Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case–control study

Daniel R.S. Middleton; Diana Menya; Nicholas Kigen; Margaret Oduor; Stephen K. Maina; Fatma Some; David Chumba; Paul Ayuo; Odipo Osano; Joachim Schüz; Valerie McCormack

doi:10.1002/ijc.32032

Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case–control study

Daniel R.S. Middleton^*
, Diana Menya
, Nicholas Kigen
, Margaret Oduor
, Stephen K. Maina
, Fatma Some
, David Chumba
, Paul Ayuo
, Odipo Osano
, Joachim Schüz
, Valerie McCormack

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

41 Citations (Scopus)

189 Downloads (Pure)

Abstract

Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Consumption of hot beverages—a probable carcinogen to humans—is associated with increased ESCC risk in other settings and is habitually practiced in Kenya. We conducted a case–control study in Eldoret, western Kenya between August 2013 and March 2018. Cases were patients with endoscopically confirmed oesophageal cancer whose histology did not rule out ESCC. Age and sex-matched controls were hospital visitors and hospital out and in-patients excluding those with digestive diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for self-reported drinking temperatures; consumption frequency; mouth burning frequency and hot porridge consumption using logistic regression models adjusted for potential confounders. Drinking temperature association with tumour sub-location was also investigated. The study included 430 cases and 440 controls. Drinkers of ‘very hot’ and ‘hot’ beverages (>95% tea) had a 3.7 (95% CI: 2.1–6.5) and 1.4-fold (1.0–2.0) ESCC risk, respectively compared to ‘warm’ drinkers. This trend was consistent in males, females, never and ever alcohol/tobacco and was stronger over than under age 50 years. The tumour sub-location distribution (upper/middle/lower oesophagus) did not differ by reported drinking temperature. Our study is the first comprehensive investigation in this setting to-date to observe a link between hot beverage consumption and ESCC in East Africa. These findings provide further evidence for the role of this potentially modifiable risk factor in ESCC aetiology.

Original language	English
Pages (from-to)	2669-2676
Number of pages	8
Journal	International Journal of Cancer
Volume	144
Issue number	11
Early online date	29 Nov 2018
DOIs	https://doi.org/10.1002/ijc.32032
Publication status	Published - 01 Jun 2019
Externally published	Yes

Bibliographical note

Funding Information:
Key words: oesophageal cancer, hot beverages, Africa, aetiology Abbreviations: ASR: age-standardised rate; CI: confidence interval; EC: oesophageal cancer; ESCC: oesophageal squamous cell carcinoma; IARC: International Agency for Research on Cancer; MTRH: Moi Teaching and Referral Hospital; OR: odds ratio Grant sponsor: The European Commission FP7 Marie Curie Actions – People – Co-funding of regional, national and international programs (COFUND); Grant sponsor: An IARC post-doctoral fellowship; Grant sponsor: An IARC-UICC Development Fellowship; Grant sponsor: NIH/NCI grant; Grant numbers: R21CA191965 DOI: 10.1002/ijc.32032 This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. History: Received 24 Sep 2018; Accepted 9 Nov 2018; Online 29 Nov 2018 Correspondence to: Daniel RS Middleton, Section of Environment and Radiation, International Agency for Research on Cancer (IARC) Lyon, France, E-mail: [email protected]; or Diana Menya, School of Public Health, College of Health Sciences, Moi University Eldoret, Kenya, E-mail: [email protected]

Funding Information:
This work was supported by the International Agency for Research on Cancer (IARC), including an IARC post-doctoral fellowship to D. Middleton partially supported by the European Commission FP7 Marie Curie Actions – People – Co-funding of regional, national and international programs (COFUND). The authors are grateful to all study participants.

