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Current Cancer Therapy Reviews


ISSN (Print): 1573-3947
ISSN (Online): 1875-6301

Review Article

Risk Assessment of Esophageal Cancer Prevalence in North East India

Author(s): Surovi Saikia, V. Vijaya Padma*, Bhupendra Prajapati and Sankha Bhattacharya

Volume 19, Issue 3, 2023

Published on: 03 March, 2023

Page: [213 - 222] Pages: 10

DOI: 10.2174/1573394719666230120115938

Price: $65


Background: The North East (NE) India region has a quite distinct gene pool with over 160 scheduled tribes and 400 other sub-tribal populations. This region is the fourth contributor to the gene pool of the Indian sub-continent, which has associations with Tibeto-Burman speakers and Austro-Asiatic speakers settled in East and NE-India with Asian ties.

Methods: Literature search and studies have shown that in India, notwithstanding the lack of data on population coverage, there exists no such evidence for a decline in age-standardized mortality rates in cancer and the number of deaths mostly in individuals less than 70 years.

Results: Analytical epidemiological studies using molecular markers are currently the need of NEIndia for prognostication of cancers in this region, which are quite different from the rest of India, such as esophageal cancer, lung cancer in females, stomach cancer, and nasopharyngeal cancers. In addition, there is a dire need for translational research in NE-India, as for cancer survival, it is not always feasible to generalize the current international guidelines for cancer to the population of NEIndia so that high survival rates are achieved just like the rest of India and high-income rich countries. Factors, such as difference in incidence rate, socioeconomic factors, tumor biology and availability of resource in this region, determine the survival rates.

Conclusion: In this review, various factors involved in the high cancer burden in this region are discussed, particularly focusing on the genetic basis.

