Oesophageal carcinoma--a study of risk factors (emphasis on nutrition) in a teaching hospital of Kumaon region of Uttarakhand.

BACKGROUND

Cancer oesophagus is common in India and is the third leading cause of cancer death in males and fourth in females. Various factors are responsible for it and present study was undertaken to study the various risk factors with stress on nutritional factors associated with it.

METHODS

Ninety-four cases of oesophagus cancer and matched equal number of healthy individuals (control) constituted the study. They were assessed for their dietary pattern during the preceding 10-15 years with the help of standard food frequency questionnaire method. Information regarding consumption of alcohol, smoking and tobacco chewing with or without betel leaf was taken in detail.

RESULTS

Seven hundred and eighty upper GI endoscopy revealed 94 (12.05%) cases of oesophageal carcinoma. Histopathology revealed squamous cell carcinoma in 87 cases (92.50%), adenocarcinoma in 6 cases (6.30%) and one with mixed picture of adenocarcinoma and squamous cell carcinoma. Sixth (36.17%) and 7th (23.40%) decade of persons were mainly affected with male to female ratio of 2.1:1. They were mostly of lower socio-economic (82.90%) status. Various risk factors came across were less consumption of green and leafy vegetables and fruits and consuming more spicy fried and hot food and beverages. Increased risk was seen more often with consumption of alcohol (neat and without or less salad and snacks), smoking beedi and cigarette, and tobacco chewing with or without betel leaf. It is directly related to amount, frequency, mode and duration of use.

CONCLUSIONS

Malignancies in general are result of multiple factors and interaction of several environmental factors. One factor cannot be blamed but combination of factors increases the risk of oesophageal carcinoma. Nutritional factor is also one of the major contributing factor increasing the risk of oesophagus cancer.