| Backgroud:Taixing City of Jiangsu Province is one of the esophageal carcinoma high incidence areas in China, the economic development of which is at the middle level among Jiangsu cities. Esophageal cancer in Taixing, the incidence of which is much higher than the national average level, brings patients and their family great mental damage and economic burden, and causes huge loss of human and social resources. Study on esophageal cancer in Taixing has great significance to the people’s health and social development. Socioeconomic status not only affects health through psychosocial and physical factors but also changes risk of disease through influencing behavior, lifestyle, environmental exposure, diet, et al. The discussions on socioeconomic status of domestic existing esophageal cancer related research are not comprehensive enough. Esophageal cancer researches in Taixing area in the past are relatively extensive and lack of pertinence, and most of the case-control studies are small-scale and have design limitations. Therefore, we conducted a population-based case-control study in the esophageal carcinoma high risk area-Taixing city of Jiangsu Province to investigate the relationship between socioeconomic status, other risk factors and esophageal squamous cell carcinoma, in order to provide theoretical basis for the prevention and control of esophageal carcinoma in this area.Objectives: To understand the population characteristics of cases of esophageal squamous cell carcinoma in Taixing; to analyze risk factors of esophageal squamous cell carcinoma in Taixing; to study the relationship between socioeconomic status and esophageal squamous cell carcinoma in Taixing, to analyze the different influences of education, occupation, ownership of household electrical appliances, per-capita living space, period of drinking tap water, composite indicator of wealth condition on esophageal squamous cell carcinoma; to study exposure of ESCC related factors under different socioeconomic status.Methods:A population-based case-control study was carried out to collect data including demography, socioeconomic status indicators (education, occupation, wealth, et al) and possible risk factors. Control subjects were matched to the case for age (±5years), sex and place of residence (villages and towns). Unconditional logistic regression was used to compare different SES indicators and composite wealth scores constructed between cases and controls, using the principal component analysis methodology.Results:(1) People who are overweight (24.0Kg/m2≤BMI<28.0Kg/m2) ten years ago have lower risk of ESCC (OR=0.61,95%CI:0.47～0.79); compared to20years old, people who lost weight over5kg ten years ago have higher risk of ESCC (OR=1.53,95%CI:1.10～2.14), who gained weight over5kg have lower risk of ESCC (OR=0.67,95%CI:0.51～0.89); compared to20years old, people whose figure got thin ten years ago have higher risk of ESCC (OR=1.31,95%CI:0.98～1.75), whose figure got fat have lower risk of ESCC (OR=0.63,95%CI:0.48～0.82).(2) People who smoke more than20cigarettes per day have higher risk of ESCC (OR=1.78,95%CI:1.11～2.86); people whose smoking index over800have higher risk of ESCC (OR=1.49,95%CI:1.02～2.17).(3) People who have a history of alcohol consumption have higher risk of ESCC (OR=2.19,95%CI:1.67～2.88); risk increases with the intensity or period of drinking increasing (Both P values are less than0.01). (4) Factors as:having received junior high school or higher education(OR=0.64,95%CI:0.44～0.92), living space over67m2per-capita(OR=0.71,95%CI:0.54～0.93), drinking tap water longer than5years(OR=0.77,95%CI:0.60～1.00)and wealth score>0.93(OR=0.64,95%CI:0.49～0.85)are associated with increased risk of ESCC.Compared to those worked in farming, forestry, animal husbandry, fishery and water conservancy, the individuals who worked in business-service industry are at lower risk of ESCC(OR=0.65,95%CI:0.43～0.98). Compared to those whose work intensity in Category I, the individuals in Category Ⅱ(OR=0.61,95%CI:0.37～0.99) and Category III(OR=0.65,95%CI:0.43～0.98) are at lower risk of ESCC.Compared to those whose number of people in household between1and2, the individuals whose number of people in household over5are at higher risk of ESCC(OR=1.61,95%CI:1.17～2.21). Compared to those whose number of siblings between0and2, the individuals whose number of people in household over3are at higher risk of ESCC. Compared to those whose number of children between0and2, the individuals whose number of children over4are at higher risk of ESCC(OR=1.67,95%CI:1.06～2.62).(5) Proportion of people with BMI≥24.0Kg/m2ten years ago increases with the SES improving, as well as proportion of people with smoking index>800and proportion of people who drink alcohol.Conclusions:In the Taixing area in Jiangsu Province,(1) people with high BMI have lower risk of ESCC;(2) smoking and drinking are risk factors of ESCC;(3) An inverse association of low SES and ESCC were found that called for further explanation. |
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