Keywords: Esophageal cancer, North-East India, kalakhar, tuibur, genetics, national cancer registry programme, ESCC.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68(6): 394-424.
[] [PMID: 30207593]
Umar SB, Fleischer DE. Esophageal cancer: epidemiology, pathogenesis and prevention. Nat Clin Pract Gastroenterol Hepatol 2008; 5(9): 517-26.
[] [PMID: 18679388]
Ilson DH, van Hillegersberg R. Management of patients with adenocarcinoma or squamous cancer of the esophagus. Gastroenterology 2018; 154(2): 437-51.
[] [PMID: 29037469]
Napier KJ, Scheerer M, Misra S. Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities. World J Gastrointest Oncol 2014; 6(5): 112-20.
[] [PMID: 24834141]
Mangalaparthi KK, Patel K, Khan AA, et al. Mutational landscape of esophageal squamous cell carcinoma in an Indian cohort. Front Oncol 2020; 10: 1457.
Uhlenhopp DJ, Then EO, Sunkara T, Gaduputi V. Epidemiology of esophageal cancer: Update in global trends, etiology and risk factors. Clin J Gastroenterol 2020; 13(6): 1010-21.
[] [PMID: 32965635]
Samarasam I. Esophageal cancer in India: Current status and future perspectives. Int J Adv Med Health Res 2017; 4(1): 5.
Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, et al. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 2014; 15(5): 489-538.
[] [PMID: 24731404]
Report of National Cancer Registry Programme (ICMR-NCDIR), Bengaluru, India. 2020. Available from:
Mathur P, Sathishkumar K, Chaturvedi M, et al. Cancer Statistics, 2020: Report From National Cancer Registry Programme, India. JCO Glob Oncol 2020; 6(6): 1063-75.
[] [PMID: 32673076]
Ngaihte P, Zomawia E, Kaushik I. Cancer in the North East India: Where we are and what needs to be done? Indian J Public Health 2019; 63(3): 251-3.
[] [PMID: 31552857]
ICMR-NCDIR. Profile of Cancer and Related Health Indicators in the North East Region of India. Bengaluru, India 2021. Available from:
Lin R, Yang Y, Wu E, Zhou M, Wang S, Zhang Q. SIRT2 promotes cell proliferation and migration through mediating ERK1/2 activation and lactosylceramide accumulation in prostate cancer. Prostate 2023; 83(1): 71-81.
[] [PMID: 36082450]
Sharma JD, Kalit M, Nirmolia T, Saikia SP, Sharma A, Barman D. Cancer: scenario and relationship of different geographical areas of the globe with special reference to North East-India. Asian Pac J Cancer Prev 2014; 15(8): 3721-9.
[] [PMID: 24870783]
Papiha SS. Genetic variation in India. Hum Biol 1996; 68(5): 607-28.
[PMID: 8908794]
Bamshad M, Kivisild T, Watkins WS, et al. Genetic evidence on the origins of Indian caste populations. Genome Res 2001; 11(6): 994-1004.
[] [PMID: 11381027]
Bamshad MJ, Watkins WS, Dixon ME, et al. Female gene flow stratifies Hindu castes. Nature 1998; 395(6703): 651-2.
[] [PMID: 9790184]
Bhattacharyya NP, Basu P, Das M, et al. Negligible male gene flow across ethnic boundaries in India, revealed by analysis of Y-chromosomal DNA polymorphisms. Genome Res 1999; 9(8): 711-9.
[] [PMID: 10447506]
Singh KS. People of India: the scheduled tribes. Delhi: Oxford University Press 1994; Vol. III.
Cavalli-Sforza LL, Menozzi P, Piazza A. History and geography of human genes. Princeton: Princeton University Press 1994.
Cordaux R, Saha N, Bentley GR, Aunger R, Sirajuddin SM, Stoneking M. Mitochondrial DNA analysis reveals diverse histories of tribal populations from India. Eur J Hum Genet 2003; 11(3): 253-64.
[] [PMID: 12678055]
Su B, Xiao C, Deka R, et al. Y chromosome haplotypes reveal prehistorical migrations to the Himalayas. Hum Genet 2000; 107(6): 582-90.
[] [PMID: 11153912]
Matisoff JA. Sino-Tibetan linguistics: present state and future prospects. Annu Rev Anthropol 1991; 20(1): 469-504.
Kataki AC, Simons MJ, Das AK, Sharma K, Mehra NK. Nasopharyngeal carcinoma in the Northeastern states of India. Chin J Cancer 2011; 30(2): 106-13.
[] [PMID: 21272442]
Sasaki R, Aoki K, Takeda S. Contribution of dietary habits to esophageal cancer in Japan. Prog Clin Biol Res 1990; 346: 83-92.
[PMID: 2374770]
Kinjo Y, Cui Y, Akiba S, et al. Mortality risks of oesophageal cancer associated with hot tea, alcohol, tobacco and diet in Japan. J Epidemiol 1998; 8(4): 235-43.
