Attributable causes of cancer in China

BackgroundMost cancers are due to modifiable lifestyle and environmental risk factors, and are potentially preventable. No studies have provided a systematic quantitative assessment of the burden of cancer mortality and incidence attributable to known risk factors in China.MethodsWe calculated the proportions of cancer deaths and new cases attributable to known risk factors in China, based on the prevalence of exposure around 1990 and national data on cancer mortality and incidence for the year 2005.ResultsChronic infection is the main risk factor for cancer in China, accounting for 29.4% of cancer deaths (31.7% in men and 25.3% in women), followed by tobacco smoking (22.6% with 32.7% in men and 5.0% in women), low fruit intake (13.0%), alcohol drinking (4.4%), low vegetable intake (3.6%) and occupational exposures (2.7%). The remaining factors, including environmental agents, physical inactivity, the use of exogenous hormones and reproductive factors are each responsible for <1.0%.ConclusionsModifiable risk factors explain nearly 60% of cancer deaths in China, with a predominant role of chronic infection and tobacco smoking. Our findings could provide a basis for cancer prevention and control programs aimed at reducing cancer risk in other developing countries.     

The burden of cancer attributable to alcohol drinking

We estimated the number of cancer cases and deaths attributable to alcohol drinking in 2002 by sex and WHO subregion, based on relative risks of cancers of the oral cavity, pharynx, esophagus, liver, colon, rectum, larynx and female breast obtained from recent meta- and pooled analyses and data on prevalence of drinkers obtained from the WHO Global Burden of Disease project. A total of 389,100 cases of cancer are attributable to alcohol drinking worldwide, representing 3.6% of all cancers (5.2% in men, 1.7% in women). The corresponding figure for mortality is 232,900 deaths (3.5% of all cancer deaths). This proportion is particularly high among men in Central and Eastern Europe. Among women, breast cancer comprises 60% of alcohol-attributable cancers. Although our estimates are based on simplified assumptions, the burden of alcohol-associated cancer appears to be substantial and needs to be considered when making public health recommendations on alcohol drinking.     

Global burden of gastric cancer attributable to Helicobacter pylori

We previously estimated that 660,000 cases of cancer in the year 2008 were attributable to the bacterium Helicobacter pylori (H. pylori), corresponding to 5.2% of the 12.7 million total cancer cases that occurred worldwide. In recent years, evidence has accumulated that immunoblot (western blot) is more sensitive for detection of anti‐H. pylori antibodies than ELISA, the detection method used in our previous analysis. The purpose of this short report is to update the attributable fraction (AF) estimate for H. pylori after briefly reviewing new evidence, and to reassess the global burden of cancer attributable to H. pylori. We therefore reviewed the literature for studies comparing the risk of developing non‐cardia gastric cancer (NCGC) in cases and controls, using both ELISA and multiple antigen immunoblot for detection of H. pylori. The results from prospective studies were combined, and the new pooled estimates were applied to the calculation of the AF for H. pylori in NCGC, then to the burden of infection‐related cancers worldwide. Using the immunoblot‐based data, the worldwide AF for H. pylori in NCGC increased from 74.7% to 89.0%. This implies approximately 120,000 additional cases of NCGC attributable to H. pylori infection for a total of around 780,000 cases (6.2% instead of 5.2% of all cancers). These updated estimates reinforce the role of H. pylori as a major cause of cancer.     

中国恶性肿瘤负担归因于人口老龄化的比例及趋势分析

目的分析中国1990—2019年恶性肿瘤负担变化归因于人口老龄化、人口数增长、恶性肿瘤年龄别发病率、病死率的比例及趋势。方法从全球疾病负担研究中提取1990—2019年中国≥25岁人群中29种恶性肿瘤的发病数、死亡数及其对应的人口数, 以1990年为基准参照, 采用因素分解法计算1991—2019年男性和女性中各恶性肿瘤历年可归因于人口老龄化、人口数增长、恶性肿瘤年龄别发病率、病死率的死亡数, 并计算历年归因恶性肿瘤死亡数占当年全部恶性肿瘤死亡数的比例及其时间变化趋势。结果 2019年中国≥25岁人群恶性肿瘤死亡总数为269.0万例, 其中归因于人口老龄化、人口数增长、恶性肿瘤年龄别发病率及病死率的恶性肿瘤死亡数分别为74.0万、109.1万、19.8万和-72.8万, 分别占2019年总死亡数的27.5%、40.6%、7.3%和-27.1%。2019年人口老龄化归因死亡数前5位的恶性肿瘤分别为肺癌、胃癌、食管癌、肝癌和结直肠癌, 29种恶性肿瘤归因于人口老龄化的死亡数占该癌种死亡总数的比例为9.3%～40.5%。归因于人口老龄化的恶性肿瘤死亡数及其占全部恶性肿瘤死亡数的比例在1997...     

