[Progress in epidemiological research of non-traditional risk factors for esophageal cancer]

Esophageal cancer is a malignancy to cause heavy global disease burden, the research of traditional risk factors, such as smoking, alcohol use, can not fully explain the heterogeneity of region specific incidence and molecular diversity of esophageal cancer. Traditional risk factor research usually focus on isolated effects of individual factor, neglecting interaction of multi factors on subtypes of esophageal cancer, and the exposure assessment of traditional risk factor research can not quantify the actual biological doses of potential risk factors, such as micronutrient deficiency and region-specific environmental pollutant exposure. Advancements in multi-omics technologies (including exposomics and genomics) have identified emerging risk factors, which have not been formally classified as established risk factors for esophageal cancer by International Agency for Research on Cancer, but revealed the non-traditional risk factors (potential carcinogenic mechanisms or population-level associations) of esophageal cancer in the past decade, including oral microorganism dysbiosis, perfluoroalkyl and polyfluoroalkyl substance exposures, and circadian disruption. This paper systematically summarizes the progress in epidemiological research of these factors to provide novel perspectives for the precise prevention and control of esophageal cancer.