Investigating Influence of Multiple Risk Factors on Survival Likelihood in Esophageal Cancer Patients: Evidence from Assam, North-East India
DOI:
https://doi.org/10.55489/njcm.151120244524Keywords:
Oesophagus, Smoking, Traditional alcoholic drinks, Risk factors, Tobacco, SurvivalAbstract
Background: To comprehend the complex interplay of multiple risk factors impacting survival at a localized level is imperative. This study aimed to explore survival patterns and identify the underlying causal factors linked to mortality risk in the region.
Methodology: Data from 200 patients with esophageal cancer treated at three prominent hospitals over the course of one year is collected for the study purpose. The Kaplan‒Meier curve and Cox proportional hazard regression model were employed.
Results: This study identified smokeless tobacco consumption habits showing a 6-fold elevated mortality risk (HR 6.22, p<0.001). Subsequently, cultivator (HR 4.85, p=0.001) and male gender (HR 4.24, p=0.001) showed higher mortality risk. Additionally, a significantly higher prevalence of death among smokers with comorbidity (66.0%) is found compared to smokers without comorbidity (44.1%), p=0.043. The survival probability shows a declining trend, i.e. 84.50% in the first year to 13% in the 6th year. With an 82% change, this variation was greatest between the 3rd and 4th years.
Conclusions: To better understand mortality risk, certain risk factors, such as salted fish, fertilizer and pesticide exposure, and length of marriage, need to be thoroughly investigated in future studies due to limited knowledge about this exposure at a localized level.
References
Sobti RC, Thakur M, Kaur T. Cancer: Epidemiology, Racial, and Geographical Disparities. InMolecular Biomarkers for Cancer Diagnosis and Therapy. Springer Nature Singapore. 2024 Jun 30:31-52. Doi: https://doi.org/10.1007/978-981-99-3746-2_3
Teng Y, Xia C, Cao M, Yang F, Yan X, He S, Cao M, Zhang S, Li Q, Tan N, Wang J, Chen W. Esophageal cancer global burden profiles, trends, and contributors. Cancer Biol Med. 2024 Jul 26;21(8):656-66.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012: Globocan 2012. Int J Cancer. 2015;136(5):E359-86. Doi: https://doi.org/10.1002/ijc.29210
American Cancer Society. Cancer facts and statistics. https://cancerstatisticscenter.cancer.org/#!/ cancer-site/Esophagus. Accessed December 11, 2023.
Stabellini N, Chandar AK, Chak A, et al. Sex differences in esophageal cancer overall and by histological subtype. Sci Rep. 2022;12(1):5248. Doi: https://doi.org/10.1038/s41598-022-09193-x
Tella SH, Mara K, Chakrabarti S, Jin Z, Mahipal A. A glimpse into the future of esophageal carcinoma in the United States: predicting the future incidence until 2040 based on the current epidemiological data. J Gastrointest Oncol. 2023 Feb 28;14(1):1-10. Doi: https://doi.org/10.21037/jgo-22-729
Lu SW, Niu KY, Pai CP, Lin SH, Chen CB, Lo YT, Lee YC, Seak CJ, Yen CC. Novel Prediction Score for Arterial-Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study. Cancers (Basel). 2024 Feb 16;16(4):804. Doi: https://doi.org/10.3390/cancers16040804
Qu HT, Li Q, Hao L, Ni YJ, Luan WY, Yang Z, Chen XD, Zhang TT, Miao YD, Zhang F. Esophageal cancer screening, early detection and treatment: Current insights and future directions. World J Gastrointest Oncol. 2024 Apr 15;16(4):1180-1191. Doi: https://doi.org/10.4251/wjgo.v16.i4.1180
Zhu J, Xu B, Li Y, Pang X, Ji S, Lian J, Lu H. Epidemiology, prognostic factors, and survival analysis in small cell esophageal carcinoma: A population-based study with external validation. Biomol Biomed. 2024 Sep 3. Doi: https://doi.org/10.17305/bb.2024.11090
Ashok, A., Jiwnani, S., Karimundackal, G., Pramesh, C.S. (2024). Esophageal Cancer. In: Badwe, R.A., Gupta, S., Shrikhande, S.V., Laskar, S. (eds) Tata Memorial Centre Textbook of Oncology. Springer, Singapore. Doi: https://doi.org/10.1007/978-981-99-3378-5_36
Park K, Ali A, Kim D, An Y, Kim M, Shin H. Robust predictive model for evaluating breast cancer survivability. Eng Appl Artif Intell. 2013;26(9):2194-205. Doi: https://doi.org/10.1016/j.engappai.2013.06.013
Marabotto E, Pellegatta G, Sheijani AD, Ziola S, Zentilin P, De Marzo MG, et al.Prevention strategies for esophageal cancer-an expert review. Cancers (Basel). 2021;13(9):2183. Doi: https://doi.org/10.3390/cancers13092183
Warren Andersen S, Blot WJ, Lipworth L, Steinwandel M, Murff HJ, Zheng W.Association of race and socioeconomic status with colorectal cancer screening, colorectal cancer risk, and mortality in southern US adults. JAMA Netw Open. 2019;2(12):e1917995. Doi: https://doi.org/10.1001/jamanetworkopen.2019.17995
Tasnim, Sadia & Sudarshan, Monisha. (2024). Identifying and improving disparities in esophageal cancer care: a narrative review. 10.21037/ccts-23-24. Doi: https://doi.org/10.21037/ccts-23-24
Kim S, Kwon S, Subramanian SV. The impact of socioeconomic status on survival after cancer in the United States : findings from the National Program of Cancer Registries Patterns of Care Study 12. 2015;26:1617-25.
