Aetiological factors in oesophageal cancer in Singapore Chinese

Abstract Analysis of a hospital‐based case‐control study of oesophageal cancer among Singapore Chinese (composed of Cantonese, Hokkien, Teochew and other dialect groups) revealed the following statistically significant risk factors for both sexes: (I) belonging to either Hokkien or Teochew dialect groups; (2) the consumption of beverages at temperatures stated subjectively to be “burning hot” prior to illness; and (3) the smoking of Chinese cigarettes. Additional risk factors for males were birth in China and the consumption of Samsu (Chinese wine). Consumption of bread, potatoes and bananas was reported at significantly lower levels in male oesophagus cancer patients than in controls. Oesophageal cancer was less common in males who had attended school for more than 8 years. Multivariate analysis (examination of the joint influence of selected variables) confirmed the strong effects of dialect group and beverage temperature for both sexes. For females the smoking of Chinese cigarettes remained a risk factor, for males the consumption of Samsu. The smoking of westerntype cigarettes and the consumption of strong liquors were not significantly related for either sex. These findings suggest that oesophageal cancer is more likely to occur among “traditional” Chinese who maintain dietary patterns which include Samsu and the drinking of beverages at hot temperatures, but avoid the bland foodstuffs (bread, potatoes and bananas) not native to their culture. The greater risk in Teochew and Hokkien may be due in part to the consumption of a greater number of beverages at “burning hot” temperatures compared with Cantonese and other dialect groups. However, these differences are based on subjective impressions which need to be verified by actual measurements of the temperature of drinks consumed by members of these population groups.