Attributable causes of cancer in China: Fruit and vegetable

Objective:To provide an evidence-based and consistent assessment of the burden of cancer attributable to inadequate fruit and vegetable intake in China in 2005.Methods:The proportions of cancers attributable to low consumption of vegetable and fruit were calculated separately to estimate the burden of related cancers for the year 2005 in China.Data on the prevalence of exposure were derived from a Chinese nutrition and health survey.Data on relative risks were mainly derived from meta-analysis.Attributable fractions were calculated based on the counterfactual scenario which was a shift in the exposure distribution.Results:The total cancer burden attributable to inadequate consumption of fruit was up to 233,000 deaths (13.0% of all cancers) and 300,000 cases (11.6% of all cancers) in 2005.Increasing consumption of vegetable to the highest quintile could avoid total cancer deaths and cases by 3.6% (64,000 persons) and 3.4% (88,000 persons).The contributions to cancer burden were higher in rural areas than in urban areas.They have greater influence on men than on women.The largest proportions of cancer burden attributable to low fruit and vegetable intake were for oral and pharyngeal cancers.Conclusion:This study showed that inadequate intake of fruit and vegetable makes a significant contribution to the cancer burden.Increasing consumption of fruit and vegetable could prevent many cancer deaths and save many lives.Promoting the consumption of fruit and vegetable is an important component in diet-based strategies for preventing cancer.     

Proportion and number of cancer cases and deaths attributable to behavioral risk factors in Vietnam

Identifying modifiable risk factors that contribute to cancer is essential in setting up preventive strategies. Therefore, this study aimed to estimate the number and proportion of cancer cases and deaths attributable to five behavior-related risk factors—tobacco smoking, second-hand smoking, alcohol consumption, high body mass index and insufficient physical activity in Vietnam in 2020. Population attributable fractions were calculated for relationships of risk factors and cancer types based on sufficient evidence according to IARC or strong evidence according to WCRF/AICR. Relative risks were retrieved from meta-analyses where possible. Prevalence of risk factors was obtained from the most current available nationally representative population surveys in Vietnam. Cancer cases and deaths were obtained from GLOBOCAN 2020. An estimated 40.5% of all cancer cases in men (39 924 cases) and 7.8% in women (6542 cases) were attributable to these risk factors. The proportions of cancer deaths attributable to these risk factors were 44.0% in men (32 807 cases) and 8.9% in women (4235 cases). Tobacco smoking was the leading cause of cancer cases and deaths in men, followed by alcohol consumption and high BMI. In women, high BMI accounted for the highest proportion of cancer cases and second-hand smoking accounted for the highest proportion of cancer deaths. Lung and upper aerodigestive tract cancer cases and deaths could have been reduced at least by half if these risk factors had been eliminated. To reduce cancer incidence and mortality, preventive actions focusing on tobacco control are likely to have the most significant impact, especially in men.     

Tobacco‐attributable burden of cancer according to socioeconomic position in France

Smoking is a major preventable cause of cancers and is increasingly concentrated among the most deprived individuals leading to increasing socioeconomic inequalities in the incidence of cancers linked to smoking. We aimed to estimate the tobacco‐attributable cancer burden according to socioeconomic position in France. The analysis was restricted to cancer sites for which tobacco smoking was recognized as a risk factor. Cancer cases by sex, age group and European Deprivation Index (EDI) among people aged 30–74 between 2006 and 2009 were obtained from cancer registries covering ～20% of the French population. The tobacco‐attributable burden of cancer according to EDI was estimated applying the population attributable fraction (PAF) computed with the Peto‐Lopez method. The PAF increased from 56% in the least deprived EDI quintile to 70% in the most deprived EDI quintile among men and from 26% to 38% among women. In total, 28% of the excess cancer cases in the four most deprived EDI quintiles in men and 43% in women could be prevented if smoking in these 4 EDI quintiles was similar to that of the least deprived EDI quintile. A substantial smoking‐attributable burden of cancer by socioeconomic position was observed in France. The results highlight the need for policies reducing tobacco consumption. More comprehensive interventions integrating the various dimensions of health determinants and proportionate according to socioeconomic position may essentially contribute to the reduction of socioeconomic inequalities in cancer.     