[] [PMID: 9816815]
Cheng KK, Day NE. Nutrition and esophageal cancer. Cancer Causes Control 1996; 7(1): 33-40.
[] [PMID: 8850433]
Li W, Zhu M, Chen P, Lu W. Study on dietary pattern and nutrients intakes of residents in areas of high and low incidence of esophageal cancer. Wei Sheng Yen Chiu 1997; 26(5): 351-5.
[PMID: 10325654]
Prasad MPR, Krishna TP, Pasricha S, Krishnaswamy K, Quereshi MA. Esophageal cancer and diet—a case‐control study. Nutr Cancer 1992; 18(1): 85-93.
[] [PMID: 1408949]
Turner PC, Nikiema P, Wild CP. Fumonisin contamination of food: progress in development of biomarkers to better assess human health risks. Mutat Res Genet Toxicol Environ Mutagen 1999; 443(1-2): 81-93.
[] [PMID: 10415433]
Kumar Phukan R, Kanta Chetia C, Shahadat Ali M, Mahanta J. Role of dietary habits in the development of esophageal cancer in Assam, the north-eastern region of India. Nutr Cancer 2001; 39(2): 204-9.
[] [PMID: 11759281]
Mirvish SS. Role of N-nitroso compounds (NOC) and N-nitrosation in etiology of gastric, esophageal, nasopharyngeal and bladder cancer and contribution to cancer of known exposures to NOC. Cancer Lett 1995; 93(1): 17-48.
[] [PMID: 7600541]
Breton J, Sichel F, Abbas A, Marnay J, Arsène D, Lechevrel M. Simultaneous use of DGGE and DHPLC to screen TP53 mutations in cancers of the esophagus and cardia from a European high incidence area (Lower Normandy, France). Mutagenesis 2003; 18(3): 299-306.
[] [PMID: 12714698]
Biramijamal F, Allameh A, Mirbod P, Groene HJ, Koomagi R, Hollstein M. Unusual profile and high prevalence of p53 mutations in esophageal squamous cell carcinomas from northern Iran. Cancer Res 2001; 61(7): 3119-23.
[PMID: 11306496]
Pütz A, Hartmann AA, Fontes PRO, et al. TP53 mutation pattern of esophageal squamous cell carcinomas in a high risk area (Southern Brazil): Role of life style factors. Int J Cancer 2002; 98(1): 99-105.
[] [PMID: 11857392]
Sepehr A, Tanière P, Martel-Planche G, et al. Distinct pattern of TP53 mutations in squamous cell carcinoma of the esophagus in Iran. Oncogene 2001; 20(50): 7368-74.
[] [PMID: 11704866]
Wang LD, Zhou Q, Feng CW, et al. Intervention and follow-up on human esophageal precancerous lesions in Henan, northern China, a high-incidence area for esophageal cancer. Gan To Kagaku Ryoho 2002; 29 (Suppl. 1): 159-72.
[PMID: 11890101]
Tobey NA, Sikka D, Marten E, Caymaz-Bor C, Hosseini SS, Orlando RC. Effect of heat stress on rabbit esophageal epithelium. Am J Physiol Gastrointest Liver Physiol 1999; 276(6): G1322-30.
[] [PMID: 10362635]
Loria D, Barrios E, Zanetti R. Cancer and yerba mate consumption: a review of possible associations. Rev Panam Salud Publica 2009; 25(6): 530-9.
[] [PMID: 19695149]
Ghadirian P. Thermal irritation and esophageal cancer in northern Iran. Cancer 1987; 60(8): 1909-14.
[<1909:AID-CNCR2820600840>3.0.CO;2-Y] [PMID: 3652017]
Chen X, Yang CS. Esophageal adenocarcinoma: a review and perspectives on the mechanism of carcinogenesis and chemoprevention. Carcinogenesis 2001; 22(8): 1119-29.
[] [PMID: 11470739]
National Cancer Registry Programme. Comparison of cancer incidence and patterns of all population based cancer registries in India. Three-year report of population based cancer: 2012–2014. 2015.
Sinha DN, Gupta PC, Pednekar M. Tobacco water: a special form of tobacco use in the Mizoram and Manipur states of India. Natl Med J India 2004; 17(5): 245-7.
[PMID: 15638304]
Iti Kaushik DPCNDEZ, Zomawia E, Kaushik I. Tobacco water - hidden killer in the north east India. Innov J Med Health Sci 2018; 8(12): 214-6.
Phukan RK, Zomawia E, Narain K, Hazarika NC, Mahanta J. Tobacco use and stomach cancer in Mizoram, India. Cancer Epidemiol Biomarkers Prev 2005; 14(8): 1892-6.
[] [PMID: 16103433]
Mahanta J, Chetia M, Hazarika NC, Narain K, Sharma SK. Toxicity of tuibur, a unique form of tobacco smoke extract used in Mizoram, India. Curr Sci 1998; 381-4.
Lalmuanpuii R, Muthukumaran RB. Fourier transform-infrared spectroscopic characterization of the particulate phase of Commercial Tuibur. Sci Vis 2016; 68-73.
