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Overview and Aims

ESCCAPE’s aims are:

  • To investigate the descriptive epidemiology of oesophageal cancer in Africa, in particular to focus on early-onset disease, gender differences, and geographical variations
  • To investigate the role of established risk factors for oesophageal squamous cell carcinoma in the African setting
  • To investigate the “causes of the causes” of environmental risk factors in this setting, i.e. to understand exposure sources, routes, and influences
  • To investigate genetic susceptibility and exposure-associated genetic signatures of oesophageal cancer in the African oesophageal cancer corridor.

Our major aetiological interests include the following:

  • Alcohol consumption, including both commercial alcohol and local brews
  • Tobacco use, both smoking and smokeless
  • Oral health and oral hygiene
  • Geophagia
  • Thermal injury
  • Household air pollution
  • Khat chewing
  • Micronutrient deficiencies, especially selenium

ESCCAPE’s research strategy is based on the following perspectives. First, a broad perspective on putative risk factors is being taken. The consortium is studying the individual and combined effects of a broad range of lifestyle, infectious, environmental, and genetic risk factors and protective factors. Second, descriptive and analytical studies are being undertaken in Africa-wide or multiple settings, with a view to interpreting findings more holistically in terms of the African oesophageal cancer corridor. Third, the consortium considers that the priority factors that need to be investigated are those that have already been established, or probable carcinogens for squamous cell oesophageal cancer in non-African settings. Such factors are being evaluated with respect to their population-level exposure levels and sources as well as their contribution to the cancer burden. The factors being studied as causal factors or risk markers include socioeconomic indicators, occupation, consumption of high-ethanol alcohols, tobacco use, opium use, exposure to polycyclic aromatic hydrocarbons (PAHs), consumption of hot foods and beverages, fruit and vegetable intake, consumption of pickled and salted vegetables, tooth loss, micronutrient deficiencies, and N-nitrosamines.