Population attributable risk of breast cancer in white women associated with immediately modifiable risk factors

Background  

Estrogen/progestin replacement therapy (EPRT), alcohol consumption, physical activity, and breast-feeding duration differ from other factors associated with breast cancer in being immediately modifiable by the individual, thereby representing attractive targets for future breast cancer prevention efforts. To justify such efforts, it is vital to quantify the potential population-level impacts on breast cancer considering population variations in behavior prevalence, risk estimate, and baseline incidence.     

Incidence of thyroid cancer in women in relation to known or suspected risk factors for breast cancer

There is evidence to suggest that breast and thyroid tumors occur together in the same woman more often than would be expected by chance. This study investigates the possibility that various known risk factors for breast cancer also influence the risk of thyroid cancer in women. Female residents of western Washington, in whom papillary, follicular, or mixed thyroid cancer had been diagnosed between 1974 and 1979 (N = 182), were interviewed regarding their medical and reproductive histories. For comparison, a random sample of 389 women from the same population were interviewed. Women who had a history of breast cancer were almost 3 times (95% confidence interval, 0.78-7.9) more likely to develop thyroid cancer than women with no such history. However, a history of breast cancer in a woman's mother did not increase her risk of thyroid cancer. Neither nulliparity, infertility, late age at first full-term pregnancy, early age at menarche, nor a history of abortion or miscarriage before first full-term pregnancy appeared to influence the occurrence of thyroid cancer. Increased weight was associated with an increased risk of thyroid cancer; relative to women who weighed 52 kg or less, those who weighed 60 kg or more had a 2.5-fold elevation in risk. These findings suggest that while cancers of the breast and thyroid are epidemiologically similar in a few ways, there are important differences in a number of their risk factors.     

Incident cancer burden attributable to excess body mass index in 30 European countries

Excess adiposity is associated with increased risks of developing adult malignancies. To inform public health policy and guide further research, the incident cancer burden attributable to excess body mass index (BMI ≥ 25 kg/m²) across 30 European countries were estimated. Population attributable risks (PARs) were calculated using European‐ and gender‐specific risk estimates from a published meta‐analysis and gender‐specific mean BMI estimates from a World Health Organization Global Infobase. Country‐specific numbers of new cancers were derived from Globocan2002. A ten‐year lag‐period between risk exposure and cancer incidence was assumed and 95% confidence intervals (CI) were estimated in Monte Carlo simulations. In 2002, there were 2,171,351 new all cancer diagnoses in the 30 countries of Europe. Estimated PARs were 2.5% (95% CI 1.5–3.6%) in men and 4.1% (2.3–5.9%) in women. These collectively corresponded to 70,288 (95% CI 40,069–100,668) new cases. Sensitivity analyses revealed estimates were most influenced by the assumed shape of the BMI distribution in the population and cancer‐specific risk estimates. In a scenario analysis of a plausible contemporary (2008) population, the estimated PARs increased to 3.2% (2.1–4.3%) and 8.6% (5.6–11.5%), respectively, in men and women. Endometrial, post‐menopausal breast and colorectal cancers accounted for 65% of these cancers. This analysis quantifies the burden of incident cancers attributable to excess BMI in Europe. The estimates reported here provide a baseline for future modelling, and underline the need for research into interventions to control weight in the context of endometrial, breast and colorectal cancer.     

