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Biomass fuel as a risk factor for esophageal squamous cell carcinoma: a systematic review and meta-analysis
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Biomass fuel as a risk factor for esophageal squamous cell carcinoma: a systematic review and meta-analysis
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Journal Article
Biomass fuel as a risk factor for esophageal squamous cell carcinoma: a systematic review and meta-analysis
2019
Overview
Background
The link between use of solid biomass fuel (wood, charcoal, coal, dung, and crop residues) for cooking and/or heating and esophageal squamous cell carcinoma (ESCC) is inconclusive.
Objective
We systematically reviewed the literature and performed a meta-analysis to determine whether cooking fuel type influences esophageal squamous cell carcinoma.
Methods
We searched MEDLINE, EMBASE, Web of Knowledge and Cochrane Database of Systematic Reviews for studies investigating cooking fuel and ESCC from 2000 until March 2019. We performed random effects meta-analysis stratified by the continent, World Bank’s country income classifications and fuel type and calculated pooled odds ratios and 95% CIs for the risk of esophageal squamous cell carcinoma in biomass fuel users compared with non-users.
Results
Our analysis included 16 studies (all case-control) with 16,189 participants (5233 cases and 10,956 controls) that compared risk of ESCC among those using nonsolid fuels and biomass fuels. We found use of biomass fuel was associated with Esophageal squamous cell carcinoma with a pooled odds ratio (OR) 3.02 (95% CI 2.22, 4.11, heterogeneity (I
2
) = 79%). In sub-group analyses by continent, Africa (OR 3.35, 95%CI 2.34, 4.80, I
2
= 73.4%) and Asia (OR 3.08, 95%CI 1.27, 7.43, I
2
= 81.7%) had the highest odds of ESCC. Use of wood as fuel had the highest odds of 3.90, 95% CI 2.25, 6.77, I
2
= 63.5%). No significant publication bias was detected.
Conclusions
Biomass fuel is associated with increased risk of Esophageal squamous cell carcinoma. Biomass fuel status should be considered in the risk assessment for Esophageal squamous cell carcinoma.
Publisher
BioMed Central,BioMed Central Ltd,BMC
Subject
Air Pollution, Indoor - adverse effects
/ Biomass
/ Cooking
/ Earth and Environmental Science
/ Esophageal Neoplasms - chemically induced
/ Esophageal Neoplasms - epidemiology
/ Esophageal Squamous Cell Carcinoma - chemically induced
/ Esophageal Squamous Cell Carcinoma - epidemiology
/ Feces
/ Heating
/ Humans
