Retrospective Analysis of Risk Factors in Cases of Biopsy Proven Carcinoma Esophagus in an Urban Indian Population

ABSTRACT

Aims and Objectives: Carcinoma (Ca) esophagus is a life-threatening malignancy in Indian scenario, due to late-stagepresentation and limited treatment options. Rampant tobacco and alcohol use have seen a rise in the incidence of squamous cellCa esophagus. Accurate identification and description of risk factors are critical to the implementation of preventive measures.The data in this regard are lacking in our country.Materials and Methods: This was a retrospective study conducted at a tertiary care center in Southern India. 103 patients withbiopsy-proven esophageal Ca presenting over a period of 22 months were studied. The data regarding smoking and alcoholconsumption, history of gastroesophageal reflux disease (GERD), Helicobacter pylori infections as assessed by rapid ureasetest during endoscopy and documentation suggestive of tylosis were collected by means of a questionnaire and analysis ofexisting medical documents. No therapeutic or diagnostic interventions were made based on the data collected.Results: Smokers were more likely to develop squamous cell Ca (82.1%, P = 0.04, Z = 1.74) as well as adenocarcinoma (41%,P = 0.01, Z = 5.18). Alcohol consumption was more likely to develop both squamous cell Ca (39%, P = 0.01, Z = 1.73) andadenocarcinoma. Smoking, GERD, and H. pylori infection had a significantly higher association with adenocarcinoma than withthe squamous cell Ca while alcohol use and caustic injury had a higher association with squamous cell Ca.Conclusion: A systematic analysis of risk factors shows that smoking and alcohol are strongly associated with bothhistopathological subtypes of this malignancy. Other risk factors were H. pylori infection, GERD, caustic injury, and tylosis.