A Study of the Risk Factors for 402 Patients with Esophageal Squamous Cell Carcinoma - A Retrospective Comparison with Health Checkup Participants

Sep 21, 2026

Objective: Esophageal cancer has a poor prognosis, yet it can be treatable endoscopically when detected early. This retrospective study aimed to determine factors associated with early detection of esophageal squamous cell carcinoma (ESCC). Methods: From April 2011 to December 2019, consecutive ESCC patients identified via upper gastrointestinal endoscopy at two Kawasaki Medical University hospitals were compared with endoscopy-based health check participants without organic lesions. Results: Multivariate analysis indicated alcohol consumption and smoking, concomitant cancer of other organs, and low body mass index (BMI) were associated with ESCC, while dyslipidemia was less common. For early versus advanced cancers, history of endoscopic screening was the only factor linked to early detection. Conclusion: Endoscopy may be recommended for early detection in subjects with these risk-associated factors.

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Abstract

Introduction

Materials and Methods

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Conclusion

doi: 10.2169/internalmedicine.2950-23 Intern Med 63: 3019-3024, 2024 [http://internmed.jp](http://internmed.jp) 【ORIGINAL ARTICLE】 A Study of the Risk Factors for 402 Patients with Esophageal Squamous Cell Carcinoma -A Retrospective Comparison with Health Checkup Participants Jun Nakamura 1, Ken Haruma 2, Noriaki Manabe 1, Tomoki Yamatsuji 3, Yoshinori Fujiwara 4, Takahisa Murao 5, Minoru Fujita 1, Akiko Shiotani 6, Mitsuhiko Suehiro 2, Hirofumi Kawamoto 2, Minoru Haisa 3, Tomio Ueno 4, Tomoari Kamada 5, Toshihiro Takao 5, Yasumasa Monobe 7, Takashi Akiyama 8, Yoshio Naomoto 3 and Jiro Hata 9 Abstract: Objective Esophageal cancer is a gastrointestinal cancer with a poor prognosis. However, it is curable and can be treated endoscopically if it is detected at an early stage. The objective of this study was to identify the factors that contribute to early detection. Methods From April 2011 to December 2019, we retrospectively investigated consecutive patients diagnosed with esophageal squamous cell carcinoma (ESCC) through upper gastrointestinal endoscopy at two hospitals of Kawasaki Medical University based on medical records. The factors contributing to the early detection of ESCC were investigated by comparing patients with ESCC with those undergoing health checkups in whom no organic lesions were found in the upper gastrointestinal tract on endoscopy (controls) . Patients Factors contributing to early detection were examined in 402 ESCC cases and 391 sex- and agematched controls, and early and advanced cancers were compared along with the risk factors for ESCC. Results A multivariate analysis showed that alcohol consumption and smoking, concomitant cancer of other organs, and a low body mass index (BMI) were factors associated with ESCC (odds ratio [OR], 4.65; 95% confidence interval [CI], 2.880-7.520, OR, 3.63; 95% CI, 2.380-5.540, OR, 2.09; 95% CI, 1.330-3.270, OR, 6.38; 95% CI, 3.780-10.800), whereas dyslipidemia was significantly less common in patients with ESCC (OR, 0.545; 95% CI, 0.348-0.853) . Comparing early and advanced cancers, a history of endoscopic screening was the only factor involved in early detection (OR, 7.93; 95% CI, 4.480-14.000) . Conclusion The factors associated with ESCC include alcohol consumption, smoking, concomitant cancer of other organs, and a low BMI. Endoscopy in subjects with these factors may therefore be recommended for the early detection of ESCC. Key words: esophageal squamous cell carcinoma, risk factors, early detection (Intern Med 63: 3019-3024, 2024) (DOI: 10.2169/internalmedicine.2950-23) 1 Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Japan, 2 Department of General Internal Medicine 2, Kawasaki Medical School, Japan, 3 Department of General Surgery, Kawasaki Medical School, Japan, 4 Department of Digestive Surgery, Kawasaki Medical School, Japan, 5 Department of Health Care Medicine, Kawasaki Medical School, Japan, 6 Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Japan, 7 Department of Pathology, Okayama Medical Laboratories Co., Ltd., Japan, 8 Department of Pathology, Kawasaki Medical School, Japan and 9 Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Japan Received: September 21, 2023; Accepted: February 12, 2024; Advance Publication by J-STAGE: April 2, 2024 Correspondence to Dr. Ken Haruma, [kharuma@med.kawasaki-m.ac.jp](kharuma@med.kawasaki-m.ac.jp) Introduction Esophageal cancer is the eighth most commonly diagnosed cancer and sixth most common cause of cancerrelated deaths worldwide. Globally, there were approximately 604,000 new cases and 544,000 deaths from esophageal cancer in 2020 (1), and the incidence is predicted to increase further (2) . As in Western countries, esophageal cancer is a male-dominated cancer in Japan. However, in contrast

FAQs

What was the main objective of the study?

To identify factors contributing to early detection of esophageal squamous cell carcinoma (ESCC).

How were ESCC cases and controls selected?

From April 2011 to December 2019, consecutive ESCC patients diagnosed by upper gastrointestinal endoscopy were compared with health checkup participants who had no organic lesions on endoscopy.

Which factors were associated with ESCC and early detection?

Alcohol consumption and smoking, concomitant cancer of other organs, and low BMI were associated with ESCC. For early versus advanced cancers, prior endoscopic screening was the only factor linked to early detection.

Sep 21, 2026

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