Identification Of The Crucial Pieces Of Esophageal Cancer Prevention And Early Detection Program In Mozambique
DOI:
https://doi.org/10.34635/rpc.1052Keywords:
esophageal cancer, risk factors, prevention, early detection, MozambiqueAbstract
Esophageal squamous cell carcinoma (ESCC) poses a significant health burden in Mozambique, with high incidence rates and late-stage diagnoses contributing to its lethality. This comprehensive review examines the epidemiology, risk factors, and potential preventive strategies for ESCC in Mozambique. Key risk factors identified include tobacco smoking, alcohol consumption, dietary factors, hot beverage consumption, infections (such as HPV and HIV), environmental chemical exposures, and dental fluorosis. Geographic variations in EC incidence highlight the need for region-specific intervention. Poverty, gender, and age disparities further complicate prevention efforts. Implementing evidence-based interventions, such as tobacco control measures, dietary diversification, and early detection programs, is essential for reducing EC morbidity and mortality in Mozambique. The Mozambican National Cancer Control Plan (NCCP) provides a framework for integrated prevention and early detection initiatives. Collaborative efforts involving policymakers, healthcare providers, and communities are crucial for addressing the multifaceted challenges EC poses in Mozambique and improving cancer outcomes.Downloads
References
2. Robertson MA, Harington JS, Bradshaw E. THE CANCER PATTERN IN AFRICAN GOLD MINERSt.
3. Cook MB, Chow WH, Devesa SS. Oesophageal cancer incidence in the United States by race, sex, and histologic type, 1977-2005. Br J Cancer. 2009 Sep 1;101(5):855–9.
4. Zeng H, Sun K, Cao M, Zheng R, Sun X, Liu S, et al. Initial results from a multi-center population-based cluster randomized trial of esophageal and gastric cancer screening in China. BMC Gastroenterol. 2020 Dec 1;20(1).
5. Yang CS, Chen X, Tu S. Etiology and Prevention of Esophageal Cancer. Gastrointest Tumors. 2016;3(1):3–16.
6. Xue H, Wang T, Lu J, Wu J. Diet And Vitamin Nutrition Of The High Esophageal Cancer Risk Population In Linxian, China. Nutr Cancer. 1982 Jan 1;4(2):154–64.
7. Islami F, Boffetta P, Ren JS, Pedoeim L, Khatib D, Kamangar F. High-temperature beverages and foods and esophageal cancer risk - A systematic review. Vol. 125, International Journal of Cancer. 2009. p. 491–524.
8. Castro C, Bosetti C, Malvezzi M, Bertuccio P, Levi F, Negri E, et al. Patterns and trends in esophageal cancermortality and incidence in Europe (1980-2011) and predictions to 2015. Annals of Oncology. 2014 Jan 1;25(1):283–90.
9. Lopes AB. Esophageal squamous cell carcinoma - precursor lesions and early diagnosis. World J Gastrointest Endosc. 2012;4(1):9.
10. jgo.org JGO-Journal of Global Oncology The African Esophageal Cancer Consortium: A Call to Action [Internet]. 2018. Available from: https://ascopubs.org/authors/open-access
11. McCormack VA, Menya D, Munishi MO, Dzamalala C, Gasmelseed N, Leon Roux M, et al. Informing etiologic research priorities for squamous cell esophageal cancer in Africa: A review of setting-specific exposures to known and putative risk factors. Vol. 140, International Journal of Cancer. Wiley-Liss Inc.; 2017. p. 259–71.
12. Mckeown T. Contemporary Themes A basis for health strategies A classification of disease. Vol. 287, BRITISH MEDICAL JOURNAL. 1983.
13. Byers T, Wender RC, Jemal A, Baskies AM, Ward EE, Brawley OW. The American Cancer Society challenge goal to reduce US cancer mortality by 50% between 1990 and 2015: Results and reflections. CA Cancer J Clin. 2016 Sep;66(5):359–69.
14. “Strong but not Broadly Shared Growth” Mozambique-Poverty Assessment. 2018.
15. Unct. UN Mozambique UNDAF (2017-2021) Results Report. 2021.
16. van den Boom B. Analysis of poverty in Mozambique *.
17. 131212-WP-P156495-PUBLIC-FRI-10-26-7AM-DC-DIGITALMEU.
