Esophageal squamous cell carcinoma is associated with alcohol use, tobacco use and African or Asian descent.
However, little is known about how racial background modifies the effects of alcohol or tobacco.
Dr Rubenstein and colleagues from Michigan investigated how racial and geographical background modifies the effect of alcohol and tobacco on esophageal squamous cell carcinoma via a systematic review and meta-analysis of published literature.
The team performed a literature search in multiple online databases regardless of language.
Eligible studies were population-based assessments of the effect of tobacco and/or alcohol on the risk of esophageal squamous cell carcinoma allowing stratification by race.
The quality of studies was assessed by the Newcastle-Ottawa Scale.
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|Alimentary Pharmacology & Therapeutics|
The research team performed a meta-analyses estimated summary effects using random effect models.
Systematic review identified 9668 unique citations of which 34 were eligible.
The research team found that the majority were of high quality.
The effect of current smoking vs. never-smoking was weaker among Asians than among Europeans, with the 95% CIs not crossing, indicating statistical significance.
The team observed that Asians also trended towards weaker effects of long-duration cigarette use and of heavy daily cigarette use.
The research team found no difference in the effect of alcohol on esophageal squamous cell carcinoma risk by race.
Dr Rubenstein's team concludes, "Contrary to our hypothesis, a weaker effect of tobacco for esophageal squamous cell carcinoma was observed among Asians than among Europeans."
"Differences in other factors must explain the higher incidence of esophageal squamous cell carcinoma among Asians."
"More studies are needed to understand the cause of the disparate incidence of esophageal squamous cell carcinoma between races."