Core Insights - Approximately 3.5 billion people are affected by oral health issues, which pose a significant public health challenge, particularly in underdeveloped regions [2] - Poor oral health is increasingly linked to a higher risk of esophageal cancer (EC), which includes two main pathological subtypes: esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), leading to around 445,000 deaths annually [2] - The oral microbiome plays a crucial role in the pathogenesis of esophageal cancer, yet its exact mechanisms remain to be fully understood [2] Research Findings - A study published in Cell Reports Medicine by researchers from Fudan University mapped the oral microbiome landscape and its interplay with poor oral health in the risk of esophageal squamous cell carcinoma [3][4] - The research analyzed metagenomic sequencing data from 390 pairs of ESCC case-control samples and 206 pairs of newly diagnosed EC case-control samples [6] - The study identified changes in 50 bacterial species in ESCC, such as an increase in Porphyromonas catoniae and a decrease in Campylobacter rectus, along with disruptions in 54 biochemical pathways [6] - The association between poor oral health and ESCC risk was more pronounced in populations with lower levels of Streptococcus mitis, indicating a potential link to thiamine recycling and energy metabolism pathways [6][8] Implications - The findings underscore the potential for targeted interventions on the oral microbiome to improve oral health and prevent or treat esophageal squamous cell carcinoma [10]

Core Viewpoint - The article discusses the high prevalence of esophageal cancer in China, attributing it to dietary habits and lifestyle choices, and emphasizes the importance of early detection and screening for high-risk populations [3][5][27]. Group 1: Esophageal Cancer Prevalence - China accounts for over half of the global esophageal cancer cases, with more than 75% of the world's patients located in Asia [7][9]. - The incidence rate of esophageal cancer in China is approximately 38.37 cases per 100,000 people, with a significantly higher rate in men at 56.20 cases per 100,000 [9][11]. - Rural areas in China exhibit a higher incidence and mortality rate of esophageal cancer, approximately double that of urban areas [11][12]. Group 2: Risk Factors - Major risk factors for esophageal cancer include smoking, alcohol consumption, and dietary habits such as high-temperature and spicy food consumption [19][22]. - A study indicates that individuals with "hot food" and "spicy food" eating habits have a 1.9 times and 1.5 times higher risk of developing esophageal cancer, respectively [23][25]. - The consumption of pickled foods, which are prevalent in high-incidence regions, is linked to increased cancer risk due to high salt content and the presence of carcinogenic substances [25][26]. Group 3: Survival Rates and Detection - The five-year survival rate for esophageal cancer in China is only 28.8%, significantly lower than that of other cancers like gastric and colorectal cancer [28][31]. - Early detection is crucial, as many patients do not seek medical attention until the disease is advanced, making timely diagnosis and treatment challenging [32][33]. - Regular endoscopic screenings are recommended for high-risk individuals, particularly those over 45 years old or with a family history of esophageal cancer [33][36].

Core Viewpoint - China accounts for half of the global esophageal cancer cases, with a significant burden due to dietary habits and lifestyle choices [6][11][12]. Group 1: Esophageal Cancer Overview - Esophageal cancer originates from the epithelial lining of the esophagus and is one of the most common digestive tract malignancies in China, ranking sixth in incidence and fourth in mortality among all cancers [7][9]. - In 2021, there were approximately 1 million esophageal cancer patients worldwide, with over 75% located in Asia, and China having the highest number of cases and deaths [11]. - The incidence rate in China is 38.37 per 100,000, with men being nearly three times more likely to be affected than women [15]. Group 2: Regional and Demographic Disparities - Rural areas in China have a significantly higher incidence and mortality rate of esophageal cancer, approximately double that of urban areas [17]. - High-risk regions include areas near the Taihang Mountains and parts of Jiangsu, Sichuan, and Guangdong, with Jiangsu having the highest standardized mortality rate at 21.62 per 100,000 [21][12]. Group 3: Dietary and Lifestyle Factors - Major risk factors for esophageal cancer include smoking, alcohol consumption, and poor nutrition, with specific dietary habits such as consuming hot and spicy foods linked to higher incidence rates [23][25]. - Studies indicate that individuals with habits of consuming hot foods and spicy diets have a 1.9 times and 1.5 times higher risk of developing esophageal cancer, respectively [28]. - The consumption of pickled foods, which are prevalent in high-incidence regions, is associated with increased cancer risk due to high salt content and the presence of carcinogenic substances like nitrosamines [29][30]. Group 4: Survival Rates and Early Detection - The five-year survival rate for esophageal cancer in China is only 28.8%, significantly lower than other cancers, primarily due to late diagnosis [32][36]. - Early detection through endoscopic screening can dramatically improve survival rates, with a reported 90% five-year survival rate for early-stage patients [39][40]. - The National Health Commission recommends regular screenings for high-risk populations, particularly those over 45 years old or with a family history of the disease [40].

