Retrospective Study of Sociodemographic, Endoscopic, and Histopathologic Features of Esophageal Cancer at a Tertiary Care Hospital of Himachal Pradesh, India
Abstract
Background: Esophageal Cancer (EC) is one of the least responsive tumors to cancer therapy with overall poor prognosis. Published data from different regions in India have indicated their observations on the local risk factors. Presently, as there seems little prospect of early detection and effective management of this cancer, understanding the etiology of EC may suggest opportunities for its primary prevention.
Material & Methods: A retrospective hospital record-based study was carried out for the period of five years (2014-2019) in Department of Gastroenterology of Indira Gandhi Medical College Shimla- a tertiary care hospital located in Sub – Himalyan ranges of North India in Himachal Pradesh.
Results: A total of 363 patients were diagnosed to have EC, 58.68% were male and 41.32% were female with male to female ratio of 1.42:1. Most patients come from rural areas (82.09%) and belonged to low socioeconomic status (38.01%). Most patients were illiterate (41.87%) and were involved in farming works (52.06%). Majority (76.03%) had a history of smoking bidi followed by alcohol consumption (29.20%). The most common primary location of the malignancy was middle third of the esophagus in 44.63% followed by lower third 35.54% and upper third 19.83%. Squamous cell histology was identified in 70.24% patients,
while 29.75% patients had adenocarcinoma.
Conclusion: EC is one of the important cancers in northern Indian state of Himachal Pradesh. Squamous cell carcinoma is the most common type followed by adenocarcinoma. The most common primary location of the malignancy was middle third of the esophagus followed by lower and upper third. The major risk factors associated with EC included tobacco and alcohol consumption besides low socioeconomic status, illiteracy, rural background and occupation of farming.
Source(s) of Support: None
Conflicting Interest: None
References
2. Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008 2030): A population based study. Lancet Oncol 2012; 13:790 801.
3. Brown LM, Devesa SS, Chow WH. Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. J Natl Cancer Inst 2008; 100:1184 7.
4. Cherian JV, Sivaraman R, Muthusamy AK, Jayanthi V. Carcinoma of the esophagus in Tamil Nadu (South India): 16 year trends from a tertiary center. J Gastrointestin Liver Dis 2007; 16:245 9.
5. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon, France: International Agency for Research on Cancer; 2013.
6. Schottenfeld D. Epidemiology of cancer of the esophagus. Semin Oncol. 1984;11:92–100
7. van Rensburg SJ. Epidemiologic and dietary evidence for a specific nutritional predisposition to esophageal cancer. J Natl Cancer Inst. 1981; 67:243–51.
8. Novacek G. Plummer-Vinson syndrome. Orphanet J Rare Dis. 2006; 1:36.
9. Indian council of medical Research, Biennial Report, 1988- 89, National Cancer Registry Programme. New Delhi: ICMR; 1992.
10. Sehgal S, Kaul S, Gupta BB, Dhar MK. Risk factors and survival analysis of the esophageal cancer in the population of Jammu, India. Indian J Cancer 2012; 49:245 50.
11. Das KC, Singh S, Pawar G, Masih R, Raju N. Risk factors analysis of squamous cell carcinoma (SCC) esophagus in North Indian females in tertiary care hospital: A case–control study. Int J Recent Sci Res 2015;6:4661-4
12. The text book of Preventive and Social Medicine. In: Mahajan, Gupta, editors. 3rd ed. 2003. p. 117-8.
13. Ke L. Mortality and incidence trends from esophagus cancer in selected geographic areas of China circa 1970-1990. Int J Cancer. 2002;102:271–4.
14. Kapoor A, Kumar V et al. Sociodemographic Parameters of Esophageal Cancer in Northwest India: A Regional Cancer Center Experience of 10 Years. Indian J Community Med. 2015 Oct-Dec; 40(4): 264–267.
15. Sankaranarayanan R, Duffy SV, Padma Kumaray G, Nair SM, Day NE, Pandanabhan TK. Risk factors for cancer of the esophagus in Kerala, India. Indian J Cancer. 1991; 49:485–9.
16. Giri PA, Singh KK, Phalke DB. Study of socio-demographic determinants of esophageal cancer at a tertiary care teaching hospital of Western Maharashtra, India. South Asian J Cancer. 2014; 3:54–6.
17. Farin K, Graca MD, William FA. Patterns of cancer incidence, mortality and prevalence across five continents: Defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006; 24:2137–50.
18. Chitra S, Ashok L, Anand L, Srinivasan V, Jaynath V. Risk factors for oesophageal cancer in Coimbatore; Southern India; A hospital based case control study. Indian J Gastroenterol. 2004; 23:19–21.
19. Blot WJ. Alcohol and cancer. Cancer Res. 1992; 52:2119s–23.
20. Tramacere I, La Vecchia C, Negri E. Tobacco smoking and esophageal and gastric cardia adenocarcinoma: A metaanalysis. Epidemiology. 2011; 22:344–9.