Publisher Copyright:
© 2018 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

aetiology
Africa
hot beverages
oesophageal cancer

ASJC Scopus subject areas

Oncology
Cancer Research

Access to Document

10.1002/ijc.32032Licence: CC BY-NC

Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case–control study
Copyright 2018 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC This is an open access Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction for non-commercial purposes, provided the author and source are cited.
Final published version, 275 KBLicence: CC BY-NC

Cite this

@article{0d489f6957aa453aa5ace503e8a322ac,

title = "Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case{\textendash}control study",

abstract = "Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Consumption of hot beverages{\textemdash}a probable carcinogen to humans{\textemdash}is associated with increased ESCC risk in other settings and is habitually practiced in Kenya. We conducted a case{\textendash}control study in Eldoret, western Kenya between August 2013 and March 2018. Cases were patients with endoscopically confirmed oesophageal cancer whose histology did not rule out ESCC. Age and sex-matched controls were hospital visitors and hospital out and in-patients excluding those with digestive diseases. Odds ratios (ORs) and 95\% confidence intervals (CIs) were estimated for self-reported drinking temperatures; consumption frequency; mouth burning frequency and hot porridge consumption using logistic regression models adjusted for potential confounders. Drinking temperature association with tumour sub-location was also investigated. The study included 430 cases and 440 controls. Drinkers of {\textquoteleft}very hot{\textquoteright} and {\textquoteleft}hot{\textquoteright} beverages (>95\% tea) had a 3.7 (95\% CI: 2.1{\textendash}6.5) and 1.4-fold (1.0{\textendash}2.0) ESCC risk, respectively compared to {\textquoteleft}warm{\textquoteright} drinkers. This trend was consistent in males, females, never and ever alcohol/tobacco and was stronger over than under age 50 years. The tumour sub-location distribution (upper/middle/lower oesophagus) did not differ by reported drinking temperature. Our study is the first comprehensive investigation in this setting to-date to observe a link between hot beverage consumption and ESCC in East Africa. These findings provide further evidence for the role of this potentially modifiable risk factor in ESCC aetiology.",

keywords = "aetiology, Africa, hot beverages, oesophageal cancer",

author = "Middleton, \{Daniel R.S.\} and Diana Menya and Nicholas Kigen and Margaret Oduor and Maina, \{Stephen K.\} and Fatma Some and David Chumba and Paul Ayuo and Odipo Osano and Joachim Sch{\"u}z and Valerie McCormack",

note = "Funding Information: Key words: oesophageal cancer, hot beverages, Africa, aetiology Abbreviations: ASR: age-standardised rate; CI: confidence interval; EC: oesophageal cancer; ESCC: oesophageal squamous cell carcinoma; IARC: International Agency for Research on Cancer; MTRH: Moi Teaching and Referral Hospital; OR: odds ratio Grant sponsor: The European Commission FP7 Marie Curie Actions {\textendash} People {\textendash} Co-funding of regional, national and international programs (COFUND); Grant sponsor: An IARC post-doctoral fellowship; Grant sponsor: An IARC-UICC Development Fellowship; Grant sponsor: NIH/NCI grant; Grant numbers: R21CA191965 DOI: 10.1002/ijc.32032 This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. History: Received 24 Sep 2018; Accepted 9 Nov 2018; Online 29 Nov 2018 Correspondence to: Daniel RS Middleton, Section of Environment and Radiation, International Agency for Research on Cancer (IARC) Lyon, France, E-mail: [email protected]; or Diana Menya, School of Public Health, College of Health Sciences, Moi University Eldoret, Kenya, E-mail: [email protected] Funding Information: This work was supported by the International Agency for Research on Cancer (IARC), including an IARC post-doctoral fellowship to D. Middleton partially supported by the European Commission FP7 Marie Curie Actions {\textendash} People {\textendash} Co-funding of regional, national and international programs (COFUND). The authors are grateful to all study participants. Publisher Copyright: {\textcopyright} 2018 The Authors. International Journal of Cancer published by John Wiley \& Sons Ltd on behalf of UICC",

year = "2019",

month = jun,

day = "1",

doi = "10.1002/ijc.32032",

language = "English",

volume = "144",

pages = "2669--2676",

journal = "International Journal of Cancer",

issn = "0020-7136",

publisher = "John Wiley \& Sons Inc.",

number = "11",

}

TY - JOUR

T1 - Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case–control study

AU - Middleton, Daniel R.S.

AU - Menya, Diana

AU - Kigen, Nicholas

AU - Oduor, Margaret

AU - Maina, Stephen K.