1990-2019年中国归因于高BMI的肾癌疾病负担

目的:描述和分析1990-2019年中国人群归因于高体质量指数（body mass index,BMI）的肾癌疾病负担变化趋势。方法:基于2019年全球疾病负担研究(GBD2019)部分数据,按照性别、年龄、年份对近三十年归因于高BMI的肾癌人群死亡数、伤残调整寿命年(disability adjusted life year,DALY)、过早死亡损失寿命年（years of life lost,YLL）和伤残损失寿命年（years lived with disability,YLD）及其年龄标化率等指标分类记录。并采用Joinpoint回归模型计算平均年度变化百分比（AAPC）反映中国与全球以及不同社会人口学指数（socio-demographic index,SDI）地区归因于高BMI的肾癌疾病负担及其变化趋势。结果:从1990到2019年,中国归因于高BMI的肾癌疾病的标化死亡率由0.03/10万上升至0.13/10万,标化DALY率从0.86/10万增加到3.45/10万,增长率分别为333%和301%。伴随年龄增加,死亡率、DALY率、YLL率和YLD率均明显上升,在DALY率的占比中,YLD率值虽低于YLL率,但增速较YLL率快。中国归因标化死亡率和标化DALY率的增长趋势显著高于全球及不同SDI地区,AAPC分别高达4.8%和4.9%（P均＜0.05),且男性的增长速率较女性更显著。结论:1990-2019年我国归因于高BMI的肾癌负担进行性加重并呈持续上升状态,早死导致疾病负担比重大,伤残疾病负担增速快,尤其是在男性和老年人群中更为显著。对此,积极控制肥胖/超重、加强肾癌早期筛查、注重康复指导和健康干预成为减轻疾病负担的重要措施。     

Attributable causes of breast cancer and ovarian cancer in China: Reproductive factors, oral contraceptives and hormone replacement therapy

Objective:To provide an evidence-based,consistent assessment of the burden of breast cancer attributable to reproductive factors(RFs,including nulliparity,mean number of children,age at first birth and breastfeeding),use of oral contraceptives(OCs,restricted to the age group of 15-49 years),and hormone replacement therapy(HRT),as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005.Methods:We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China.In the case of RFs,we compared the exposure distributions in 2001 and counterfactual exposure.Results:Exposure of RFs in 2001 was found to account for 6.74% of breast cancer,corresponding to 9,617 cases and 2,769 deaths,and for 2.78% of ovarian cancer(711 cases,294 deaths).The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer.The prevalence of OC use was 1.74% and the population attributable fraction(PAF) of breast cancer was 0.71%,corresponding to 310 cases and 90 deaths.The PAF of breast cancer due to HRT was 0.31%,resulting in 297 cases and 85 deaths.Conclusion: RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.     

Population attributable proportion and number of cancer cases attributed to potentially modifiable risk factors in Iran in 2020

In the current study, we aimed to calculate the fraction of cancer attributable to modifiable risk factors in Iran in 2020. Population attributable fractions (PAFs) were calculated for established cancer risk factors using three data sources: the national cancer incidence reports, relative risks extracted from global and national meta-analyses, and exposure prevalence from national/subnational population-based surveys. In addition to overall cancers, the PAFs were estimated separately for each cancer site among men and women. Overall, 32.6% of cancers in 2020 in Iran were attributable to known risk factors. The PAF in men (40.2%) was twice as high as in women (21.1%). Cigarette smoking (15.4%), being overweight (5.0%), opium use (3.9%) and H. pylori infection (3.8%) were the leading causes of cancers. For men, the highest PAFs belonged to cigarette smoking (26.3%), opium use (6.8%) and being overweight (3.1%), while for women, the highest PAFs belonged to being overweight (7.2%), H. pylori infection (2.7%) and cigarette smoking (2.7%). Among Iranian men and women, the PAFs of waterpipe smoking were 2% and 0.9%, respectively. A third of incident cancers in Iran are due to modifiable exposures, mainly cigarette smoking, being overweight, and H. pylori infection. Opium consumption and waterpipe smoking collectively accounted for 8.8% of cancer occurrence in men and 1.3% in women in Iran. These emerging risk factors should be taken into consideration in future PAF studies.     

