Professor Xiaorong Wang
School of Public Health
The Chinese University of Hong Kong
Hong Kong, China
http://www.sphpc.cuhk.edu.hk/cms/
Project title
Etiological study of esophageal cancer in Chinese population – With special reference to dietary factors and genetic polymorphisms (2010/240)
Scientific abstract
Background: Esophageal cancer (EC) is the sixth leading cause of cancer mortality in the world. It is particularly common in Chinese populations, in which squamous carcinoma is a predominant type, estimated to contribute to about half of the world's EC cases. The incidence of EC varies greatly across China, however, where there are six regions that have been identified as the highest risk area. One of them is Yanting of Sichuan Province, with strikingly high EC incidence and mortality.
The etiology of EC remains inconclusive, though both environmental exposures and genetic factors are believed to play important roles. A very limited number of studies to date have been available to focus on investigating environmental exposures, in particular dietary habits, nutritional factors and genetic factors simultaneously.
Objectives: This study is proposed to identify etiological factors including both genetic polymorphisms and environmental factors, particular in dietary habits and nutritional patterns as well as smoking and alcohol drinking; to understand how the modifiable dietary factors and personal behaviors augment or counter the pathways by which genetic variants increase the cancer risk.Setting: the study will be conducted in the Yanting area, Sichuan Province, one of the highest EC risk regions in China.
Methods: A population-based case-control study is designed. We will select 800 newly diagnosed squamous EC cases (35 - 80 years old, male or female) from a big tumour hospital in the Yanting area and 800 age and sex matched population controls from the same area. We will administer face to face interviews using standardized questionnaire and validated food frequency questionnaire to elicit relevant information during the past 5 years prior to the onset of the disease for cases, or during the past 5 year for controls. The information to be obtained includes basic demographic characteristics, lifetime residence history, detailed smoking history and alcohol drinking habits, disease history, with special attention to esophageal diseases, family cancer history and detailed dietary history and habits. Blood sample will be collected from all the subjects for analyzing the genotype polymorphisms of CYP1A1, CYP2E1, GSTM1, GSTT1, GSTP1, MTHFR C677T, MTHFR A1298C, ALDH2, ADH2, ERCC, ERCC21 and XRCC1, as well as SNP.
Data analysis will center on assessing the independent and joint effects of important risk factors for EC, and interactions between the environmental factors and genetic factors by using sophistical multivariate statistical approaches. The independent and joint effects of dietary habits, nutritional patterns, and smoking and alcohol drinking and their interactions with genetic factors will be determined. The study will be finished in three years.
Impact: This study will identify the roles of modifiable dietary factors and personal behaviors and their interactions with genetic polymorphisms in the causal pathway of esophageal cancer, which is highly significant from preventive medicine and public health perspectives. Understanding the etiologic issues may provide a fundamental insight into the development of the cancer, and help form novel strategies for prevention and treatment of EC in a population-based level.
Project plain language abstract
Simplified Title: Study on dietary and genetic factors for esophageal cancer in Chinese population
Background: Esophageal cancer (EC) is the sixth leading cause of cancer mortality in the world. It is particularly common in Chinese populations, which contribute to about half of the world's EC cases. The high EC incidence and mortality are not evenly distributed cross China, however. There are six regions that have been identified as the highest risk area, one of which is Yanting of Sichuan Province. The causal factors of EC remain inconclusive, though both environmental exposures and genetic factors are believed to play important roles. A very limited number of studies to date have been available to focus on investigating environmental exposures, in particular dietary habits, nutritional factors and genetic factors simultaneously.
Aims & Goals: The aims of this proposed study is to find out the risk factors for EC, in terms of both genetic and environmental factors, particular in dietary habits and nutritional patterns, and personal behaviors, such as smoking and alcohol drinking; to understand how these factors work together in the development of EC. How it will be done: We will use population-based case-control study design, and select 800 EC patients (35 - 80 years old, male or female) from a big tumour hospital in the Yanting area and 800 people without EC from the same area, as a control group. The patients will be matched by the controls in age and sex. We will administer face to face interviews using standardized questionnaire and validated food frequency questionnaire to elicit relevant information, including basic demographic characteristics, detailed smoking history and alcohol drinking habits, esophageal disease history, family cancer history and detailed dietary history and habits. Blood sample will be collected from all the subjects for analyzing the candidate genotype polymorphisms. The obtained data will be analyzed and compared between the patients and the controls. The independent and joint effects of important risk factors for EC will be assessed by using sophistical statistical approaches. The study will be finished in three years.
Potential Impact: This study will identify the roles of modifiable dietary factors and personal behaviors and their interactions with genetic polymorphisms in the development of esophageal cancer. The study is of high significance from preventive medicine and public health perspectives. It will provide a fundamental insight into the development of the cancer, and help develop novel strategies for prevention and treatment of EC in a population-based level.
| Institution and location | Degree | Year | Scientific Field |
|---|---|---|---|
| School of Public Health, Sichuan, University, China | PhD | 1989 | Environmental Epidemiology |
| School of Public Health, Sichuan University, China | MPH | 1986 | Environmental Health |
| Sichuan Medical University, China | MD | 1983 | Medicine and Surgery |
| Department of Environmental Health, Harvard School of Public Health, USA | Postdoctoral Fellowship | 2001 | Occupational /Environmental Epidemiology |
| Department of Public Health, Faculty of Medicine, University of Tokyo, Japan | Postdoctoral Fellowship | 1995 | Epidemiology and Public Health |
| 2007 – Present | Associate Professor, Department of Community & Family Medicine, School of Public Health, the Chinese University of Hong Kong |
| 2001- 2007 | Senior Research Associate, Occupational Health Program, the Department of Environmental Health, Harvard School of Public Health, USA |
| 1998 - 1999) | Research Associate, Department of Community & Family Medicine, the Chinese University of Hong Kong |
| 1995 – 1997 | Associate Professor, International Education Institute, Teikyo, University School of Medicine, Tokyo, Japan |
| 1993 – 1994 | Associate Professor, the Department of Environmental and Occupational Health, School of Public Health, Sichuan University, China |
| 1989 – 1993 | Lecturer, Department of Occupational Medicine, School of Public Health, Sichuan University, China |
