Nutrición Hospitalaria 05819 / http://dx.doi.org/10.20960/nh.05819
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Trabajo Original

Association of socioeconomic status and nine modifiable lifestyle factors on esophageal cancer risk in European and East Asian populations — Evidence from a comprehensive Mendelian randomization study


Ruizhi Ye, Fengming Zhang, Guangxian You

Prepublicado: 2025-06-06

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Background and aims: the intricate relationships between socioeconomic factors, modifiable lifestyle choices, and esophageal cancer risk remain uncertain. We aim to investigate the associations of socioeconomic status, modifiable lifestyle factors, and esophageal cancer risk. Methods: we employed multiple Mendelian randomization (MR) analyses, including three different MR approaches. GWAS databases from European and East Asian populations, encompassing variables such as household income, educational attainment, and the Townsend deprivation index (TDI), were analyzed. The risk of esophageal cancer was assessed using data from three distinct cohorts of European and East Asian descent (Database 1: n = 476,306; Database 2: n = 372,756; Database 3: n = 160,589). Nine modifiable lifestyle factors were incorporated in the multivariable and mediation MR analyses. Meta-analysis was employed to synthesize results across the three datasets. Results: higher household income was connected with a reduced esophageal cancer risk (odds ratio (OR) = 0.698, 95 % confidence interval (95 % CI): 0.556-0.876, p = 0.002). Body mass index (BMI) partially mediated the relationship between household income and the risk of esophageal cancer (OR = 0.914, 95 % CI: 0.841-0.992, p = 0.031, mediation ratio: 27.23 %). However, no significant evidence was found to support a direct association between educational attainment, TDI, and esophageal cancer risk. Conclusions: these findings suggest that higher household income is inversely associated with esophageal cancer risk, with BMI acting as a partial mediator of this relationship. Accordingly, targeted early screening and preventive measures for esophageal cancer should be prioritized among low-income populations, particularly those with obesity.

Palabras Clave: Socioeconomic status. Modifiable lifestyle factors. Esophageal cancer. Mendelian randomization. Mediation effect.



