Journal
JOURNAL OF GASTROENTEROLOGY
Volume 53, Issue 1, Pages 37-51Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s00535-017-1375-5
Keywords
Review; Adenocarcinoma; Carcinoma; Squamous cell; Esophageal neoplasms; Risk factors
Categories
Funding
- FEDER funds through the Operational Competitiveness Programme
- Foundation for Science and Technology-FCT (Portuguese Ministry of Science, Technology and Higher Education) [FCOMP-01-0124-FEDER-021181, PTDC/SAU-EPI/122460/2010]
- Unidade de Investigacao em Epidemiologia - Instituto de Saude Publica da Universidade do Porto (EPIUnit) [POCI-01-0145-FEDER-006862
- UID/DTP/04750/2013]
- FCT [SFRH/BPD/75918/2011]
- Programa Operacional Capital Humano (POCH/FSE)
- Fundação para a Ciência e a Tecnologia [PTDC/SAU-EPI/122460/2010] Funding Source: FCT
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There are marked differences in the etiology of the major histological types of esophageal cancer (EC)-squamous cell carcinomas (ESCC) and adenocarcinomas (EAC). This study aimed to summarize the current scientific knowledge on modifiable risk factors for EC, by histological type, through a systematic review of meta-analyses referenced in PubMed and ISI Web of Knowledge. We identified 100 meta-analyses on risk factors for ESCC (n = 54), EAC (n = 43), or EC (n = 51). ESCC risk significantly increased with alcohol and mat, drinking, smoking, red and processed meat consumption and human papillomavirus infection, while it was negatively associated with body mass index and consumption of fruit, vegetables, white meat, folate, and some carotenoids. Cessation of drinking and smoking significantly reduced ESCC risk. For EAC, an increased risk was reported for smoking, body mass index, and red and processed meat consumption, while risk decreased with Helicobacter pylori infection, low/moderate alcohol drinking, physical activity, and consumption of fruit, vegetables, folate, fiber, beta-carotene, and vitamin C. Differences in results between meta-analyses and mechanisms underlying some of the associations found are discussed. This work reinforces the importance of a separate assessment of EC subtypes to allow for a proper evaluation of incidence trends and planning of prevention/control interventions.
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