Worldwide burden of cancer attributable to HPV by site,country and HPV type

HPV is the cause of almost all cervical cancer and is responsible for a substantial fraction of other anogenital cancers and oropharyngeal cancers. Understanding the HPV‐attributable cancer burden can boost programs of HPV vaccination and HPV‐based cervical screening. Attributable fractions (AFs) and the relative contributions of different HPV types were derived from published studies reporting on the prevalence of transforming HPV infection in cancer tissue. Maps of age‐standardized incidence rates of HPV‐attributable cancers by country from GLOBOCAN 2012 data are shown separately for the cervix, other anogenital tract and head and neck cancers. The relative contribution of HPV16/18 and HPV6/11/16/18/31/33/45/52/58 was also estimated. 4.5% of all cancers worldwide (630,000 new cancer cases per year) are attributable to HPV: 8.6% in women and 0.8% in men. AF in women ranges from <3% in Australia/New Zealand and the USA to >20% in India and sub‐Saharan Africa. Cervix accounts for 83% of HPV‐attributable cancer, two‐thirds of which occur in less developed countries. Other HPV‐attributable anogenital cancer includes 8,500 vulva; 12,000 vagina; 35,000 anus (half occurring in men) and 13,000 penis. In the head and neck, HPV‐attributable cancers represent 38,000 cases of which 21,000 are oropharyngeal cancers occurring in more developed countries. The relative contributions of HPV16/18 and HPV6/11/16/18/31/33/45/52/58 are 73% and 90%, respectively. Universal access to vaccination is the key to avoiding most cases of HPV‐attributable cancer. The preponderant burden of HPV16/18 and the possibility of cross‐protection emphasize the importance of the introduction of more affordable vaccines in less developed countries.     

Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States

Contemporary information on the fraction of cancers that potentially could be prevented is useful for priority setting in cancer prevention and control. Herein, the authors estimate the proportion and number of invasive cancer cases and deaths, overall (excluding nonmelanoma skin cancers) and for 26 cancer types, in adults aged 30 years and older in the United States in 2014, that were attributable to major, potentially modifiable exposures (cigarette smoking; secondhand smoke; excess body weight; alcohol intake; consumption of red and processed meat; low consumption of fruits/vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and 6 cancer‐associated infections). The numbers of cancer cases were obtained from the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute; the numbers of deaths were obtained from the CDC; risk factor prevalence estimates were obtained from nationally representative surveys; and associated relative risks of cancer were obtained from published, large‐scale pooled analyses or meta‐analyses. In the United States in 2014, an estimated 42.0% of all incident cancers (659,640 of 1570,975 cancers, excluding nonmelanoma skin cancers) and 45.1% of cancer deaths (265,150 of 587,521 deaths) were attributable to evaluated risk factors. Cigarette smoking accounted for the highest proportion of cancer cases (19.0%; 298,970 cases) and deaths (28.8%; 169,180 deaths), followed by excess body weight (7.8% and 6.5%, respectively) and alcohol intake (5.6% and 4.0%, respectively). Lung cancer had the highest number of cancers (184,970 cases) and deaths (132,960 deaths) attributable to evaluated risk factors, followed by colorectal cancer (76,910 cases and 28,290 deaths). These results, however, may underestimate the overall proportion of cancers attributable to modifiable factors, because the impact of all established risk factors could not be quantified, and many likely modifiable risk factors are not yet firmly established as causal. Nevertheless, these findings underscore the vast potential for reducing cancer morbidity and mortality through broad and equitable implementation of known preventive measures. CA Cancer J Clin 2018;68:31‐54 . © 2017 American Cancer Society .     

Proportion of premenopausal and postmenopausal breast cancers attributable to known risk factors: Estimates from the E3N‐EPIC cohort

Breast cancer is the most frequently diagnosed cancer among women worldwide. Breast cancer risk factors have been widely explored individually; however, little is known about their combined impact. We included 67,634 women from the French E3N prospective cohort, aged 42–72 at baseline. During a 15‐year follow‐up period, 497 premenopausal and 3,138 postmenopausal invasive breast cancer cases were diagnosed. Population‐attributable fractions (PAFs) were used to estimate cases proportions attributable to risk factors under hypothetical scenarios of lowest exposure. We examined overall premenopausal and postmenopausal invasive breast cancers and tumour subtypes (ER status and HER2 expression). Premenopausal breast cancer was not significantly attributable to non‐behavioral (61.2%, ?15.5 to 91.88%) nor to behavioral (39.9%, ?71.0 to 93.9%) factors, contrary to postmenopausal breast cancer (41.9%, 4.5 to 68.7% and 53.5%, 12.8 to 78.7%, respectively). Individually, the highest statistically significant PAFs were obtained in premenopause for birth weight (33.6%, 5.7 to 56.6%) and age at menarche (19.8%, 5.2 to 33.6%) for non‐behavioral factors and in postmenopause for history of benign breast diseases (14.9%, 11.6 to 18.0%) and age at menarche (9.7%, 3.9 to 15.5%) for non‐behavioral factors and for body shape at menarche (17.1%, 9.7 to 24.3%), use of hormone replacement therapy (14.5%, 9.2 to 19.6%), dietary pattern (10.1%, 2.6 to 17.4%) and alcohol consumption (5.6%, 1.9 to 9.3%) for behavioral factors. These proportions were higher for ER+, HER2? and ER+/HER2? postmenopausal breast cancers. Our data support the hypothesis that in postmenopause, never starting unhealthy behaviors can reduce the number of diagnosed breast cancers.     