Tewari M. Cancer Care in India. Indian J EndocSurg Res 2022;17(1):1-3. Doi: https://doi.org/10.5005/jp-journals-10088-11192
Dessalegn B, Getachew S, Yirgu R, Enqueselassie F, Assefa M, Addissie A. Time intervals from first symptom recognition to pathological diagnosis among patients with oesophageal cancer in Ethiopia: a cross-sectional study. BMJ Open. 2022 Aug 4;12(8):e060812. Doi: https://doi.org/10.1136/bmjopen-2022-060812
Sandström N, Johansson M, Jekunen A, Andersén H. Socioeconomic status and lifestyle patterns in the most common cancer types-community-based research. BMC Public Health. 2023;23(1):1722. Doi: https://doi.org/10.1186/s12889-023-16677-6
Housten AJ, Gunn CM, Paasche-Orlow MK, Basen-Engquist KM. Health literacy interventions in cancer: A systematic review. J Cancer Educ. 2021;36(2):240-52. Doi: https://doi.org/10.1007/s13187-020-01915-x
Chen, Ping-Ho, Mahmood, Qaisar, Mariottini, Gian Luigi, Chiang, Tai-An, Lee, Ka-Wo, Adverse Health Effects of Betel Quid and the Risk of Oral and Pharyngeal Cancers, BioMed Research International, 2017, 3904098, 25 pages, 2017. Doi: https://doi.org/10.1155/2017/3904098
Chen CL, Chi CW, Chang KW. Safrolelike DNA adducts in oral tissue from oral cancer patients with a betel quid chewing history. Carcinogenesis. 1999;20:2331-4. Doi: https://doi.org/10.1093/carcin/20.12.2331
IARC Monographs Vol 128 group. Carcinogenicity of acrolein, crotonaldehyde, and arecoline. Lancet Oncol. 2021 Jan;22(1):19-20. Doi: https://doi.org/10.1016/S1470-2045(20)30727-0
Ashek Elahi Noor, Boyapati Ramanarayana, Relationship of smokeless tobacco uses in the perspective of oral cancer: A global burden, Oral Oncology Reports, Volume 10, 2024, 100516, Doi: https://doi.org/10.1016/j.oor.2024.100516
Zisis Kozlakidis, Io Hong Cheong, Hui Wang; Betel Nut and Arecoline: Past, Present, and Future Trends. Innovations in Digital Health, Diagnostics, and Biomarkers 1 January 2022; 2 (2022): 64-72. Doi: https://doi.org/10.36401/IDDB-22-05
Xie, H., Jing, R., Liao, X. et al. Arecoline promotes proliferation and migration of human HepG2 cells through activation of the PI3K/AKT/mTOR pathway. Hereditas 159, 29 (2022). Doi: https://doi.org/10.1186/s41065-022-00241-0
Sun H, Yu W, Li H, Hu X, Wang X. Bioactive Components of Areca Nut: An Overview of Their Positive Impacts Targeting Different Organs. Nutrients. 2024; 16(5):695. Doi: https://doi.org/10.3390/nu16050695
Muthukumaran, R. B., Bhattacharjee, P., Bhowmick, P., Zote, L., Malsawmtluangi, Kumar, N. S., Jahau, L., Cooke, M. S., Hu, C. W., & Chao, M. R. (2023). Genetic and epigenetic instability induced by betel quid associated chemicals. Toxicology reports, 10, 223-234. Doi: https://doi.org/10.1016/j.toxrep.2023.02.001
Saikia JR, Schneeweiss FH, Sharan RN. Arecoline-induced changes of poly-ADP-ribosylation of cellular proteins and its influence on chromatin organization Cancer-Lett. Cancer-Lett. 1999;139:59-65. Doi: https://doi.org/10.1016/S0304-3835(99)00008-7
Zarean E, Azizmohammad Looha M, Amini P, Mahmoudi M, Azimi T. Factors affecting long-survival of patients with esophageal cancer using non-mixture cure fraction model. Asian Pac J Cancer Prev. 2018;19(6):1677-83. Doi: https://doi.org/10.31557/APJCP.2018.19.11.3081
Meyer MS, Joshipura K, Giovannucci E, Michaud DS. A review of the relationship between tooth loss, periodontal disease, and cancer. Cancer Causes Control. 2008;19(9):895-907. Doi: https://doi.org/10.1007/s10552-008-9163-4
Nwizu N, Wactawski-Wende J, Genco RJ. Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontol 2000. 2020;83(1):213-33. Doi: https://doi.org/10.1111/prd.12329
Ji Zhang, Rino Bellocco, Gunilla Sandborgh-Englund, Jingru Yu, Margaret Sällberg Chen, Weimin Ye; Poor Oral Health and Esophageal Cancer Risk: A Nationwide Cohort Study. Cancer Epidemiol Biomarkers Prev 1 July 2022; 31 (7): 1418-1425. Doi: https://doi.org/10.1158/1055-9965.EPI-22-0151
