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Oesophageal cancer and diet — DTM&H MCQ

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ModerateEnvironmental HealthOesophageal cancer and dietDTM&H

A 55-year-old man in southern China presents with progressive dysphagia over 6 months. He has a long history of consuming fermented and pickled vegetables. Upper GI endoscopy shows a mid-oesophageal squamous cell carcinoma. What dietary factor is most strongly associated?

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Correct answer: E — N-nitroso compounds in preserved foods

N-nitroso compounds in fermented, pickled, and smoked foods are strongly associated with oesophageal squamous cell carcinoma in the 'Asian oesophageal cancer belt' (northern China, Iran, Central Asia). Aflatoxin causes HCC. Betel nut is associated with oral cancer. Arsenic in water causes skin cancer and peripheral vascular disease. Hot beverages are a cofactor but N-nitroso compounds are the primary dietary carcinogen.

Reference: IARC; Manson's Tropical Diseases