This article is more than 5 years old. Information may no longer be current.
Black men who smoke, drink have high risk for esophageal squamous cell carcinoma
Click Here to Manage Email Alerts
Black men who have ever smoked tobacco and drank alcohol have the highest incidence of esophageal squamous cell carcinoma compared with other races and women, according to recent study data.
As the estimated incidence of esophageal squamous cell carcinoma (ESCC) in this patient population approached that of other screened diseases — such as esophageal adenocarcinoma (EAC) in white non-Hispanic men with weekly GERD — researchers concluded that a screening program may be warranted.
Anoop Prabhu
“Overall, the study seems to show that in select, high-risk populations (in this case African-American men with a history of alcohol and tobacco use), the incidence of an otherwise rare disease is quite significant,” Anoop Prabhu, MD, from the Ann Arbor Veterans Affairs Medical Center and the division of gastroenterology at University of Michigan Medical School, told Healio Gastroenterology.
Prabhu and colleagues developed a Markov computer model to estimate the race- sex- and exposure-specific incidence of ESCC relative to that of EAC in white men with weekly GERD, for whom endoscopic screening is typically recommended. They used the National Health Interview Survey to determine race- and sex-specific tobacco and alcohol exposure data, used meta-analyses to estimate standardized incidence ratios of tobacco and alcohol for ESCC, and used SEER data to determine current ESCC incidence in the U.S.
“The NHIS defines ‘drinkers’ as those having consumed [more than] 12 alcoholic drinks in their entire lifetime and ‘smokers’ as those having smoked [more than] 100 cigarettes in their lifetime,” the researchers wrote.
SEER data showed that black men had the highest incidence of ESCC compared with white non-Hispanic, Hispanic or Asian men. The highest ESCC incidence in black men was 34.6 new cases per 100,000 in patients aged 75 to 79 years. Black women also had the highest incidence compared with women of other races, the highest of which was 10.9 new cases per 100,000 in patients aged 75 to 79 years.
The estimated incidence of ESCC in black men who ever drank alcohol and smoked tobacco approached the risk of EAC in white non-Hispanic men with weekly GERD aged 50 to 60 years. For example, in black male smokers and drinkers, ESCC incidence was 30 new cases per 100,000 in patients aged 60 years, compared with 40 new cases of EAC per 100,000 in white men with weekly GERD. In comparison, EAC risk in white non-Hispanic women with weekly GERD at this age was 6.2 new cases per 100,000. The estimated incidence of ESCC among women who both smoked and drank was low across all ages and races.
“Though no screening recommendations currently exist for ESCC, our estimate showed the incidence of ESCC in this high-risk population approaches that of a population where screening is almost universally recommended (white men with weekly GERD). In that context, it may be worth exploring the benefits of a targeted screening program,” Prabhu said. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
Read more about
Click Here to Manage Email Alerts