Zhang S, Yu P, Wang J-B, Fan J-H, Qiao Y-L, Taylor PR. Association between tooth loss and upper gastrointestinal cancer: A 30-year follow-up of the Linxian Dysplasia Nutrition Intervention Trial Cohort. Thorac Cancer. 2019;10(4):966-74. Doi: https://doi.org/10.1111/1759-7714.13037
Peterson LA. Formation, repair, and genotoxic properties of bulky DNA adducts formed from tobacco-specific nitrosamines. J Nucleic Acids. 2010;2010(1). Doi: https://doi.org/10.4061/2010/284935
Bernard R, Fazili I, Rajagopala SV, Das SR, Hiremath G. Association between Oral microbiome and esophageal diseases: a state-of-the-art review. Dig Dis. 2022; 40: 345-354. Doi: https://doi.org/10.1159/000517736
Chiang HC, Hughes M, Chang WL. The role of microbiota in esophageal squamous cell carcinoma: A review of the literature. Thorac Cancer. 2023 Oct;14(28):2821-2829. Doi: https://doi.org/10.1111/1759-7714.15096
The health consequences of using smokeless tobacco: Report of the Advisory Committee to the Surgeon General. NIH Publication No. 86-2874. Bethesda, MD: US Department of Health and Human Services. Public Health Service. 1986;
Gupta, J., Gupta, K. K., Samadi, F. M., & Kabiraj, A. (2012). Smokeless tobacco and oral cancer: A review. Indian J Oral Sci, 3(2), 74-78. Doi: https://doi.org/10.4103/0976-6944.106458
Menon S, Nightingale P, Trudgill N. Is hormone replacement therapy in post‐menopausal women associated with a reduced risk of oesophageal cancer? United European Gastroenterol J. 2014 [cited 2024 Jul 27];2(5):374-82. Doi: https://doi.org/10.1177/2050640614543736
Michaud DS, Fu Z, Shi J, Chung M. Periodontal disease, tooth loss, and cancer risk. Epidemiol Rev. 2017;39(1):49-58. Doi: https://doi.org/10.1093/epirev/mxx006
Mu H-W, Chen C-H, Yang K-W, Pan C-S, Lin C-L, Hung D-Z. The prevalence of esophageal cancer after caustic and pesticide ingestion: A nationwide cohort study. PLoS One. 2020;15(12):e0243922. Doi: https://doi.org/10.1371/journal.pone.0243922
Knekt, P., Järvinen, R., Dich, J., & Hakulinen, T. (1999). Risk of colorectal and other gastro-intestinal cancers after exposure to nitrate, nitrite and N-nitroso compounds: a follow-up study. International journal of cancer, 80(6), 852-856. Doi: https://doi.org/10.1002/(SICI)1097-0215(19990315)80:6<852::AID-IJC9>3.0.CO;2-S
Choi YJ, Lee DH, Han KD, Kim HS, Yoon H, Shin CM, Park YS, Kim N. The relationship between drinking alcohol and esophageal, gastric or colorectal cancer: A nationwide population-based cohort study of South Korea. PLoS One. 2017 Oct 3;12(10):e0185778. Doi: https://doi.org/10.1371/journal.pone.0185778
Thrift AP, Nagle CM, Fahey PP, Russell A, Smithers BM, Watson DI, et al. The influence of prediagnostic demographic and lifestyle factors on esophageal squamous cell carcinoma survival. Int J Cancer. 2012;131(5). Doi: https://doi.org/10.1002/ijc.27420
Menya D, Kigen N, Oduor M, Maina SK, Some F, Chumba D, et al. Traditional and commercial alcohols and esophageal cancer risk in Kenya. Int J Cancer. 2019;144(3):459-69. Doi: https://doi.org/10.1002/ijc.31804
Chen M-F, Chen P-T, Lu M-S, Lee C-P, Chen W-C. Survival benefit of surgery to patients with esophageal squamous cell carcinoma. Sci Rep. 2017;7(1). Doi: https://doi.org/10.1038/srep46139
Mahboubi E, Kmet J, Cook PJ, Day NE, Ghadirian P, Salmasizadeh S. Oesophageal cancer studies in the Caspian littoral of Iran: The Caspian cancer registry. Br J Cancer. 1973;28(3):197-214. Doi: https://doi.org/10.1038/bjc.1973.138
Saddoughi SA, Taswell J, Spears GM, Harmsen WS, Allen MS, Blackmon SH, et al. Patients younger than 45 years of age have superior 5-year survival in advanced esophageal cancer. Shanghai Chest. 2019;3:42-42. Doi: https://doi.org/10.21037/shc.2019.07.01
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