OBJECTIVETo investigate the risk factors related to the esophageal squamous cell cancer in Feicheng county in Shandong province.

METHODSA case-control study was carried out in Feicheng county. There were two parts consisted in the cases. 253 cases, aged from 40 to 69 years old, were recruited from the screened endoscopic survey program from January 2004 to December 2006. The other part of cases was recruited from the people's Hospital of Feicheng city. 8159 subjects whose had normal endoscope test result were recruited as the control group. Besides cardiograph and ventral ultrasound examination the screening program also included an endoscope test during which mucosal stain with 1.2% iodine solution. The biopsies were taken from the screen and underwent pathologic evaluation by two pathologists; A self-administrative questionnaire survey was conducted in all the subjects to collect information about smoking, alcohol consumption and dietary. The binary Logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (95% CI). The study protocol was approved by the local ethics committee and the study was conducted with the informed consents of all the study subjects.

RESULTSThere were 235 esophageal cancers cases (70 identified in screening program, 183 were hospitalized patients) and 8159 controls in the case-control study. Three potential confounders were detected after univariate analysis. After adjusted the three confounders, age, sex and education, we found, smoking, alcohol drinking were the top ranked risk factors for esophageal cancer. When combing smoking and alcohol drinking, the or was 2.73 (95% CI: 1.54 - 4.82) for male, and the proportional attribute relative risk was 51.47%. We also observed that more dietary cellulose and vitamin C intake have protective effects.

CONCLUSIONSmoking and alcohol drinking could increase the risk of esophageal cancer, and taking more dietary cellulose and vitamin C might decrease the risk.