Risk factors of Esophageal Cancer in Punjab- A Case Control Study

Area of Science:

• Oncology
• Environmental Health
• Epidemiology

Background:

• Esophageal cancer is a global health concern, with esophageal squamous cell carcinoma being highly prevalent in Punjab.
• High pesticide use and heavy metal exposure in Punjab are suspected environmental contributors to cancer rates.

Purpose of the Study:

• To investigate the association between pesticide exposure, heavy metals, and esophageal carcinoma in Punjab.
• To identify environmental risk factors for esophageal squamous cell carcinoma to inform preventive strategies.

Main Methods:

• A case-control study was conducted in Punjab involving 380 esophageal carcinoma cases and 760 matched controls.
• Risk factor data were collected via questionnaires, and biological samples (urine, blood, biopsies) were analyzed for pesticide metabolites and heavy metals.

Main Results:

• Dimethylphosphate (a pesticide metabolite) in urine was significantly associated with esophageal carcinoma (OR 5.41, p<0.05).
• Established risk factors include tobacco use (OR 1.60), alcohol consumption (OR 1.65), and hot beverages (OR 1.81).
• Higher intake of fruits (OR 0.74) and vegetables (OR 0.81) showed a protective effect.

Conclusions:

• Pesticide exposure is identified as a novel risk factor for esophageal squamous cell carcinoma in Punjab.
• Tobacco, alcohol, and diet remain significant contributors, underscoring the need for comprehensive prevention strategies.
• The study highlights the importance of stricter environmental regulations and public health interventions.