Background: Oesophageal cancer is the fourth most common cancer in black South African males with an age-standardised incidence rate of 7.31 per 100 000 in 2010, and sixth in black South African females, 3.59 per 100 000. The adoption of lifestyle behaviours such as tobacco and alcohol use was on the rise in that decade, amongst black South Africans living in Johannesburg. Aim: The overall aim was to investigate the association of smoking and alcohol use on oesophageal cancer amongst 18 to 74-year-old black South Africans in Johannesburg from 1999 to 2009. Methods: Secondary analysis were done based on a matched case-control study design. We used the conditional univariate and matched multiple logistic regression for statistical analysis as the main analysis. Gender was ascertained as an effect modifier therefore the analysis were done separately for males and females. Sensitivity analysis of the findings were tested using the unconditional univariate and unmatched multiple logistic regression. Results: Heavy smokers had an increased likelihood of oesophageal cancer as shown in the conditional multivariate logistic regression (AOR = 9.0; 95% CI: 5.2 – 15.5) in males and (AOR = 5.2; 95% CI: 1.3 – 20.1) in females. Alcohol consumption was a much stronger risk factor for oesophageal cancer among female heavy drinkers (AOR = 2.1; 95% CI: 1.5 – 2.9) relative to the light drinkers, controlling for other variables. There was a significant interaction of tobacco use and alcohol drinking as they acted synergistically to increase the likelihood of oesophageal cancer among current heavy smokers and heavy drinkers, (AOR = 15.0; 95% 7.2 – 31.3) in males and (AOR = 2.7; 95% 0.6 – 11.2) in females, compared to non-drinkers. iv Conclusion: We established that over the ten-year study period, smoking and alcohol use were both associated with oesophageal cancer independently and as combined exposures. An increase in sin tax on cigarettes and alcohol as well as increased education on the risk factors associated with the development of oesophageal cancer could be used as interventions to decrease the burden of this disease. Keywords: Smoking, Alcohol, Cancer, South Africa / LG2018

A research report submitted to the Faculty of Medicine, University of the Witwatersrand, in partial fulfillment of the requirements for the Degree of Master of Medicine in the division of General Surgery. Johannesburg 2012 / Oesophageal cancer causes much morbidity and mortality in South Africa. This disease has a 5-year survival of less than 10% despite improvements in therapy. Most patients present with advanced disease and are suitable only for palliative care. Current standard of palliative care for patients with end-stage oesophageal cancer that present with dysphagia include brachytherapy and stenting. Brachytherapy improves survival and has a more stable quality of life in the long term when compared to stenting. Conversely stenting has a more acute relief of dysphagia. In South Africa many patients with malignant dysphagia face socio-economic constraints that cause delays in therapy, especially in patients from rural areas. Many prospective randomized trials of palliative treatment have been done in the developed world, not taking into account socio-economic constraints. We present a study from Tshepong Hospital (Klerksdorp, North West province), a secondary hospital in South Africa.

Mok Chi Ho, Samuel. / Thesis (Ph.D.)--Chinese University of Hong Kong, 1987. / Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

by Chan Chi Wai, Angus. / "Submitted in Jan 1999, revised in Jan 2000." / Thesis (M.D.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (p. 262-294). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2007. / Härtill 6 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.