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| 1 | Systematic review and meta-analysis of esophageal cancer in Africa:Epidemiology, risk factors, management and outcomes显示文摘BACKGROUND Esophageal cancer(EC)is associated with a poor prognosis,particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease.AIM To provide further understanding of EC in the context of the unique cultural and genetic diversity,and socio-economic challenges faced on the African continent.METHODS We performed a systematic review of studies from Africa to obtain data on epidemiology,risk factors,management and outcomes of EC.A non-systematic review was used to obtain incidence data from the International Agency for Research on Cancer,and the Cancer in Sub-Saharan reports.We searched EMBASE,PubMed,Web of Science,and Cochrane Central from inception to March 2019 and reviewed the list of articles retrieved.Random effects metaanalyses were used to assess heterogeneity between studies and to obtain odds ratio(OR)of the associations between EC and risk factors;and incidence rate ratios for EC between sexes with their respective 95%confidence intervals(CI).RESULTS The incidence of EC is higher in males than females,except in North Africa where it is similar for both sexes.The highest age-standardized rate is from Malawi(30.3 and 19.4 cases/year/100000 population for males and females,respectively)followed by Kenya(28.7 cases/year/100000 population for both sexes).The incidence of EC rises sharply after the age of 40 years and reaches a peak at 75 years old.Meta-analysis shows a strong association with tobacco(OR 3.15,95%CI:2.83-3.50).There was significant heterogeneity between studies on alcohol consumption(OR 2.28,95%CI:1.94-2.65)and on low socioeconomic status(OR 139,95%CI:1.25-1.54)as risk factors,but these could also contribute to increasing the incidence of EC.The best treatment outcomes were with esophagectomy with survival rates of 76.6%at 3 years,and chemo-radiotherapy with an overall combined survival time of 267.50 d.CONCLUSION Africa has high incidence and mortality rates of EC,with preventable and nonmodifiable risk factors.Men in this setting are at increased risk due to their higher prevalence of tobacco and alcohol consumption.Management requires a multidisciplinary approach,and survival is significantly improved in the setting of esophagectomy and chemoradiation therapy. | Akwi W Asombang Nathaniel Chishinga Alick Nkhoma Jackson Chipaila Bright Nsokolo Martha Manda-Mapalo Joao Filipe G Montiero Lewis Banda Kulwinder S Dua | 2019 | World Journal of Gastroenterology2019，25，31： | 9 |
| 2 | A complex journey: transmission of microbial symbionts 显示文摘 | Bright M Bulgheresi S | 2010 | Nature Reviews Microbiology2010，8，3： | 1 |
| 3 | The NBS large-area alpha- particle counting systems显示文摘 | Hutchinson J M R Bright S J | 1987 | J Res NBS1987，92，5： | 1 |
| 4 | Recovery of trace DNA and its application to DNA profiling of shoe insoles 显示文摘 | Bright J A Petricevic S F | 2004 | Forensic Sci Int2004，145，1： | 1 |
| 5 | Determination of the deposition order of overlapping latent fingerprints and inks using secondary ion mass spectrometry显示文摘 | Bright N J Webb R P Bleay S | 2012 | Anal Chem2012，84，9： | 1 |
| 6 | Characteristics of women with recurrent molar pregnancies显示文摘 | Lorigan P C Sharma S Bright N | 2000 | Gynecol Oncol2000，78，31： | 1 |
| 7 | Improvement of protein quality in cereals显示文摘 | BRIGHT S W J SHEWRY P R | 1983 | Crit Rev Plant Sci1983，，1： | 1 |
| 8 | Protozoan size influences algal pigment degradation during grazing显示文摘 | Strom S L Morello T A Bright K J | 1998 | Mar Ecol Prog Ser1998，164，： | 1 |
| 9 | Exploring the Relationships Between Organizational Virtuousness and Performance 显示文摘 | Cameron K S Bright D Caza A | 2004 | A merican Behavioral Scientist2004，，06： | 1 |
| 10 | Nitric oxide, stomatal closure, and abiotic stress 显示文摘 | Neill S Barros R Bright J | 2008 | Journal of experimental botany2008，59，2： | 1 |
| 11 | Recommendations on the Statistical Analysis of the Comet Assay 显示文摘 | Bright J Aylott M Bate S | 2011 | Pharm Stat2011，10，6： | 1 |
| 12 | PPAR Regulation ofInflammatory Signaling in CNS Diseases显示文摘 | Bright JJ Kanakasabai S Chearwae W | 2008 | PPAR Res2008，2008，： | 1 |
| 13 | PPAR Regulation of inflammatory signaling in CNS diseases 显示文摘 | BRIGHT J J KANAKASABAI S CHEARWAE W | 2008 | PPAR Res2008，，65： | 1 |
| 14 | Mechanisms of pathogenicity of influenza A (H5N1) viruses in mice显示文摘 | Bright R A Cho D S Rowe T | 2003 | Avian Dis2003，47，3： | 1 |
| 15 | Disease-associated muta tions in CNGB3 produce gain of function alterations in cone cy- clic nucleotide-gated channels显示文摘 | Bright S R Brown T E Varnum M D | 2005 | Mol Vis2005，11，： | 1 |
| 16 | Transparent conducting oxide 显示文摘 | Bright C | 2000 | MRS Bull2000，25，： | 1 |
| 17 | New criteria for diagnosis of infective endoearditis: utilization of specific echocardiographic findings: Duke Endocarditis Service显示文摘 | DURACK D T LUKES A S BRIGHT D K | 1994 | Am J Med1994，96，： | 1 |
| 18 | Transparent conducting oxides显示文摘 | GINLEY D S BRIGHT C | 2000 | MRS Bulletin2000，25，8： | 1 |
| 19 | Mechanisms of pathogenicity of influenza A(H5N1) viruses in mice显示文摘 | Bright R A Cho D S Rowe T | 2003 | Avian Dis2003，47，3： | 1 |
| 20 | Transparent Conducting Oxides显示文摘 | GINLEY D S BRIGHT C | 2000 | MRS Bulletin2000，25，8： | 1 |
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