Dietary and Demographical Risk Factors for Oesophageal Squamous Cell Carcinoma in the Eastern Anatolian Region of Turkey Where Upper Gastrointestinal Cancers are Endemic

  • Koca, Timur (Department of Radiation Oncology, Regional Training and Research Hospital) ;
  • Arslan, Deniz (Department of Medical Oncology, Regional Training and Research Hospital) ;
  • Basaran, Hamit (Department of Radiation Oncology, Regional Training and Research Hospital) ;
  • Cerkesli, Arda Kaymak (Department of Radiation Oncology, Regional Training and Research Hospital) ;
  • Tastekin, Didem (Department of Medical Oncology, Oncology Institute, Medical Faculty, Istanbul University) ;
  • Sezen, Duygu (Department of Radiation Oncology, Regional Training and Research Hospital) ;
  • Koca, Ozlem (Department of Microbiology, Nenehatun Gynecology and Obstetric Hospital) ;
  • Binici, Dogan Nasir (Department of Internal Medicine, Regional Training and Research Hospital) ;
  • Bassorgun, Cumhur Ibrahim (Department of Pathology, Faculty of Medicine, Akdeniz University) ;
  • Ozdogan, Mustafa (Department of Medical Oncology, Medstar Hospital)
  • Published : 2015.03.18


Background: Oesophageal squamous cell carcinoma (ESCC) is endemic in the Eastern Anatolian region of Turkey. The present study was performed to identify risk factors for ESCC that specifically reflect the demography and nutritional habits of individuals living in this region. Materials and Methods: The following parameters were compared in 208 ESCC patients and 200 control individuals in the Eastern Anatolian region: age, sex, place of living, socioeconomic level, education level, smoking, alcohol intake, nutritional habits, and food preservation methods. Results: The mean age of ESCC patients was 56.2 years, and 87 (41.8%) were 65 years-old or older. The ratio of women to men in the patient group was 1.39/1. ESCC patients consumed significantly less fruit and yellow or green vegetables and more hot black tea, 'boiled yellow butter', and mouldy cheese than did control individuals. Residence in rural areas, smoking, and cooking food by burning animal manure were also significantly associated with ESCC. Conclusions: The consumption of boiled yellow butter and mouldy cheese, which are specific to the Eastern Anatolian region, and the use of animal manure for food preparation were identified as risk factors in this region. Further studies are required to potentially identify the carcinogenic substances that promote the development of ESCC in this region.


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