Madathil S, Senthil Kumar N, Zodinpuii D, Muthukumaran RB, Lalmuanpuii R, Nicolau B. Tuibur: tobacco in a bottle-commercial production of tobacco smoke-saturated aqueous concentrate. Addiction 2018; 113(3): 577-80.
[] [PMID: 29314330]
Xiao H, Singh SV. p53 regulates cellular responses to environmental carcinogen benzo[a]pyrene-7,8-diol-9,10-epoxide in human lung cancer cells. Cell Cycle 2007; 6(14): 1753-61.
[] [PMID: 17630511]
Ihsan R, Devi TR, Yadav DS, et al. Investigation on the role of p53 codon 72 polymorphism and interactions with tobacco, betel quid, and alcohol in susceptibility to cancers in a high-risk population from North East India. DNA Cell Biol 2011; 30(3): 163-71.
[] [PMID: 21043833]
Själander A, Birgander R, Kivelä A, Beckman G. p53 polymorphisms and haplotypes in different ethnic groups. Hum Hered 1995; 45(3): 144-9.
[] [PMID: 7615299]
Beckman G, Birgander R, Själander A, et al. Is p53 polymorphism maintained by natural selection? Hum Hered 1994; 44(5): 266-70.
[] [PMID: 7927355]
Fan R, Wu MT, Miller D, et al. The p53 codon 72 polymorphism and lung cancer risk. Cancer Epidemiol Biomarkers Prev 2000; 9(10): 1037-42.
[PMID: 11045785]
Talukdar FR, Ghosh SK, Laskar RS, Mondal R. Epigenetic, genetic and environmental interactions in esophageal squamous cell carcinoma from northeast India. PLoS One 2013; 8(4)e60996
Malik MA, Upadhyay R, Mittal RD, Zargar SA, Mittal B. Association of xenobiotic metabolizing enzymes genetic polymorphisms with esophageal cancer in Kashmir Valley and influence of environmental factors. Nutr Cancer 2010; 62(6): 734-42.
[] [PMID: 20661821]
Jain M, Kumar S, Rastogi N, et al. GSTT1, GSTM1 and GSTP1 genetic polymorphisms and interaction with tobacco, alcohol and occupational exposure in esophageal cancer patients from North India. Cancer Lett 2006; 242(1): 60-7.
[] [PMID: 16338071]
Huang ZG. Meta-analysis on glutathione S-transferase M1 polymorphisms and the risk of esophageal cancer. Meta-Analysis Zhonghua Liu Xing Bing Xue Za Zhi 2004; 25(10): 898-901.
Li B, Wang B, Niu LJ, Jiang L, Qiu CC. Hypermethylation of multiple tumor-related genes associated with DMNT3b up-regulation served as a biomarker for early diagnosis of esophageal squamous cell carcinoma. Epigenetics 2011; 6(3): 307-16.
[] [PMID: 21150312]
Lima SCS, Hernández-Vargas H, Simão t, et al. Identification of a DNA methylome signature of esophageal squamous cell carcinoma and potential epigenetic biomarkers. Epigenetics 2011; 6(10): 1217-27.
[] [PMID: 21946330]
Huang Y, Chang X, Lee J, et al. Cigarette smoke induces promoter methylation of single-stranded DNA-binding protein 2 in human esophageal squamous cell carcinoma. Int J Cancer 2011; 128(10): 2261-73.
[] [PMID: 20658532]
Meng XY, Zhu ST, Zhou QZ, Li P, Wang YJ, Zhang ST. Promoter methylation regulates cigarette smoke-stimulated cyclooxygenase-2 expression in esophageal squamous cell carcinoma. J Dig Dis 2012; 13(4): 208-13.
[] [PMID: 22435505]
Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: Development of an atlas of cancer in India. Int J Cancer 2005; 116(5): 740-54.
[] [PMID: 15849747]
Phukan RK, Ali MS, Chetia CK, Mahanta J. Betel nut and tobacco chewing; potential risk factors of cancer of oesophagus in Assam, India. Br J Cancer 2001; 85(5): 661-7.
[] [PMID: 11531248]
Singh V, Singh LC, Vasudevan M, et al. Esophageal cancer epigenomics and integrome analysis of genome-wide methylation and expression in high risk northeast Indian population. OMICS 2015; 19(11): 688-99.
[] [PMID: 26496483]
Chattopadhyay I, Kapur S, Purkayastha J, et al. Gene expression profile of esophageal cancer in North East India by cDNA microarray analysis. World J Gastroenterol 2007; 13(9): 1438-44.
[] [PMID: 17457978]
Das M, Saikia BJ, Sharma SK, Sekhon GS, Mahanta J, Phukan RK. p16 hypermethylation: A biomarker for increased esophageal cancer susceptibility in high incidence region of North East India. Tumour Biol 2015; 36(3): 1627-42.
[] [PMID: 25361631]
Das M, Sharma SK, Sekhon GS, Saikia BJ, Mahanta J, Phukan RK. Promoter methylation of MGMT gene in serum of patients with esophageal squamous cell carcinoma in North East India. Asian Pac J Cancer Prev 2014; 15(22): 9955-60.
