Castro C, et al. – The physicians aimed to summarize the current scientific knowledge on modifiable risk factors for esophageal cancer (EC) through a systematic review of meta–analyses referenced in PubMed and ISI Web of Knowledge by histological type. This research strengthened the importance of a separate assessment of EC subtypes to allow for a proper evaluation of incidence trends and planning of prevention/control interventions.

• A total of 100 meta-analyses on risk factors for esophageal cancer —squamous cell carcinomas (ESCC) (n = 54), EAC (n = 43), or EC (n = 51) were identified.  

• With alcohol and maté drinking, smoking, red and processed meat consumption and human papillomavirus infection, ESCC risk was significantly increased, while it was negatively associated with body mass index and consumption of fruit, vegetables, white meat, folate, and some carotenoids.
• ESCC risk was significantly reduced by cessation of drinking and smoking.
• An increased risk was reported for smoking, body mass index, and red and processed meat consumption for EAC, whereas risk decreased with Helicobacter pylori infection, low/moderate alcohol drinking, physical activity, and consumption of fruit, vegetables, folate, fiber, beta-carotene, and vitamin C.
• They discussed differences in outcomes between meta-analyses and mechanisms underlying some of the associations found.