentional practice of consuming soil, occurs across the African esophageal cancer corridor, particularly during pregnancy. We investigated whether this practice is linked to endemic esophageal squamous cell carcinoma (ESCC) in this region. We conducted ESCC case‐control studies in Tanzania, Malawi and Kenya. Cases were patients with incident histologically/clinically confirmed ESCC and controls were hospital patients/visitors without digestive diseases. Participants were asked if they had ever eaten soil (never/regularly/pregnancy‐only). Odds ratios (OR) are adjusted for sex, age, tobacco, alcohol, country, religion and marital status. Overall, 934 cases (Malawi 535, Tanzania 304 and Kenya females 95) and 995 controls provided geophagia information. Among controls, ever‐geophagia was common in women (Malawi 49%, Kenya 43% and Tanzania 29%) but not in men (10% Malawi, <1% Tanzania). In women, ESCC ORs were 1.25 (95% CI: 0.70, 2.22) for regular versus never geophagia and 0.88 (95% CI: 0.64, 1.22) for pregnancy‐only versus never. Findings were stronger based on comparisons of cases with hospital visitor controls and were null using hospital patients as controls. In conclusion, geophagia is too rare to contribute to the male ESCC burden in Africa. In women, the practice is common but we did not find consistent evidence of a link to ESCC. The study cannot rule out selection bias masking modest effects. Physical effects of geophagia do not appear to have a large impact on overall ESCC risk. Research with improved constituent‐based geophagia exposure assessment is needed.
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spelling pubmed-84114222021-09-08 Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies Narh, Clement T. Dzamalala, Charles P. Mmbaga, Blandina T. Menya, Diana Mlombe, Yohannie Finch, Peter Nyakunga, Gissela Schüz, Joachim McCormack, Valerie Int J Cancer Cancer Epidemiology Geophagia, the intentional practice of consuming soil, occurs across the African esophageal cancer corridor, particularly during pregnancy. We investigated whether this practice is linked to endemic esophageal squamous cell carcinoma (ESCC) in this region. We conducted ESCC case‐control studies in Tanzania, Malawi and Kenya. Cases were patients with incident histologically/clinically confirmed ESCC and controls were hospital patients/visitors without digestive diseases. Participants were asked if they had ever eaten soil (never/regularly/pregnancy‐only). Odds ratios (OR) are adjusted for sex, age, tobacco, alcohol, country, religion and marital status. Overall, 934 cases (Malawi 535, Tanzania 304 and Kenya females 95) and 995 controls provided geophagia information. Among controls, ever‐geophagia was common in women (Malawi 49%, Kenya 43% and Tanzania 29%) but not in men (10% Malawi, <1% Tanzania). In women, ESCC ORs were 1.25 (95% CI: 0.70, 2.22) for regular versus never geophagia and 0.88 (95% CI: 0.64, 1.22) for pregnancy‐only versus never. Findings were stronger based on comparisons of cases with hospital visitor controls and were null using hospital patients as controls. In conclusion, geophagia is too rare to contribute to the male ESCC burden in Africa. In women, the practice is common but we did not find consistent evidence of a link to ESCC. The study cannot rule out selection bias masking modest effects. Physical effects of geophagia do not appear to have a large impact on overall ESCC risk. Research with improved constituent‐based geophagia exposure assessment is needed. John Wiley & Sons, Inc. 2021-05-28 2021-09-15 /pmc/articles/PMC8411422/ /pubmed/34004024 http://dx.doi.org/10.1002/ijc.33688 Text en © 2021 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cancer Epidemiology
Narh, Clement T.
Dzamalala, Charles P.
Mmbaga, Blandina T.
Menya, Diana
Mlombe, Yohannie
Finch, Peter
Nyakunga, Gissela
Schüz, Joachim
McCormack, Valerie
Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies
title Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies
title_full Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies
title_fullStr Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies
title_full_unstemmed Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies
title_short Geophagia and risk of squamous cell esophageal cancer in the African esophageal cancer corridor: Findings from the ESCCAPE multicountry case‐control studies
title_sort geophagia and risk of squamous cell esophageal cancer in the african esophageal cancer corridor: findings from the esccape multicountry case‐control studies
topic Cancer Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411422/
https://www.ncbi.nlm.nih.gov/pubmed/34004024
http://dx.doi.org/10.1002/ijc.33688
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