AU - Some, Fatma

AU - Chumba, David

AU - Ayuo, Paul

AU - Osano, Odipo

AU - Schüz, Joachim

AU - McCormack, Valerie

N1 - Funding Information: Key words: oesophageal cancer, hot beverages, Africa, aetiology Abbreviations: ASR: age-standardised rate; CI: confidence interval; EC: oesophageal cancer; ESCC: oesophageal squamous cell carcinoma; IARC: International Agency for Research on Cancer; MTRH: Moi Teaching and Referral Hospital; OR: odds ratio Grant sponsor: The European Commission FP7 Marie Curie Actions – People – Co-funding of regional, national and international programs (COFUND); Grant sponsor: An IARC post-doctoral fellowship; Grant sponsor: An IARC-UICC Development Fellowship; Grant sponsor: NIH/NCI grant; Grant numbers: R21CA191965 DOI: 10.1002/ijc.32032 This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. History: Received 24 Sep 2018; Accepted 9 Nov 2018; Online 29 Nov 2018 Correspondence to: Daniel RS Middleton, Section of Environment and Radiation, International Agency for Research on Cancer (IARC) Lyon, France, E-mail: [email protected]; or Diana Menya, School of Public Health, College of Health Sciences, Moi University Eldoret, Kenya, E-mail: [email protected] Funding Information: This work was supported by the International Agency for Research on Cancer (IARC), including an IARC post-doctoral fellowship to D. Middleton partially supported by the European Commission FP7 Marie Curie Actions – People – Co-funding of regional, national and international programs (COFUND). The authors are grateful to all study participants. Publisher Copyright: © 2018 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Consumption of hot beverages—a probable carcinogen to humans—is associated with increased ESCC risk in other settings and is habitually practiced in Kenya. We conducted a case–control study in Eldoret, western Kenya between August 2013 and March 2018. Cases were patients with endoscopically confirmed oesophageal cancer whose histology did not rule out ESCC. Age and sex-matched controls were hospital visitors and hospital out and in-patients excluding those with digestive diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for self-reported drinking temperatures; consumption frequency; mouth burning frequency and hot porridge consumption using logistic regression models adjusted for potential confounders. Drinking temperature association with tumour sub-location was also investigated. The study included 430 cases and 440 controls. Drinkers of ‘very hot’ and ‘hot’ beverages (>95% tea) had a 3.7 (95% CI: 2.1–6.5) and 1.4-fold (1.0–2.0) ESCC risk, respectively compared to ‘warm’ drinkers. This trend was consistent in males, females, never and ever alcohol/tobacco and was stronger over than under age 50 years. The tumour sub-location distribution (upper/middle/lower oesophagus) did not differ by reported drinking temperature. Our study is the first comprehensive investigation in this setting to-date to observe a link between hot beverage consumption and ESCC in East Africa. These findings provide further evidence for the role of this potentially modifiable risk factor in ESCC aetiology.

AB - Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Consumption of hot beverages—a probable carcinogen to humans—is associated with increased ESCC risk in other settings and is habitually practiced in Kenya. We conducted a case–control study in Eldoret, western Kenya between August 2013 and March 2018. Cases were patients with endoscopically confirmed oesophageal cancer whose histology did not rule out ESCC. Age and sex-matched controls were hospital visitors and hospital out and in-patients excluding those with digestive diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for self-reported drinking temperatures; consumption frequency; mouth burning frequency and hot porridge consumption using logistic regression models adjusted for potential confounders. Drinking temperature association with tumour sub-location was also investigated. The study included 430 cases and 440 controls. Drinkers of ‘very hot’ and ‘hot’ beverages (>95% tea) had a 3.7 (95% CI: 2.1–6.5) and 1.4-fold (1.0–2.0) ESCC risk, respectively compared to ‘warm’ drinkers. This trend was consistent in males, females, never and ever alcohol/tobacco and was stronger over than under age 50 years. The tumour sub-location distribution (upper/middle/lower oesophagus) did not differ by reported drinking temperature. Our study is the first comprehensive investigation in this setting to-date to observe a link between hot beverage consumption and ESCC in East Africa. These findings provide further evidence for the role of this potentially modifiable risk factor in ESCC aetiology.

KW - aetiology

KW - Africa

KW - hot beverages

KW - oesophageal cancer

U2 - 10.1002/ijc.32032

DO - 10.1002/ijc.32032

M3 - Article

C2 - 30496610

AN - SCOPUS:85060698932

SN - 0020-7136

VL - 144

SP - 2669

EP - 2676

JO - International Journal of Cancer

JF - International Journal of Cancer

IS - 11

ER -

Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case–control study

Abstract

Bibliographical note

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Fingerprint

Cite this