PDF(Pubmed)
Abstract：
Africa is the continent most affected by esophageal cancer in the world. Alcoholic beverages are controversially blamed, as esophageal cancer is a rare disease in several other countries ranked in the top 10 for consumption of alcoholic beverages. This study aims to conduct a comprehensive systematic review of published literature, statistically summarizing the strength of the association between drinking patterns and types, and the risk of esophageal cancer in Africa. A computerized search of reputable databases such as Medline/PubMed, EMBASE, Web of Science, and African Journals Online was performed to identify relevant studies published up to September 2023. The quality of the studies was evaluated using the Newcastle-Ottawa scale for case-control studies and the Agency for Healthcare Research and Quality tool for cross-sectional studies. A funnel plot and Egger test were utilized to assess potential publication bias. Meta-analyses were conducted using random-effects models with RevMan 5.3 and Stata software to estimate summary effects. The systematic review identified a total of 758,203 studies, primarily from Eastern and Southern Africa. The pooled samples across all studies comprised 29,026 individuals, including 11,237 individuals with cancer and 17,789 individuals without cancer. Meta-analysis revealed a significant association between alcohol consumption and the risk of esophageal cancer (odds ratio [OR] = 1.81; 95% confidence interval [CI], 1.50-2.19). Further analysis based on the frequency of alcoholic beverage consumption indicated a stronger association with daily (OR = 2.38; 95% CI, 1.81-3.13) and weekly (OR = 1.94; 95% CI, 1.32-2.84) drinkers in contrast to occasional drinkers (OR = 1.02; 95% CI, 0.81-1.29). Additionally, consumption of traditional alcoholic beverages was significantly associated with the risk of esophageal cancer in African populations (OR = 2.00; 95% CI, 1.42-2.82). However, no relationship has been established between the exclusive consumption of non-traditional drinks and the risk of esophageal cancer. In conclusion, the results of this study confirm the hypothesis that daily and weekly drinking patterns, significantly increase the risk of esophageal cancer in Africa, while occasional consumption does not show a significant association. Additionally, the consumption of traditional alcoholic beverages is notably linked to the risk of esophageal cancer in African populations.
摘要：
非洲是世界上受食道癌影响最大的大陆。酒精饮料受到争议，在其他几个国家，食道癌是一种罕见的疾病，在酒精饮料消费量排名前10位。本研究旨在对已发表的文献进行全面系统的回顾，统计总结饮酒模式和类型之间的关联强度，以及非洲食道癌的风险。对Medline/PubMed等信誉良好的数据库进行计算机化搜索，EMBASE,WebofScience,和非洲期刊在线进行，以确定截至2023年9月发表的相关研究。使用用于病例对照研究的纽卡斯尔-渥太华量表和用于横断面研究的医疗保健研究机构和质量工具来评估研究的质量。漏斗图和Egger检验用于评估潜在的发表偏倚。使用RevMan5.3和Stata软件的随机效应模型进行Meta分析以估计汇总效应。系统评价共确定了758,203项研究，主要来自东部和南部非洲。所有研究的汇总样本包括29,026名个体，包括11,237名癌症患者和17,789名无癌患者。荟萃分析显示，饮酒与食管癌风险之间存在显着关联（比值比[OR]=1.81；95％置信区间[CI]，1.50-2.19)。基于酒精饮料消费频率的进一步分析表明，与每日（OR=2.38;95％CI，1.81-3.13）和每周（OR=1.94;95％CI，1.32-2.84）饮酒者的相关性更强，而偶尔饮酒者（OR=1.02;95％CI，0.81-1.29）。此外,在非洲人群中,饮用传统酒精饮料与食管癌风险显著相关(OR=2.00;95%CI,1.42-2.82).然而,非传统饮料的独家消费与食道癌风险之间没有关系.总之,这项研究的结果证实了这样一个假设，即每天和每周的饮酒模式，显著增加非洲食管癌的风险，而偶尔消费并没有显示出显著的关联。此外,传统酒精饮料的消费与非洲人群的食道癌风险显著相关.
