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. 2019 Jun 1;144(11):2669-2676.
doi: 10.1002/ijc.32032. Epub 2019 Jan 27.

Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case-control study

Daniel Rs Middleton  1 , Diana Menya  2 , Nicholas Kigen  3 , Margaret Oduor  4 , Stephen K Maina  3 , Fatma Some  5 , David Chumba  5 , Paul Ayuo  5 , Odipo Osano  6 , Joachim Schüz  1 , Valerie McCormack  1
Affiliations

Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case-control study

Daniel Rs Middleton et al. Int J Cancer. .

Abstract

Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Consumption of hot beverages-a probable carcinogen to humans-is associated with increased ESCC risk in other settings and is habitually practiced in Kenya. We conducted a case-control study in Eldoret, western Kenya between August 2013 and March 2018. Cases were patients with endoscopically confirmed oesophageal cancer whose histology did not rule out ESCC. Age and sex-matched controls were hospital visitors and hospital out and in-patients excluding those with digestive diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for self-reported drinking temperatures; consumption frequency; mouth burning frequency and hot porridge consumption using logistic regression models adjusted for potential confounders. Drinking temperature association with tumour sub-location was also investigated. The study included 430 cases and 440 controls. Drinkers of 'very hot' and 'hot' beverages (>95% tea) had a 3.7 (95% CI: 2.1-6.5) and 1.4-fold (1.0-2.0) ESCC risk, respectively compared to 'warm' drinkers. This trend was consistent in males, females, never and ever alcohol/tobacco and was stronger over than under age 50 years. The tumour sub-location distribution (upper/middle/lower oesophagus) did not differ by reported drinking temperature. Our study is the first comprehensive investigation in this setting to-date to observe a link between hot beverage consumption and ESCC in East Africa. These findings provide further evidence for the role of this potentially modifiable risk factor in ESCC aetiology.

Keywords: Africa; aetiology; hot beverages; oesophageal cancer.

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Figures

Figure 1
Figure 1
Odds ratios (OR) and 95% confidence intervals (CI) for the association of self‐reported drinking temperatures with oesophageal cancer risk in Kenya—overall and by subgroup.
See this image and copyright information in PMC

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