Core Viewpoint - The article discusses the high prevalence of esophageal cancer in China, attributing it to dietary habits, particularly the consumption of hot and spicy foods, as well as the impact of lifestyle choices such as smoking and alcohol consumption. Group 1: Esophageal Cancer Prevalence - China accounts for over half of the global esophageal cancer cases, with more than 90% being squamous cell carcinoma [10][8] - The incidence and mortality rates of esophageal cancer in China rank sixth and fourth among all malignancies, respectively [7][9] - In 2021, the incidence rate in China was 38.37 per 100,000, with men being nearly three times more likely to be affected than women [15][10] Group 2: Regional and Demographic Disparities - Rural areas in China have a significantly higher incidence and mortality rate of esophageal cancer, approximately double that of urban areas [18][14] - High-risk regions include areas around the Taihang Mountains and parts of Jiangsu, Sichuan, and Guangdong [19][20] - The standardized mortality rate is highest in Jiangsu at 21.62 per 100,000, followed by Sichuan and Henan [21][20] Group 3: Dietary and Lifestyle Factors - Major risk factors for esophageal cancer include smoking, alcohol consumption, and poor nutritional intake [24][27] - Hot and spicy food consumption is linked to higher cancer risk, with studies indicating that individuals with these dietary habits have a 1.9 times higher risk [31][29] - The World Health Organization classifies beverages above 65°C as a potential carcinogen, with common Chinese foods often exceeding this temperature [30][9] Group 4: Survival Rates and Detection Challenges - The five-year survival rate for esophageal cancer in China is only 28.8%, significantly lower than other cancers [41][44] - Early detection is challenging due to the asymptomatic nature of early-stage esophageal cancer, leading to late diagnoses [45][41] - Recommendations for screening include endoscopic examinations for high-risk individuals aged 45 and above [47][41]

Core Viewpoint - The article discusses the health risks associated with consuming hot food and beverages, particularly the increased risk of esophageal cancer due to long-term habits of eating and drinking at high temperatures [1][3]. Group 1: Risks of Hot Food and Beverages - Regular consumption of very hot food and drinks can lead to repeated burns of the esophageal mucosa, increasing the risk of cancer [4][6]. - The World Health Organization classifies beverages above 65°C as a Group 2A carcinogen, indicating a potential cancer risk [6]. Group 2: Dietary Habits Contributing to Esophageal Cancer - Heavy seasoning and consumption of pickled foods, which contain nitrites, can elevate the risk of esophageal cancer [7][9]. - Eating too quickly can cause injuries to the esophagus, as food may not be chewed properly, leading to potential mucosal damage [9][10]. - Smoking and excessive alcohol consumption are significant contributors to esophageal cancer risk, as both substances can harm the esophageal lining [10][12]. Group 3: Symptoms Indicating Potential Esophageal Cancer - Early symptoms of esophageal cancer may include a sensation of a foreign body in the throat, which can occur regardless of eating [13]. - Difficulty swallowing solid foods can progress to challenges with liquids, indicating worsening conditions [14]. - Pain behind the sternum may occur, particularly related to eating, and should be differentiated from other conditions like coronary heart disease [16]. - Persistent hoarseness may arise if the cancer compresses the recurrent laryngeal nerve [17]. Group 4: High-Risk Groups and Screening Recommendations - Individuals aged 45 and older, especially those with a family history of esophageal cancer or specific lifestyle habits, are considered high-risk and should undergo regular screenings [19][21]. - Initial endoscopic examinations should be followed up based on findings, with intervals ranging from one to five years depending on the results [21].