Staple Ethiopian diet and cancer of the oesophagus.

BACKGROUND: Previous reports from Ethiopia suggest that oesophageal cancers are due to thermal injury of hot food and beverages. However, in most other countries diet plays an important role.

OBJECTIVES: To investigate the association of diet and incidence of carcinoma of oesophagus in Ethiopia.

DESIGN: A prospective study.

SETTING: All adult patients, who were either referred or self referred from other health institutions, were investigated in Mexico Higher Clinic, Addis Ababa, Ethiopia.

SUBJECTS: All patients who presented for endoscopy for the duration of one year, February 1st to January 2002, were included in the study.

RESULTS: There were 902 adult patients of whom 596 (66%) were male and 306 (34%) were female. The age range was 16 to 81 with a mean of 37 and the male to female ratio was 1.95:1. Christians out-numbered Muslims. There were more merchants than office workers or peasants. Those who came from Addis Ababa were 600 (66%) and the rural patients were 302 (34%). The ethnic groupings indicated Amhara, Gurage and Oromo to be the predominant ones. Six hundred sixty two patients ate tef, 140 ate wheat and 100 ate kocho (Qocho). There were 27 specimens, which had malignant cells. Thirteen specimens failed to show malignant cells. Thirteen (13%) Qocho eaters had cancer of oesophagus, nine (6.5%) wheat eaters had cancer and only five of tef eaters (0.70%) were affected. Dysphagia was the single most common symptom with which patients presented in cases of cancer of oesophagus. Cancer of oesophagus was located in upper, middle and EG junctional area in 5, 12 and 10 patients respectively. There were 16 cases of squamous cells and 11 cases of adenocarcinoma of a total of 40 specimen taken. Thirteen specimens failed to show malignant cells.

CONCLUSION: Kocho (Qocho) eating appearsto be associated with developing cancer of the oesophagus.