The epidemiology of hypopharynx and cervical esophagus cancer

Our plain-English summary of The epidemiology of hypopharynx and cervical esophagus cancer, by C.R. Popescu, S.V. Bertesteanu, D. Mirea, et al (Journal of Medicine and Life, 2010).

The study

• Authors: C.R. Popescu, S.V. Bertesteanu, D. Mirea, R. Grigore, D. lonescu, B. Popescu
• Journal: Journal of Medicine and Life
• Published: 2010;3(4):396-401
• Cited by: 19 articles, as counted by NIH iCite
• Read it: PubMed · Free full text

Abstract

At the beginning of the 21st century the hypopharynx and the cervical esophagus cancer represents a major issue for all countries of the world. The epidemiology of the hypopharynx and cervical esophagus cancer deals with the spread of the disease in the human population with regard to sex, age, profession, time and space, as well as risk factors that contribute to these phenomena. The main goal is to investigate the causes and the factors involved in the development of the tumors at the pharyngoesophageal junction, knowledge that contributes to the latest therapeutic assessment through interdisciplinary collaboration (E.N.T. surgeon, general surgeon, radiation oncologist, chemotherapist, and nutritionist). The epidemiology of the hypopharynx and cervical esophagus cancer includes three major areas of interest: descriptive (the study of the spread in mass population), analytical (the study of causal risk factors on the disease) and experimental (that verifies by experiments on animals the prior identified hypothesis).

In plain English

This article, by Romanian ear, nose and throat surgeons, was a narrative review of cancer of the hypopharynx (lower throat) and cervical (neck) esophagus. It presented no new data of its own. It reviewed incidence and risk factors including tobacco, alcohol, occupation, diet and genetics. On asbestos, the review stated that an association between hypopharynx cancer and asbestosis had been described in 16 cohort studies and 6 case-control studies. It presented a table, modified after a 2006 Committee on Asbestos report, of results attributed to Marchand et al. (2000) and adjusted for age and alcohol. In that table, the relative risk of pharynx cancer was 6.2 (95% CI 3.4 to 11.4) for a smoking history of 30 or more (unit printed as packs/year) with intermediate/high asbestos exposure. The comparison group, at 1.0, was under 30 with none/small exposure. The authors wrote that the data were suggestive but not sufficient to establish a causal relation between asbestos exposure and hypopharynx cancer. They wrote that evidence linking asbestos to cervical esophagus cancer was inadequate for a cause-effect relation. They stated that chronic asbestos fiber exposure did not produce pharyngo-esophageal tumors in animals.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of published epidemiology, divided into descriptive, analytical (risk factor) and experimental (animal) evidence; no original data
• Who was studied: No study population of its own. The review drew on published registry, cohort, case-control and animal studies of hypopharynx and cervical esophagus cancer from various countries, including Romania.
• Exposure: Risk factors reviewed: tobacco, alcohol, occupational factors including asbestos fibers, rubber industry work and sulfuric acid, diet, genetic factors, preexisting conditions and infections
• Main results:
  • The review stated that an association between hypopharynx cancer and asbestosis (the article's term) had been described in 16 cohort studies and 6 case-control studies.
  • Table 2 was modified after the Committee on Asbestos: Selected Health Effects (2006) report. It gives results attributed to Marchand et al. (2000), adjusted for age and alcohol consumption, by smoking history (printed as packs/year) and asbestos exposure. The reference group (RR 1.0) was under 30 with none/small exposure. Under 30 with intermediate/high exposure: RR 1.2 (0.6 - 2.3). 30 or more with none/small exposure: RR 4.0 (2.2 - 7.2). 30 or more with intermediate/high exposure: RR 6.2 (3.4 - 11.4).
  • For hypopharynx cancer, the review stated that only one case-control study suggests asbestos exposure as a cofactor along with tobacco. It said the data were suggestive but not sufficient to establish a causal relation.
  • For cervical esophagus cancer, the review stated that a number of studies indicate an association with asbestos exposure, but that the evidence is inadequate to establish a cause-effect relation.
  • The review stated that, in animals, chronic exposure to asbestos fibers did not lead to pharyngo-esophageal tumors, whereas chronic tobacco smoke exposure led to neoplastic changes.
  • Citing Boffetta et al. (2003), a case-control study in France, Italy, Spain and Switzerland, the review reported raised odds ratios for several occupations. Masons: OR 6.9 (95% CI 1.2-41.0, 4 cases). Cement industry workers: OR 4.1 (95% CI 0.9-19.4, 3 cases).
• The authors' conclusion: The authors concluded that further studies are needed on risk factors for hypopharynx and cervical esophagus cancer. On asbestos, they stated that the evidence is suggestive but not sufficient to establish a causal relation.
• Limitations the authors state:
  • The authors noted that occupational exposures are hard to evaluate because the affected worker groups frequently also use tobacco and alcohol.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Throat and laryngeal cancer.

Medical terms in this study, explained in our Lexicon: Epidemiology.

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