Abstract

PIP: Analysis of a hospital-based case-control study of esophageal cancer among Singapore Chinese (composed of Cantonese, Hokkien, Teochew, and other dialect groups) revealed the following statistically significant risk factors for both sexes: 1) belonging to either Hokkien or Teochew dialect group; 2) consuming beverages at temperatures stated subjectively to be burning hot before illness; and 3) smoking Chinese cigarettes. Additional risk factors for males were birth in China and consumption of Samsu (Chinese wine). Bread, potato, and banana consumption was reported at significantly lower levels in male esophagus cancer patients than controls. Esophageal cancer was less common in males who attended school for more than 8 years. Multivariate analysis (joint influence of selected variables) confirmed the strong effects of dialect group and beverage temperature for both sexes. For females, Chinese cigarette smoking remained a risk factor; for males, Samsu consumption. Smoking western cigarettes and drinking strong liquors were not significantly related for either sex. These findings suggest that esophageal cancer is more likely to occur among traditional Chinese who maintain dietary patterns which include Samsu and scalding beverages but avoid bland foodstuffs not native to the culture. The greater risk in Teochew and Hokkien may be due in part to beverage temperature, since "burning hot" was cited more frequently in these dialect groups. However, these differences are based on subjective impressions and require further verification.