article · JCO Global Oncology
In this high-burden setting, tobacco remains the principal modifiable driver of ESCC. Alcohol showed only a modest independent effect, limited to very high intake, and did not increase the risk among smokers beyond the high risk from smoking. Socioeconomic and environmental disadvantages cluster with behavioral risks, underscoring a syndemic context. These findings, consistent with prior Johannesburg Cancer Study reports yet offering greater exposure granularity, support targeted prevention strategies focused on smoking cessation, mitigation of hazardous drinking patterns, and reduction of household environmental exposures.
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DOI: 10.1200/go-25-00669
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