Biomass fuel as a risk factor for esophageal squamous cell carcinoma: a systematic review and meta-analysis
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Environmental Health
Abstract
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 (I2) = 79%). In sub-group analyses by continent, Africa (OR 3.35, 95%CI 2.34, 4.80, I2 = 73.4%) and Asia (OR
3.08, 95%CI 1.27, 7.43, I2 = 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, I2 = 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.
Description
Keywords
Biomass fuel, Risk factor, Esophageal squamous cell carcinoma
Citation
Okello, S., Akello, SJ, Dwomoh, E., Byaruhanga, E., Opio, CK, Zhang, R., ... & Christiani, DD (2019). Biomass fuel as a risk factor for esophageal squamous cell carcinoma: a systematic review and meta-analysis. Environmental Health , 18 (1), 1-11. https://doi.org/10.1186/s12940-019-0496-0