Environmental risk factors for oesophageal cancer in Malawi: A case-control study |
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Authors: | YB Mlombe NE Rosenberg LL Wolf CP Dzamalala K Chalulu J Chisi NJ Shaheen MC Hosseinipour CG Shores |
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Affiliation: | 1. College of Medicine, University of Malawi, Blantyre, Malawi;2. UNC Project-Malawi, Lilongwe, Malawi;3. University of North Carolina, Chapel Hill, North Carolina, USA;4. Queen Elizabeth Central Hospital, Blantyre, Malawi |
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Abstract: | AimThere is a high burden of oesophageal cancer in Malawi with dismal outcomes. It is not known whether environmental factors are associated with oesophageal cancer. Without knowing this critical information, prevention interventions are not possible. The purpose of this analysis was to explore environmental factors associated with oesophageal cancer in the Malawian context.MethodsA hospital-based case-control study of the association between environmental risk factors and oesophageal cancer was conducted at Kamuzu Central Hospital in Lilongwe, Malawi and Queen Elizabeth Central Hospital in Blantyre, Malawi. Ninety-six persons with squamous cell carcinoma and 180 controls were enrolled and analyzed. These two groups were compared for a range of environmental risk factors, using logistic regression models. Unadjusted and adjusted odds ratios and 95% confidence intervals (CI) were calculated.ResultsFirewood cooking, cigarette smoking, and use of white maize flour all had strong associations with squamous cell carcinoma of the oesophagus, with adjusted odds ratios of 12.6 (95% CI: 4.2–37.7), 5.4 (95% CI: 2.0–15.2) and 6.6 (95% CI: 2.3–19.3), respectively.ConclusionsSeveral modifiable risk factors were found to be strongly associated with squamous cell carcinoma. Research is needed to confirm these associations and then determine how to intervene on these modifiable risk factors in the Malawian context. |
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