[] [PMID: 25520135]
Singh V, Singh AP, Sharma I, et al. Epigenetic deregulations of Wnt/β-catenin and transforming growth factor beta-Smad pathways in esophageal cancer: Outcome of DNA methylation. J Cancer Res Ther 2019; 15(1): 192-203.
[] [PMID: 30880778]
Sharma A, Das BC, Sehgal A, et al. GSTM1 and GSTT1 polymorphism and susceptibility to esophageal cancer in high- and low-risk regions of India. Tumour Biol 2013; 34(5): 3249-57.
[] [PMID: 23749488]
Yadav DS, Chattopadhyay I, Verma A, et al. A pilot study evaluating genetic alterations that drive tobacco- and betel quid-associated oral cancer in Northeast India. Tumour Biol 2014; 35(9): 9317-30.
[] [PMID: 24943687]
Bhushan A, Singh A, Kapur S, et al. Identification and validation of fibroblast growth Factor 12 gene as a novel potential biomarker in esophageal cancer using cancer genomic datasets. OMICS 2017; 21(10): 616-31.
[] [PMID: 29049013]
Saxena , Phukan R, Singh A, et al. Molecular profiling to identify molecular mechanism in esophageal cancer with familial clustering. Oncol Rep 2009; 21(5): 1135-46.
[] [PMID: 19360286]
Chattopadhyay I, Singh A, Phukan R, et al. Genome-wide analysis of chromosomal alterations in patients with esophageal squamous cell carcinoma exposed to tobacco and betel quid from high-risk area in India. Mutat Res Genet Toxicol Environ Mutagen 2010; 696(2): 130-8.
[] [PMID: 20083228]
Ihsan R, Chattopadhyay I, Phukan R, et al. Role of epoxide hydrolase 1 gene polymorphisms in esophageal cancer in a high-risk area in India. J Gastroenterol Hepatol 2010; 25(8): 1456-62.
[] [PMID: 20659238]
Desai P, Awatiger MM, Mane DR. Evaluation of immunoexpression of AJUBA protein in normal oral mucosa and oral squamous cell carcinoma. Appl Immunohistochem Mol Morphol 2023; 31(1): 1-8.
[] [PMID: 36222508]
Rai AK, Freddy AJ, Banerjee A, et al. Distinct involvement of 9p21-24 and 13q14.1-14.3 chromosomal regions in raw betel-nut induced esophageal cancers in the state of Meghalaya, India. Asian Pac J Cancer Prev 2012; 13(6): 2629-33.
[] [PMID: 22938432]
Singh V, Singh LC, Singh AP, et al. Status of epigenetic chromatin modification enzymes and esophageal squamous cell carcinoma risk in northeast Indian population. Am J Cancer Res 2015; 5(3): 979-99.
Ghatak S, Yadav RP, Lalrohlui F, et al. Xenobiotic pathway gene polymorphisms associated with gastric cancer in high risk mizo-mongoloid population, Northeast India. Helicobacter 2016; 21(6): 523-35.
[] [PMID: 27006283]
Phukan RK, Narain K, Zomawia E, Hazarika NC, Mahanta J. Dietary habits and stomach cancer in Mizoram, India. J Gastroenterol 2006; 41(5): 418-24.
[] [PMID: 16799882]
Assefa B, Tadesse A, Abay Z, et al. Peptic ulcer disease among dyspeptic patients at endoscopy unit, University of Gondar hospital, Northwest Ethiopia. BMC Gastroenterol 2022; 22(1): 164.
[] [PMID: 35382748]
Abebaw W, Kibret M, Abera B. Prevalence and risk factors of H. pylori from dyspeptic patients in northwest Ethiopia: a hospital based cross-sectional study. Asian Pac J Cancer Prev 2014; 15(11): 4459-63.
[] [PMID: 24969869]
Singh A, Kapur S, Chattopadhyay I, et al. Cytokeratin immunoexpression in esophageal squamous cell carcinoma of high-risk population in Northeast India. Appl Immunohistochem Mol Morphol 2009; 17(5): 419-24.
[] [PMID: 19417629]
Shen Y, Zhang H, Yao S, et al. Methionine oxidation of CLK4 promotes the metabolic switch and redox homeostasis in esophageal carcinoma via inhibiting MITF selective autophagy. Clin Transl Med 2022; 12(1)e719
[] [PMID: 35092699]
Swargiary P, Boruah N, Singh CS, Chatterjee A. Genome-wide analysis of DNaseI hypersensitivity unveils open chromatin associated with histone H3 modifications after areca nut with lime exposure. Mutagenesis 2022; 37(3-4): 182-90.
[] [PMID: 36112508]
Umar M, Upadhyay R, Kumar S, Ghoshal UC, Mittal B. Modification of risk, but not survival of esophageal cancer patients by esophageal cancer-related gene 1 Arg290Gln polymorphism: A case-control study and meta-analysis. J Gastroenterol Hepatol 2013; 28(11): 1717-24.
[] [PMID: 23869757]

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