ArticlePloS one2015
Africa's Oesophageal Cancer Corridor: Geographic Variations in Incidence Correlate with Certain Micronutrient Deficiencies.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 38 papers, 3 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 130 citations in OpenAlex.
- Environmental and life-style risk factors for esophageal squamous cell carcinoma in Africa: a systematic review and meta-analysis.BMC public health · 2023Pooled it
- Systematic Review of Genetic Factors in the Etiology of Esophageal Squamous Cell Carcinoma in African Populations.Frontiers in genetics · 2019Pooled it
- Esophageal cancer male to female incidence ratios in Africa: A systematic review and meta-analysis of geographic, time and age trends.Cancer epidemiology · 2018Pooled it
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- Soil selenium and oesophageal cancer incidence in China: a large ecological study of population-based cancer registry data.International journal of health geographics · 2026Article
- Zinc in Soil-Plant-Human Systems: A Synthesis of Its Fate, Essential Roles, and Health Implications.Scientifica · 2026Review
- Spatial clustering of esophageal cancer in central Oromia, Ethiopia: A spatial autocorrelation and scan statistics analysis.PloS one · 2026Article
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- The role of redox-active iron, copper, manganese, and redox-inactive zinc in toxicity, oxidative stress, and human diseases.EXCLI journal · 2025Review
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- Keratin 17 and Collagen type 1 genes: Esophageal cancer molecular marker discovery and evaluation.The clinical respiratory journal · 2024Article
- Zinc Deficiency as a General Feature of Cancer: a Review of the Literature.Biological trace element research · 2024Review
- Age-period-cohort analysis of incidence, mortality and disability-adjusted life years of esophageal cancer in global, regional and national regions from 1990 to 2019.BMC public health · 2024Article
- Burden of esophageal cancer in global, regional and national regions from 1990 to 2021 and its projection until 2050: results from the GBD study 2021.Frontiers in oncology · 2024Article
- Global trends in the burden of esophageal cancer, 1990-2019: results from the Global Burden of Disease Study 2019.Journal of thoracic disease · 2023Article
- Micro-climatic variations across Malawi have a greater influence on contamination of maize with aflatoxins than with fumonisins.Mycotoxin research · 2023Article
- Review
- Tracing global flows of bioactive compounds from farm to fork in Nutrient Balance Sheets can help guide intervention towards healthier food supplies.Nature food · 2022Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundThe aetiology of Africa's easterly-lying corridor of squamous cell oesophageal cancer is poorly understood. Micronutrient deficiencies have been implicated in this cancer in other areas of the world, but their role in Africa is unclear. Without prospective cohorts, timely insights can instead be gained through ecological studies.
methodsAcross Africa we assessed associations between a country's oesophageal cancer incidence rate and food balance sheet-derived estimates of mean national dietary supplies of 7 nutrients: calcium (Ca), copper (Cu), iron (Fe), iodine (I), magnesium (Mg), selenium (Se) and zinc (Zn). We included 32 countries which had estimates of dietary nutrient supplies and of better-quality GLOBCAN 2012 cancer incidence rates. Bayesian hierarchical Poisson lognormal models were used to estimate incidence rate ratios for oesophageal cancer associated with each nutrient, adjusted for age, gender, energy intake, phytate, smoking and alcohol consumption, as well as their 95% posterior credible intervals (CI). Adult dietary deficiencies were quantified using an estimated average requirements (EAR) cut-point approach.
resultsAdjusted incidence rate ratios for oesophageal cancer associated with a doubling of mean nutrient supply were: for Fe 0.49 (95% CI: 0.29-0.82); Mg 0.58 (0.31-1.08); Se 0.40 (0.18-0.90); and Zn 0.29 (0.11-0.74). There were no associations with Ca, Cu and I. Mean national nutrient supplies exceeded adult EARs for Mg and Fe in most countries. For Se, mean supplies were less than EARs (both sexes) in 7 of the 10 highest oesophageal cancer ranking countries, compared to 23% of remaining countries. For Zn, mean supplies were less than the male EARs in 8 of these 10 highest ranking countries compared to in 36% of other countries.
conclusionsEcological associations are consistent with the potential role of Se and/or Zn deficiencies in squamous cell oesophageal cancer in Africa. Individual-level analytical studies are needed to elucidate their causal role in this setting.
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