An exploration of the living and working environments of esophageal cancer patients: Gaining a contextual understanding of the risk factors for disease

Introduction: The etiology of esophageal cancer is mainly studied using traditional epidemiological research approaches. Although these approaches have led to insight on the risk factors of disease, findings reported in studies utilizing such conventional approaches often peel away the context surrounding these risk factors.;Methods: A narrative research design was applied which utilized the lifegrid alongside a semi-structured interview guide, occupational and residential summary boxes, occupational risk maps and residential pictures, and a series of other supplementary research tools. A sample of forty-six esophageal cancer patients drawn from participating Toronto and London Ontario hospitals shared their life stories as they pertained to key etiological factors. Emphasis was placed on the latency period. Data was analyzed using holistic-content, categorical-content, and chi-square analyses.;Results: The unconventional use of a nested approach considered the different levels of risk factors for esophageal cancer. This elucidated the social and environmental dimensions at play demonstrating how risk factors for EC are sandwiched between individual resources and macro environmental forces. As such, lived experiences and exposures do not occur in isolation. The lifegrid was administered for the first time as an analytical tool to conduct holistic-content analysis. These results, alongside those generated via various other forms of analyses, validated current knowledge and allowed for a context-sensitive understanding of the risk factors for esophageal cancer which considered both timing and place.;Conclusions: By examining both the living and working environments of esophageal cancer patients in this unconventional way, a context-sensitive understanding of the inter-related and deeper-rooted causes of this disease were provided. This study demonstrated how the adoption of alternative research approaches can and should be utilized in order to gain better insight to the etiology of disease. The findings of this research can aid in providing a clearer understanding of the risk factors of disease so that more targeted prevention and intervention strategies and policies can be developed.;Objectives: The main objective of this study was to gain a context-sensitive understanding of the risk factors for esophageal cancer by examining the living and working environments of these patients through the use of a less conventional research approach.