Waters JK, Reznik SI. Update on Management of Squamous Cell Esophageal Cancer. Curr Oncol Rep 2022;24(3):375-85.
DOI: 10.1007/s11912-021-01153-4
Zhu H, Ma X, Ye T, Wang H, Wang Z, Liu Q, Zhao K. Esophageal cancer in China: Practice and research in the new era. Int J Cancer 2023;152(9):1741-51.
DOI: 10.1002/ijc.34301
Li H, Teng Y, Yan X, Cao M, Yang F, He S, et al. Profiles and Findings of Population-Based Esophageal Cancer Screening With Endoscopy in China: Systematic Review and Meta-analysis. JMIR Public Health Surveill 2023;9:e45360.
DOI: 10.2196/45360
Yang CS, Chen XL. Research on esophageal cancer: With personal perspectives from studies in China and Kenya. Int J Cancer 2021;149(2):264-76.
DOI: 10.1002/ijc.33421
Tong X, Jin M, Wang L, Zhang D, Yin Y, Shen Q. Prognostic biomarkers for immunotherapy in esophageal cancer. Front Immunol 2024;15:1420399.
DOI: 10.3389/fimmu.2024.1420399
Ghosh NR, Jones LA. Dietary risk factors for esophageal cancer based on World Health Organization regions. Nutrition 2022;95:111552.
DOI: 10.1016/j.nut.2021.111552
Huang FL, Yu SJ. Esophageal cancer: Risk factors, genetic association, and treatment. Asian J Surg 2018;41(3):210-5.
DOI: 10.1016/j.asjsur.2016.10.005
Smyth EC, Lagergren J, Fitzgerald RC, Lordick F, Shah MA, Lagergren P, et al. Oesophageal cancer. Nature reviews Disease primers 2017;3:17048.
DOI: 10.1038/nrdp.2017.48
Deboever N, Jones CM, Yamashita K, Ajani JA, Hofstetter WL. Advances in diagnosis and management of cancer of the esophagus. BMJ 2024;385:e074962.
DOI: 10.1136/bmj-2023-074962
Li S, He Y, Liu J, Chen K, Yang Y, Tao K, et al. An umbrella review of socioeconomic status and cancer. Nat Commun 2024;15(1):9993.
DOI: 10.1038/s41467-024-54444-2
Abnet CC, Arnold M, Wei WQ. Epidemiology of Esophageal Squamous Cell Carcinoma. Gastroenterology 2018;154(2):360-73.
DOI: 10.1053/j.gastro.2017.08.023
Delman AM, Ammann AM, Turner KM, Vaysburg DM, Van Haren RM. A narrative review of socioeconomic disparities in the treatment of esophageal cancer. J Thorac Dis 2021;13(6):3801-8.
DOI: 10.21037/jtd-20-3095
Sardana RK, Chhikara N, Tanwar B, Panghal A. Dietary impact on esophageal cancer in humans: a review. Food Funct 2018;9(4):1967-77.
DOI: 10.1039/C7FO01908D
Williams J, Allen L, Wickramasinghe K, Mikkelsen B, Roberts N, Townsend N. A systematic review of associations between non-communicable diseases and socioeconomic status within low- and lower-middle-income countries. J Glob Health 2018;8(2):020409.
DOI: 10.7189/jogh.08.020409
Kaphingst KA, Peterson E, Zhao J, Gaysynsky A, Elrick A, Hong SJ, et al. Cancer communication research in the era of genomics and precision medicine: a scoping review. Genet Med 2019;21(8):1691-8.
DOI: 10.1038/s41436-018-0402-0
Sommer I, Griebler U, Mahlknecht P, Thaler K, Bouskill K, Gartlehner G, et al. Socioeconomic inequalities in non-communicable diseases and their risk factors: an overview of systematic reviews. BMC Public Health 2015;15:914.
DOI: 10.1186/s12889-015-2227-y
Pohl SA, Nelson BA, Patwary TR, Amanuel S, Benz EJ Jr, Lathan CS. Evolution of community outreach and engagement at National Cancer Institute-Designated Cancer Centers, an evolving journey. CA Cancer J Clin 2024;74(4):383-96.
DOI: 10.3322/caac.21841
Sekula P, Del Greco M F, Pattaro C, Köttgen A. Mendelian Randomization as an Approach to Assess Causality Using Observational Data. J Am Soc Nephrol 2016;27(11):3253-65.
DOI: 10.1681/ASN.2016010098
Yang Y, Chen B, Zheng C, Zeng H, Zhou J, Chen Y, Su Q, Wang J, Wang J, Wang Y, Wang H, Jin R, Bo Z, Chen G, Wang Y. Association of glucose-lowering drug target and risk of gastrointestinal cancer: a mendelian randomization study. Cell Biosci 2024;14(1):36.
DOI: 10.1186/s13578-024-01214-8
Goding Sauer A, Siegel RL, Jemal A, Fedewa SA. Current Prevalence of Major Cancer Risk Factors and Screening Test Use in the United States: Disparities by Education and Race/Ethnicity. Cancer Epidemiol Biomarkers Prev 2019;28(4):629-42.
DOI: 10.1158/1055-9965.EPI-18-1169
