ArticleInternational journal of cancer2019
Dental fluorosis and oral health in the African Esophageal Cancer Corridor: Findings from the Kenya ESCCAPE case-control study and a pan-African perspective.
Article in International journal of cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 3 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- Genome-wide association study of esophageal squamous cell cancer identifies shared and distinct risk variants in African and Chinese populations.American journal of human genetics · 2023Pooled it
- 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 and meta-analysis of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes.World journal of gastroenterology · 2019Pooled it
- The global burden of oesophageal cancer from 1990 to 2023 and projections to 2040: a comprehensive analysis of the Global Burden of Disease Study 2023.Journal of global health · 2026Article
- Oral hygiene and cancer risk: emerging evidence and public health perspectives.Discover oncology · 2026Review
- The global, regional, and national burden of early, middle, and late-onset esophageal cancer and trends from 1990 to 2021: a systematic analysis of the Global Burden of Disease Study 2021.Journal of thoracic disease · 2025Article
- Assessing cross-country inequalities in global burden of gastrointestinal cancers: slope and concentration index approach.Discover oncology · 2025Article
- Salivary proteomic signatures in severe dental fluorosis.Scientific reports · 2024Article
- Poor oral health and the risk of esophageal squamous cell carcinoma in Malawi.International journal of cancer · 2024Article
- Landscape of esophageal cancer in Northern Kenya: experience from Garissa Regional Cancer Center.Ecancermedicalscience · 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
- A scoping review on the association between early childhood caries and life on land: The Sustainable Development Goal 15.PloS one · 2024Article
- A Genomic Analysis of Esophageal Squamous Cell Carcinoma in Eastern Africa.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- Fluoride distribution in selected foodstuffs from Nakuru County, Kenya, and the risk factors for its human overexposure.Scientific reports · 2023Article
- Global trends in the burden of esophageal cancer, 1990-2019: results from the Global Burden of Disease Study 2019.Journal of thoracic disease · 2023Article
- Review
- An international report on bacterial communities in esophageal squamous cell carcinoma.International journal of cancer · 2022Article
- A very-hot food and beverage thermal exposure index and esophageal cancer risk in Malawi and Tanzania: findings from the ESCCAPE case-control studies.British journal of cancer · 2022Article
- Non-Acid Fluid Exposure and Esophageal Squamous Cell Carcinoma.Digestive diseases and sciences · 2022Review
- Cross-talk between the microbiome and chronic inflammation in esophageal cancer: potential driver of oncogenesis.Cancer metastasis reviews · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
Abstract
There are no studies of oral health in relation to esophageal cancer in Africa, or of Eastern Africa's endemic dental fluorosis, an irreversible enamel hypo-mineralization due to early-life excessive fluoride intake. During 2014-18, we conducted a case-control study of squamous cell esophageal cancer in Eldoret, western Kenya. Odds ratios (AORs (95% confidence intervals)) were adjusted for design factors, tobacco, alcohol, ethnicity, education, oral hygiene and missing/decayed teeth. Esophageal cancer cases (N = 430) had poorer oral health and hygiene than controls (N = 440). Compared to no dental fluorosis, moderate/severe fluorosis, which affected 44% of cases, had a crude OR of 20.8 (11.6, 37.4) and on full adjustment was associated with 9.4-fold (4.6, 19.1) increased risk, whilst mild fluorosis (43% of cases) had an AOR of 2.3 (1.3, 4.0). The prevalence of oral leukoplakia and tooth loss/decay increased with fluorosis severity, and increased cancer risks associated with moderate/severe fluorosis were particularly strong in individuals with more tooth loss/decay. Using a mswaki stick (AOR = 1.7 (1.0, 2.9)) rather than a commercial tooth brush and infrequent tooth brushing also independently increased risk. Geographic variations showed that areas of high esophageal cancer incidence and those of high groundwater fluoride levels have remarkably similar locations across Eastern Africa. In conclusion, poor oral health in combination with, or as a result of, high-altitude susceptibility to hydro-geologically influenced dental fluorosis may underlie the striking co-location of Africa's esophageal cancer corridor with the Rift Valley. The findings call for heightened research into primary prevention opportunities of this highly fatal but common cancer.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.