Diet habits, alcohol drinking, tobacco smoking, green tea drinking, and the risk of esophageal squamous cell carcinoma in the Chinese population

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Abstract
Objective This study aims to investigate the risk of esophageal squamous cell carcinoma in relation to exogenous factors in a rural area of China with a high incidence of esophageal squamous cell carcinoma. Methods A population-based case–control study was conducted in Yangzhong County, Jiangsu Province, China, with 355 histologically confirmed esophageal squamous cell carcinoma cases recruited between 1 January 2004 and 28 February 2006 and 408 controls matched by sex and age, randomly selected from the local population. Results Stratified logistic regression analysis by sex revealed that hot-temperature food items, pork braised in brown sauce and old stocked rice intake could increase the risk of esophageal squamous cell carcinoma with odds ratio of 2.127 (95% confidence interval: 1.394–3.245), 2.059 (95% confidence interval: 1.417–2.993) and 9.059 (95% confidence interval: 5.930–13.840), respectively, in men and 3.048 (95% confidence interval: 1.733–5.364), 1.914 (95% confidence interval: 1.159–3.162) and 14.532 (95% confidence interval: 7.816–27.019), respectively, in women, whereas diet high in salt and chili, tobacco smoking and alcohol drinking only showed possible risk effects in men with odds ratio 2.338 (95% confidence interval: 1.568–3.485), 3.378 (95% confidence interval: 2.117–5.389), 1.976 (95% confidence interval: 1.337–2.921) and 2.197 (95% confidence interval: 1.510–3.195), respectively. Green tea drinking showed a protective effect in women (odds ratio=0.257; 95% confidence interval: 0.070–0.941). Conclusions Findings from this study provided evidence that dietary habits, tobacco-smoking and alcohol drinking contribute to the etiology of esophageal squamous cell carcinoma. A healthy dietary habit, with smoking cessation and alcohol controlling is of a great importance in the prevention of esophageal cancer.