Esophageal squamous cell carcinoma is a common cancer worldwide and has a very high mortality rate.
Squamous dysplasia is the precursor lesion for esophageal squamous cell carcinoma and it can be seen during routine endoscopy with Lugol’s iodine staining.
Dr Abnet and colleagues examined the risk factors for squamous dysplasia.
The research team also determined if a risk model could be constructed which would be useful in selecting apparently healthy subjects for endoscopic screening in a high risk population.
The researchers designed a cross sectional study in which 724 adult volunteers aged 40 to 65 years were enrolled in Linzhou, People’s Republic of China.
The team reported that all subjects completed a questionnaire regarding potential environmental exposures, and received physical and dental examinations.
| Higher household income is associated with a lower odds of having dysplasia|
The patients underwent upper endoscopy with Lugol’s iodine staining and biopsy.
The researchers categorized subjects as having or not having histologically proven squamous dysplasia/early cancer.
The investigators examined risk factors for dysplasia using univariate and multivariate logistic regression.
The utility of the final multivariate model as a screening tool was assessed using a receiver operating characteristics curve.
The researchers found that 32 % of subjects with complete data had prevalent squamous dysplasia.
Using the final multivariate model, the team noted that more household members, a family history of cancer and higher systolic blood pressure were associated with higher odds of having dysplasia.
In addition, the team observed that heating the home without a chimney, and having lost more but not all of your teeth were associated with higher odds of having dysplasia.
Higher household income was associated with a lower odds of having dysplasia.
Although the team found several statistically significant associations, the final model had little ability to accurately predict dysplasia status.
The researchers reported that the maximum simultaneous sensitivity and specificity values of the model were 57% and 54%, respectively.
Dr Abnet’s team concluded, “We found that risk factors for dysplasia were similar to those previously identified as risk factors for esophageal squamous cell carcinoma in this population.”
“The final model did a poor job of identifying subjects who had squamous dysplasia.”
“Other methods will need to be developed to triage individuals to endoscopy in this high risk population.”