Zagkos L, Schwinges A, Amin HA, Dovey T, Drenos F. Exploring the contribution of lifestyle to the impact of education on the risk of cancer through Mendelian randomization analysis. Sci Rep 2024;14(1):6074.
DOI: 10.1038/s41598-024-54259-7
Skrivankova VW, Richmond RC, Woolf BAR, Yarmolinsky J, Davies NM, Swanson SA, et al. Strengthening the Reporting of Observational Studies in Epidemiology Using Mendelian Randomization: The STROBE-MR Statement. JAMA 2021;326(16):1614-21.
DOI: 10.1001/jama.2021.18236
Gibson MJ, Spiga F, Campbell A, Khouja JN, Richmond RC, Munafò MR. Reporting and methodological quality of studies that use Mendelian randomisation in UK Biobank: a meta-epidemiological study. BMJ Evid Based Med 2023;28(2):103-10.
DOI: 10.1136/bmjebm-2022-112006
Mbatchou J, Barnard L, Backman J, Marcketta A, Kosmicki JA, Ziyatdinov A, et al. Computationally efficient whole-genome regression for quantitative and binary traits. Nat Genet 2021;53(7):1097-103.
DOI: 10.1038/s41588-021-00870-7
Liu M, Jiang Y, Wedow R, Li Y, Brazel DM, Chen F, et al. Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use. Nat Genet 2019;51(2):237-44.
DOI: 10.1038/s41588-018-0307-5
Pirastu N, McDonnell C, Grzeszkowiak EJ, Mounier N, Imamura F, Merino J, et al. Using genetic variation to disentangle the complex relationship between food intake and health outcomes. PLoS Genet 2022;18(6):e1010162.
DOI: 10.1371/journal.pgen.1010162
Bowden J, Holmes MV. Meta-analysis and Mendelian randomization: A review. Res Synth Methods 2019;10(4):486-96.
DOI: 10.1002/jrsm.1346
Dudbridge F. Polygenic Mendelian Randomization. Cold Spring Harb Perspect Med 2021;11(2):a039586.
DOI: 10.1101/cshperspect.a039586
Boef AG, Dekkers OM, le Cessie S. Mendelian randomization studies: a review of the approaches used and the quality of reporting. Int J Epidemiol 2015;44(2):496-511.
DOI: 10.1093/ije/dyv071
Burgess S, Thompson SG; CRP CHD Genetics Collaboration. Avoiding bias from weak instruments in Mendelian randomization studies. Int J Epidemiol 2011;40(3):755-64.
DOI: 10.1093/ije/dyr036
Kamat MA, Blackshaw JA, Young R, Surendran P, Burgess S, Danesh J, et al. PhenoScanner V2: an expanded tool for searching human genotype-phenotype associations. Bioinformatics 2019;35(22):4851-3.
DOI: 10.1093/bioinformatics/btz469
Sedgwick P. Multiple hypothesis testing and Bonferroni's correction. BMJ 2014;349:g6284.
DOI: 10.1136/bmj.g6284
Burgess S, Davies NM, Thompson SG. Bias due to participant overlap in two-sample Mendelian randomization. Genet Epidemiol 2016;40(7):597-608.
DOI: 10.1002/gepi.21998
Allen L, Williams J, Townsend N, Mikkelsen B, Roberts N, Foster C, et al. Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: a systematic review. Lancet Glob Health 2017;5(3):e277-89.
DOI: 10.1016/S2214-109X(17)30058-X
Schultz WM, Kelli HM, Lisko JC, Varghese T, Shen J, Sandesara P, et al. Socioeconomic Status and Cardiovascular Outcomes: Challenges and Interventions. Circulation 2018;137(20):2166-78.
DOI: 10.1161/CIRCULATIONAHA.117.029652
Peng L, Wen WP. Socioeconomic status and asthma: A bidirectional Mendelian randomization study. World Allergy Organ J 2023;16(6):100790.
DOI: 10.1016/j.waojou.2023.100790
Geng C, Meng K, Tang Y. Identifying the mediating role of inflammation on the relationship between socioeconomic status and Alzheimer's disease: a Mendelian randomization analysis and mediation analysis. J Neurol 2024;271(5):2484-93.
DOI: 10.1007/s00415-023-12176-1
Marino P, Mininni M, Deiana G, Marino G, Divella R, Bochicchio I, et al. Healthy Lifestyle and Cancer Risk: Modifiable Risk Factors to Prevent Cancer. Nutrients 2024;16(6):800.
DOI: 10.3390/nu16060800
Zhan ZQ, Chen YZ, Huang ZM, Luo YH, Zeng JJ, Wang Y, et al. Metabolic syndrome, its components, and gastrointestinal cancer risk: a meta-analysis of 31 prospective cohorts and Mendelian randomization study. J Gastroenterol Hepatol 2024;39(4):630-41.
DOI: 10.1111/jgh.16477

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