Submission ID 130359
| Issue/Objective | Esophageal cancer (EC), particularly squamous cell carcinoma, is an under-recognized contributor to health inequities in the Ethiopian Rift Valley. Disparities in EC burden are driven by upstream determinants, including culturally embedded dietary practices, household energy use, and environmental exposures such as indoor air pollution. However, locally grounded evidence on modifiable risk factors remains limited, constraining equitable, context-specific prevention strategies. This study aimed to identify locally relevant risk factors of EC in Arsi and Bale Zones of Ethiopia and generate evidence to inform upstream, equity-focused cancer prevention interventions. |
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| Methodology/Approach | We undertook a 1:2 matched case-control study among 100 histologically confirmed EC cases recruited from Tikur Anbessa Specialized Hospital and Adama General Hospital, and 200 neighborhood controls matched by age (±2 years) and sex. Data were collected using structured questionnaires administered to case patients in hospitals and controls in their homes. Conditional logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs), controlling for potential confounders. |
| Results | Conditional logistic regression showed several factors were significantly associated with risk of EC, after controlling for possible confounders: frequent consumption of hot porridge (daily: aOR 8.4; 95% CI: 1.7-41.0; twice daily: aOR 13.5; 95% CI: 3.1-58.1), daily intake of hot coffee (aOR 7.6; 95% CI: 2.1-28.5), and coffee with milk (aOR 3.9; 95% CI: 1.3-11.0). Having prior digestive disease was also a strong predictor (aOR 10.1; 95% CI: 2.7-37.8). Having a separate kitchen was protective (aOR 0.2; 95% CI: 0.11-0.6), suggesting reduced indoor air pollution exposure. |
| Discussion/Conclusion | This study highlights the critical role that upstream social, cultural, and environmental determinants play a central role in EC inequities in rural Ethiopia. Practices such as consuming very hot foods and indoor biomass cooking are shaped by structural constraints affecting vulnerable populations. Addressing these through low-cost, scalable interventions, including community education, improved cooking technologies, and housing modifications, can reduce risk. Integrating such strategies into primary healthcare and non-communicable diseases programs offers a practical pathway to advance health equity and reduce EC burden in low-resource settings. |
| Presenters and Affiliations | Gemechu G. Bulcha Addis Ababa University, Oromia Health Bureau Maria E. Leon International Agency for Research on Cancer, WHO Christian Abnet Metabolic Epidemiology Branch Division of Cancer Epidemiology and Genetic National Cancer Institute Gwen A. Murphy Metabolic Epidemiology Branch Division of Cancer Epidemiology and Genetic National Cancer Institute Valarie McCormack International Agency for Research on Cancer, WHO Aseffa Sime Addis Ababa University, College of Health Science Isabelle Deltour International Agency for Research on Cancer, WHO Joachim Schuz International Agency for Research on Cancer, WHO Pritchett Natalie Metabolic Epidemiology Branch Division of Cancer Epidemiology and Genetic National Cancer Institute Sanford M. Dawsey Metabolic Epidemiology Branch Division of Cancer Epidemiology and Genetic National Cancer Institute Beyan Jeylan ICAP at Columbia University |