Does menopausal hormone replacement therapy interact with known factors to increase risk of breast cancer?

PURPOSE: We and other investigators have previously shown that postmenopausal combined estrogen and progestin replacement therapy (EPRT) increases the risk of breast cancer and that the risk associated with EPRT is substantially higher than for estrogen replacement therapy (ERT) alone. The present study was conducted to determine whether any particular subgroup of women are at particularly high risk of breast cancer if they use EPRT and whether tumor characteristics in women who develop cancer while on ERT or EPRT are different from those in women not using ERT or EPRT. PATIENTS AND METHODS: We conducted a population-based case-control study in Los Angeles, CA, with patients diagnosed with breast cancer in the late 1980s and early 1990s. Control subjects were matched to patients on age, ethnicity, and neighborhood of residence. We present data on 1,897 postmenopausal patients and 1,637 controls aged 55 to 72 years who had not undergone a simple hysterectomy. RESULTS: Relative risk of breast cancer associated with EPRT use did not vary with body mass index (body mass index at or below v above median [24.6 kg/m(2)]; P =.98), alcohol intake (> or + one v < one drink per week; P =.16), parity (nulliparous v parous; P =.45), history of benign breast disease (yes v no; P =.99), or family history of breast cancer (first degree v none; P =.57). All of these results were compatible with our previously reported estimate of an increased risk of breast cancer of 5% per year of use of EPRT. Hormone users, principally EPRT users, were more likely to have hormone receptor--positive, especially progesterone-positive, tumors. CONCLUSION: We found no evidence that the risk of breast cancer associated with EPRT is limited to subgroups of women with specific cofactors. Tumors in EPRT users are more often hormone receptor--positive, indicating that they may have a better prognosis than breast cancer overall.     

Nutritional assessment and risk factors associated to malnutrition in patients with esophageal cancer

Introduction: Esophageal cancer is the fourth most common cause of cancer death in China. Patients with esophageal cancer are more likely to suffer from malnutrition. The purpose of this study is to assess nutritional status of patients with esophageal cancer from multiple perspectives and analyze the risk factors. Methods: A total of 1482 esophageal cancer patients were enrolled in the study. We investigated the Scored Patient Generated Subjective Global Assessment (PG-SGA) scores, NRS-2002 scores, Karnofsky performance status scores, anthropometric, and laboratory indicators of patients. Unconditional logistic regression analysis was applied to identify the risk factors of nutritional status. Results: PG-SGA (≥4) and NRS-2002 (≥3) showed the incidence of malnutrition were 76% and 50%, respectively. In the patients with PG-SGA score ≥4, the proportion of patients who did not receive any nutritional support was 60%. The incidence of malnutrition in females was significantly higher than that in males. Besides, abnormality rates of Red blood cell (P < 0.001), MAC (P = 0.037), and MAMC (P < 0.001) in males was significantly higher than that in females, while abnormality rates of TSF (P < 0.001) was lower than that in females. After adjusted with the other potential risk factors listed, unconditional logistic regression analysis indicated smoking (odds ratio: 2.868, 95% confidence interval: 1.660-4.954), drinking (OR: 1.726, 95% CI: 1.099-2.712), family history (OR: 1.840, 95% CI: 1.132-2.992), radiotherapy or chemotherapy (OR: 1.594, 95% CI: 1.065-2.387), and pathological stage (OR: 2.263, 95% CI: 1.084-4.726) might be the risk factors of nutritional status, while nutritional support can reduce the risk of malnutrition. Conclusion: Effective nutritional risk assessment methods and nutritional intervention measures can be adopted according to the research data to improve quality of life of esophageal cancer patients.