Epidemiological aspects of endemic upper gastrointestinal cancers in eastern Turkey.

The aim of our study was to present the epidemiological aspects of endemic upper gastrointestinal (esophageal and gastric) cancers in the Van region of Eastern Turkey.The patients were diagnosed by esophagogastroscopy, biopsy and histopathological analysis. The control group consisted of 73 healthy subjects. Epidemiological characteristics (age, sex, dietary habits, educational status, life style) were evaluated by questionnaires. Helicobacter pylori infection was diagnosed in nontumoral gastric mucosal biopsy specimens by Giemsa staining.298 esophageal Ca and 384 gastric Ca patients were diagnosed in seven years (1994-2001). Most of the patients (90%) were of rural origin. Endoscopic prevalence rate of upper gastrointestinal (UGI) Ca was the highest (1 Ca per 7 esophagogastroscopy) in the Van region compared to other parts of Turkey. Esophageal Ca were 1.5 times more common in females whereas gastric Ca were 1.6 times more common in males. Ninety per cent of esophageal cancers were epidermoid and the remaining 10% were adenocarcinomas. Ninety-seven per cent of gastric Ca were adenocarcinomas. Helicobacter pylori infection was not significantly increased in gastric Ca patients compared to controls.Low educational and socioeconomic status, consumption of smoked, salted, hot, fatty foods, overdrinking hot tea and well water, cigarette smoking, poor intake of fresh fruits and vegetables and poor hygienic conditions were probable culprit factors.