18. MOZAMBIQUE MULTIDIMENSIONAL POVERTY ANALYSIS STATUS AND TRENDS EMBASSY OF SWEDEN IN MAPUTO. 2019.
19. ajol-file-journals_384_articles_116898_submission_proof_116898-4573-324428-1-10-20150513.
20. Asombang AW, Chishinga N, Nkhoma A, Chipaila J, Nsokolo B, Manda-Mapalo M, et al. Systematic review and meta-analysis of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes. Vol. 25, World Journal of Gastroenterology. Baishideng Publishing Group Co; 2019. p. 4512–33.
21. jgo.org JGO-Journal of Global Oncology Clinical and Pathologic Profiles of Esophageal Cancer in Mozambique: A Study of Consecutive Patients Admitted to Maputo Central Hospital [Internet]. 2018. Available from: https://ascopubs.org/authors/open-access
22. Lorenzoni C, Vilajeliu A, Carrilho C, Ismail MR, Castillo P, Augusto O, et al. Trends in cancer incidence in Maputo, Mozambique, 1991-2008. PLoS One. 2015 Jun 25;10(6).
23. Lorenzoni CF, Ferro J, Carrilho C, Colombet M, Parkin DM. Cancer in Mozambique: Results from two population-based cancer registries. Int J Cancer. 2020 Sep 15;147(6):1629–37.
24. Statistics at a glance, 2022 Top 5 most frequent cancers Number of new cases 26 578.
25a. D.M. Parkin, A. Jemal, F. Bray, A.R. Korir, B. Kamaté, E. Singh, W.Y. Joko, M. Sengayi-Muchengeti, B. Liu and J. Ferlay. The Cancer in Sub-Saharan Africa. Volume III (2019): 31-35. https://www.uicc.org/sites/default/files/atoms/files/AFCRN%20Cancer%20in%20Sub%20Saharan%20Africa.pdf
25b. Parkin DM, Ferlay J, Jemal A, Borok M, Manraj SS, N’Da GG, et al. Cancer in Sub-Saharan Africa.(2018) 251 p. https://publications.iarc.fr/Book-And-Report-Series/Iarc-Scientific-Publications/Cancer-In-Sub-Saharan-Africa-2018
26. Middleton DRS, Bouaoun L, Hanisch R, Bray F, Dzamalala C, Chasimpha S, et al. Esophageal cancer male to female incidence ratios in Africa: A systematic review and meta-analysis of geographic, time and age trends. Cancer Epidemiol. 2018 Apr 1;53:119–28.
27. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394–424.
28. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015 Mar 1;136(5):E359–86.
29. Come J, Castro C, Morais A, Cossa M, Tulsidas S, Cunha L, et al. Clinical and Pathological Profiles of Esophageal Cancer in Mozambique: A Study of Consecutive Patients Admitted to Maputo Central Hospital [Internet]. 2018. Available from: https://ascopubs.org/go/authors/open-access
30. 633.00.
31. Agents Classified by the IARC Monographs, Volumes 1-136.
32. Baan R, Straif K, Grosse Y, Secretan B, Ghissassi F El, Bouvard V, et al. Policy Watch Carcinogenicity of alcoholic beverages [Internet]. 2007. Available from: http://oncology.thelancet.comVol8
33. Rehm J, Mathers C, Patra J, Popova S, Thavorncharoensap M, Teerawattananon Y. GLOBAL BURDEN OF DISEASE AND INJURY AND ECONOMIC COST ATTRIBUTABLE TO ALCOHOL USE AND ALCOHOL USE DISORDERS.
34. Padrão P, Damasceno A, Silva-Matos C, Laszczyńska O, Prista A, Gouveia L, et al. Alcohol consumption in Mozambique: Regular consumption, weekly pattern and binge drinking. Drug Alcohol Depend. 2011 May 1;115(1–2):87–93.
35. Pires J, Padrão P, Damasceno A, Silva-Matos C, Lunet N. Alcohol consumption in Mozambique: Results from a national survey including primary and surrogate respondents. Ann Hum Biol. 2012 Nov;39(6):534–7.
