Prevalence and risk factors for esophageal squamous cell cancer and precursor lesions in Anyang, China: a population-based endoscopic survey

BACKGROUND: The etiology of esophageal squamous cell cancer (ESCC) in high prevalence regions of China remains unclear. METHODS: Endoscopic biopsies were conducted among 7381 inhabitants aged from 25 to 65 of Anyang, China. RESULTS: In this study, 2.57, 0.20 and 0.16% of the participants had mild, moderate and severe squamous dysplasia, respectively; 0.19 and 0.08% showed squamous carcinoma in situ and invasive ESCC. Using deep well (depth >100 meters) as water source (odds ratio=0.72, 95% confidence interval: 0.54-0.96) was negatively associated with ESCC and its precursors, whereas tobacco and alcohol use were not significantly associated with ESCC. CONCLUSIONS: Water source and other factors in this region need further evaluation by longitudinal studies.