Qat use and esophageal cancer in Ethiopia: A pilot case-control studyReportar como inadecuado




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Background

Qat Catha edulis chewing is reported to induce lesions in the buccal mucosa, irritation of the esophagus, and esophageal reflux. Case series suggest a possible etiological role in oral and esophageal cancers. This pilot study aimed to generate preliminary estimates of the magnitude and direction of the association between qat use and esophageal cancer EC risk and to inform the logistics required to conduct a multi-center case–control study.

Methods

Between May 2012 and May 2013, 73 EC cases including 12 gastro-esophageal junction cases and 133 controls matched individually on sex, age, and residence were enrolled at two endoscopy clinics and a cancer treatment hospital in Addis Ababa. A face-to-face structured questionnaire was administered. Qat use was defined as ever having chewed qat once a week or more frequently for at least one year. Odds ratios were calculated using conditional logistic regression.

Results

Only 8% of cases resided in Addis Ababa. Qat use was more frequent in cases 36% than in controls 26%. A 2-fold elevation in EC risk was observed in ever qat chewers compared with never users in unadjusted conditional logistic regression OR = 2.12; 95% CI = 0.94, 4.74, an association that disappeared after adjusting for differences in tobacco use, consumption of alcohol and green vegetables, education level, and religion OR = 0.95; 0.22, 4.22. Among never tobacco users, however, a non-significant increase in EC risk was suggested in ever qat users also after adjustment. Increases in EC risk were observed with ever tobacco use, alcohol consumption, low consumption of green vegetables, a salty diet, illiteracy, and among Muslims; the four latter associations were significant.

Conclusions

This pilot study generated EC risk estimates in association with a habit practiced by millions of people and never before studied in a case–control design. Results must be interpreted cautiously in light of possible selection bias, with some demographics such as education level and religion differing between cases and controls. A large case–control study with enrolment of EC cases and carefully matched controls at health facilities from high-risk areas in the countryside, where the majority of cases occur, is needed to further investigate the association between qat use and EC.



Autor: Maria E. Leon , Mathewos Assefa, Endale Kassa, Abate Bane, Tufa Gemechu, Yared Tilahun, Nigatu Endalafer, Gilles Ferro, Kurt Stra

Fuente: http://plos.srce.hr/



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