36. Wainberg M, Oquendo MA, Peratikos MB, Gonzalez-Calvo L, Pinsky I, Duarte CS, et al. Hazardous alcohol use among female heads-of-household in rural Mozambique. Alcohol. 2018 Dec 1;73:37–44.
37. Morojele NK, Dumbili EW, Obot IS, Parry CDH. Alcohol consumption, harms and policy developments in sub-Saharan Africa: The case for stronger national and regional responses. Vol. 40, Drug and Alcohol Review. Blackwell Publishing; 2021. p. 402–19.
38. Gandini S, Botteri E, Iodice S, Boniol M, Lowenfels AB, Maisonneuve P, et al. Tobacco smoking and cancer: A meta-analysis. Int J Cancer. 2008 Jan 1;122(1):155–64.
39. Levin ML, Goldstein H, Gerhardt PR. CANCER AND TOBACCO SMOKING A Preliminary Report The published literature on use of tobacco and its possible association with human cancer fails to [Internet]. Available from: http://jama.jamanetwork.com/
40. Department of Health U, Services H, for Disease Control C, Center for Chronic Disease Prevention N, Promotion H, on Smoking O. Executive Summary (The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General).
41. Araújo C, Silva-Matos C, Damasceno A, Gouveia ML, Azevedo A, Lunet N. Manufactured and hand-rolled cigarettes and smokeless tobacco consumption in Mozambique: Regional differences at early stages of the tobacco epidemic. Drug Alcohol Depend. 2011 Dec 15;119(3):e58–65.
42. Padrão P, Damasceno A, Silva-Matos C, Carreira H, Lunet N. Tobacco consumption in Mozambique: Use of distinct types of tobacco across urban and rural settings. Nicotine and Tobacco Research. 2013 Jan;15(1):199–205.
43. Yang CS, Sun Y, Yang Q, Miller KW, Li G, Zheng SF, et al. Vitamin A and Other Deficiencies in Linxian, a High Esophageal Cancer Incidence Area in Northern China [Internet]. Available from: http://jnci.oxfordjournals.org/
44. Abnet CC, Lai B, Qiao YL, Vogt S, Luo XM, Taylor PR, et al. Zinc concentration in esophageal biopsy specimens measured by x-ray fluorescence and esophageal cancer risk. J Natl Cancer Inst. 2005 Feb 16;97(4):301–6.
45. Blot WJ, Li JY, Taylor PR, Guo W, Dawsey S, Wang GQ, et al. ARTICLES Nutrition Intervention Trials in Linxian, China: Supplementation With Specific Vitamin/Mineral Combinations, Cancer Incidence, and Disease-Specific Mortality in the General Population [Internet]. Available from: http://jnci.oxfordjournals.org/
46. Sporn MB, Roberts AB. Role of Retinoids in Differentiation and Carcinogenesis·.
47. van Rensburg SJ, van Rensburg SJ. Esophageal squamous cell cancer susceptibility: Environmental and nutritional associations reveal a universally applicable pathogenesis scenario (Review). Vol. 1, World Academy of Sciences Journal. Spandidos Publications; 2019. p. 219–28.
48. Liu J, Wang J, Leng Y, Lv C. Intake of fruit and vegetables and risk of esophageal squamous cell carcinoma: A meta-analysis of observational studies. Int J Cancer. 2013 Jul 15;133(2):473–85.
49. Sewram V, Sitas F, Oconnell D, Myers J. Diet and esophageal cancer risk in the eastern cape province of South Africa. Nutr Cancer. 2014 Jul 4;66(5):791–9.
50. Padrão P, Laszczyńska O, Silva-Matos C, Damasceno A, Lunet N. Low fruit and vegetable consumption in Mozambique: Results from a WHO STEPwise approach to chronic disease risk factor surveillance. Vol. 107, British Journal of Nutrition. 2012. p. 428–35.
51. Arimond M, Wiesmann D, Becquey E, Carriquiry A, Daniels MC, Deitchler M, et al. Simple food group diversity indicators predict micronutrient adequacy of women’s diets in 5 diverse, resource-poor settings1-7. Journal of Nutrition. 2010 Nov;140(11).
52. Roohani N, Hurrell R, Kelishadi R, Schulin R. Zinc and its importance for human health: An integrative review. Journal of Research in Medical Sciences. 2013.
