The Association between Diet and Esophageal Cancer in Afghanistan: A Case-Control Study

Introduction: Esophageal cancer is one of the most common cancers worldwide. According to World Health Organization (WHO) estimates, esophageal cancer is the fourth most
common cancer among Afghan men and the fi fth most common cancer among Afghan women in 2018. Data on the link between diet and disease are extremely limited in Afghanistan.
Therefore, we aimed to investigate the relationship between diet and esophageal cancer in Afghanistan. In this hospital-based case-control study, 84 esophageal cancer patients (newly
diagnosed), and 164 controls with no history of chemotherapy or radiotherapy (due to cancer) were included. The cases and controls are aged between 20 and 75 years and matched in
terms of age ± 5year and sex. All participants were interviewed face to face by trained female investigators using structured questionnaires. Diff erences in general characteristics and diet
between cases and controls were examined by the t-test and chi-square test. The Binary Logistic Regression was used to examine the association between food consumption and esophagus
cancer. The mean age of study participants was 55 years. The salty food 1 time or more per day 9.3 times (95% CI: 3.390-25.807), intake of meat 1 time or more per day 7.345 times (95%
CI: 079-26.083), and pepper 1 time or more per day 2.342 times (95% CI: 0.968- 1.456) were increased the odds of esophageal cancer in Afghans population.

Conclusion: We found that high intake of salty food, pepper, and red meat positively associated with risk of esophageal cancer and the higher intake of fruits, vegetables, fish, and
poultry reduce the risk of esophageal cancer in Afghans population. Further studies (e.g. cohort studies) with a large sample size are required to establish this association.

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