53. A review of interventions based on dietary diversifica-tion or modification strategies with the potential to enhance intakes of total and absorbable zinc [Internet]. 2009. Available from: www.icrw.org
54. The Situation of Children in Mozambique 2021.
55. MOZAMBIQUE Water and Development Country Plan I. EXECUTIVE SUMMARY. 2020.
56. Loomis D, Guyton KZ, Grosse Y, Lauby-Secretan B, El Ghissassi F, Bouvard V, et al. Carcinogenicity of drinking coffee, mate, and very hot beverages. Vol. 17, The Lancet Oncology. Lancet Publishing Group; 2016. p. 877–8.
57. Munishi MO, Hanisch R, Mapunda O, Ndyetabura T, Ndaro A, Schüz J, et al. Africa’s oesophageal cancer corridor: Do hot beverages contribute? Cancer Causes and Control. 2015 Oct 14;26(10):1477–86.
58. Middleton DRS, Menya D, Kigen N, Oduor M, Maina SK, Some F, et al. Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case–control study. Int J Cancer. 2019 Jun 1;144(11):2669–76.
59. Ndege GO. Culture and Customs of Mozambique GREENWOOD PRESS.
60. RESUMO DOS PRINCIPAIS RESULTADOS | DEZEMBRO DE 2022 PREVALÊNCIA DE HIV, por PROVÍNCIA.
61. Coghill AE, Shiels MS, Suneja G, Engels EA. Elevated cancer-specific mortality among HIV-infected patients in the United States. Journal of Clinical Oncology. 2015 Jul 20;33(21):2376–83.
62. Shiels MS, Cole SR, Kirk GD, Poole C. A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals. J Acquir Immune Defic Syndr (1988). 2009 Dec;52(5):611–22.
63. Shmakova A, Germini D, Vassetzky Y. HIV-1, HAART and cancer: A complex relationship. Vol. 146, International Journal of Cancer. Wiley-Liss Inc.; 2020. p. 2666–79.
64. Li X, Gao C, Yang Y, Zhou F, Li M, Jin Q, et al. Systematic review with meta-analysis: The association between human papillomavirus infection and oesophageal cancer. Aliment Pharmacol Ther. 2014;39(3):270–81.
65. Da Costa AM, Fregnani JHTG, Pastrez PRA, Mariano VS, Neto CS, Guimarães DP, et al. Prevalence of high risk hpv dna in esophagus is high in Brazil but not related to esophageal squamous cell carcinoma. Histol Histopathol. 2018 Apr 1;33(4):357–63.
66. Kayamba V, Bateman AC, Asombang AW, Shibemba A, Zyambo K, Banda T, et al. HIV infection and domestic smoke exposure, but not human papillomavirus, are risk factors for esophageal squamous cell carcinoma in Zambia: A case-control study. Cancer Med. 2015 Apr 1;4(4):588–95.
67. Menéndez C, Castellsagué X, Renom M, Sacarlal J, Quintó L, Lloveras B, et al. Prevalence and risk factors of sexually transmitted infections and cervical neoplasia in women from a rural area of southern Mozambique. Infect Dis Obstet Gynecol. 2010;2010.
68. Izzotti A, Pulliero A. The effects of environmental chemical carcinogens on the microRNA machinery. Int J Hyg Environ Health. 2014;217(6):601–27.
69. Titcombe ME, Simcik M. Personal and indoor exposure to PM2.5 and polycyclic aromatic hydrocarbons in the southern highlands of Tanzania: A pilot-scale study. Environ Monit Assess. 2011 Sep;180(1–4):461–76.
70. Maxwell NI. Environmental Injustices of Energy Facilities. Encyclopedia of Energy. 2004;503–15.
71. Kayamba V, Heimburger DC, Morgan DR, Atadzhanov M, Kelly P. Exposure to biomass smoke as a risk factor for oesophageal and gastric cancer in low-income populations: A systematic review. Vol. 29, Malawi Medical Journal. Malawi Medical Journal; 2017. p. 212–7.
72. Brouwer R, Falcão MP. Wood fuel consumption in Maputo, Mozambique. Biomass Bioenergy. 2004 Sep;27(3):233–45.
73. Ushida J, Sugie S, Kawabata K, Pham QV, Tanaka T, Fujii K, et al. Chemopreventive effect of curcumin on N-Nitrosomethylbenzylamine-induced esophageal carcinogenesis in rats. Japanese Journal of Cancer Research. 2000;91(9):893–8.
74. Keshavarzi B, Moore F, Najmeddin A, Rahmani F, Malekzadeh A. Quality of drinking water and high incidence rate of esophageal cancer in Golestan province of Iran: A probable link. Environ Geochem Health. 2012 Feb;34(1):15–26.
75. Zhao C, Zhou J, Gu Y, Pan E, Sun Z, Zhang H, et al. Urinary exposure of N-nitrosamines and associated risk of esophageal cancer in a high incidence area in China. Science of The Total Environment. 2020 Oct 10;738:139713.
76. Muthukumaran RB, Bhattacharjee P, Bhowmick P, Zote L, Malsawmtluangi, Kumar NS, et al. Genetic and epigenetic instability induced by betel quid associated chemicals. Toxicol Rep. 2023 Jan 1;10:223–34.
77. Siziya S. Tobacco smoking prevalence among in-school adolescents aged 13-15 years: baseline for evaluation of the implementation of the FCTC in Lusaka district, Zambia. Vol. 35, Medical Journal of Zambia.
78. Goff EU, Fine DH. Analysis of volatile N-nitrosamines in alcoholic beverages. Food Cosmet Toxicol. 1979 Jan 1;17(6):569–73.
79. Isaacson C. The change of the staple diet of black South Africans from sorghum to maize (corn) is the cause of the epidemic of squamous carcinoma of the oesophagus. Med Hypotheses. 2005;64(3):658–60.
80. Yli-Mattila T, Sundheim L. Fumonisins in African Countries. Vol. 14, Toxins. MDPI; 2022.
81. I.
82. Van Egmond HP, Schothorst RC, Jonker MA. Regulations relating to mycotoxins in food : PPPPerspectives in a global and European context. Vol. 389, Analytical and Bioanalytical Chemistry. 2007. p. 147–57.
83. Misihairabgwi JM, Ishola A, Quaye I, Sulyok M, Krska R. Diversity and fate of fungal metabolites during the preparation of oshikundu, a Namibian traditional fermented beverage. World Mycotoxin J. 2018;11(3):471–81.
84. Warth B, Parich A, Atehnkeng J, Bandyopadhyay R, Schuhmacher R, Sulyok M, et al. Quantitation of mycotoxins in food and feed from burkina faso and mozambique using a modern LC-MS/MS multitoxin method. In: Journal of Agricultural and Food Chemistry. 2012. p. 9352–63.
85. Phyto82n03_353.
86. Menya D, Maina SK, Kibosia C, Kigen N, Oduor M, Some F, et al. Dental fluorosis and oral health in the African Esophageal Cancer Corridor: Findings from the Kenya ESCCAPE case–control study and a pan-African perspective. Int J Cancer. 2019 Jul 1;145(1):99–109.
87. Kebede A, Retta N, Abuye C, Whiting SJ, Kassaw M, Zeru T, et al. Dietary fluoride intake and associated skeletal and dental fluorosis in school age children in rural Ethiopian Rift Valley. Int J Environ Res Public Health. 2016 Aug 1;13(8).
88. Artemisa M, Mapengo A, Marsicano JA, Garcia De Moura P, Sales-Peres A, Hobdell M, et al. Dental caries in adolescents from public schools in Maputo, Mozambique. Int Dent J. 2010;60:273–81.
89. Kebede A, Retta N, Abuye C, Whiting S, Kassaw M, Zeru T, et al. Minimizing Bioavailability of Fluoride through Addition of Calcium-magnesium Citrate or a Calcium and Magnesium-containing Vegetable to the Diets of Growing Rats. Int J Biochem Res Rev. 2016 Jan 10;10(2):1–8.
90. PLANO NACIONAL DE CONTROLO DO.
91. Organization WH. KEY PREVENTION AND CONTROL INTERVENTIONS FOR REDUCING CANCER BURDEN IN THE WHO AFRICAN REGION A Handbook for Leaders and Managers.
92. Silva-Matos C, Beran D. Non-communicable diseases in Mozambique: Risk factors, burden, response and outcomes to date. Vol. 8, Globalization and Health. 2012.
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