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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 | Mastery of endoscopic and Laparoscoplc显示文摘 | Wstephen E Lee L S Nathaniel J S | 2001 | Surnery2001，1，： | 1 |
| 3 | The role of elevation and soil chemistry in the distribution and ion accumulation of floral morphs of Streptanthus polygaloides Gray (Brassicaceae), a Californian nickel?hyperaccumulator 显示文摘 | Nathaniel P Michael F Robert S B | 2014 | Plant ecology & diversity2014，7，42： | 1 |
| 4 | Measuring the self-stigma associated with seeking psychological help显示文摘 | Vogel D L Nathaniel G W Haake S | 2006 | Journal of Counse-ling Psychology2006，53，3： | 1 |
| 5 | Defects in cardiac function precede morphological abnormalities in fish embryos exposed to polycyclic aromatic hydrocarbons 显示文摘 | John P I Tracy K C Nathaniel L S | 2004 | Toxicology and Appliocl Pharmacology2004，196，： | 1 |
| 6 | Safety and feasibility of a CT protocol for acute stroke: combined CT, CT Angiography, and CT perfusion imaging in 53 consecutive patients 显示文摘 | Wade S Heidi C Nathaniel A | 2003 | AJNR2003，24，4： | 1 |
| 7 | Polyphosphazenes: Synthesis-properties-applieations显示文摘 | Robert E Singler Nathaniel S Schneider Gary L Hagnauer | 1975 | Polymer Engineer-ing and Science1975，15，5： | 1 |
| 8 | Is sleep apnea an independent risk factor for prevalent and incident diabete] in the Busseh on Health Study? 显示文摘 | Nathaniel S Marshal I Keith K | 2009 | J Clin Sleep Med2009，15，5： | 1 |
| 9 | Human TREX2 components PCID2 and centrin 2, but not ENY2,have distinct functions in protein export and co-localize tothecentrosome 显示文摘 | Cunningham N C Schmidt C A Nathaniel J S | 2013 | Elsevier2013，320，： | 1 |
| 10 | Nickel-Catalyzed Asymmetric Reductive Cross-Coupling between Heteroaryl Iodides and ct-Chloronitriles 显示文摘 | Nathaniel T Kadunce Reisman S E | 2015 | JAmChemSoc2015，137，10： | 1 |
| 11 | Cerebral metabolic correlates as potential predictors of response to anterior cingulotomy for obsessive compulsive disorder显示文摘 | Scott L Rauch Darin D Dougherty G.Rees Cosgrove Edwin H Cassem Nathaniel M Alpert Bruce H Price Andrew A Nierenberg Helen S Mayberg Lee Baer Michael A Jenike Alan J Fischman | 2001 | Biological Psychiatry2001，，9： | 1 |
| 12 | Interdependent networks with identical degrees of mutually dependent nodes显示文摘 | Buldyrev S V Nathaniel S Gabriel A C | 2011 | Phys Rev E2011，83，1： | 1 |
| 13 | Structural dy- namics of soluble chloride intracellular channel protein CLIC1 examined by amide hydrogen-deuterium exchange mass spec- trometry显示文摘 | Stoychev SH Nathaniel C Fanucchi S | 2009 | Biochemistry2009，48，35： | 1 |
| 14 | An improved QC process for temperature in the daily cooperative weather obser- vations 显示文摘 | Hubbard K G Nathaniel B G You J S | 2007 | Atmos Oceanic Technical2007，24，： | 1 |
| 15 | Nucleic acid purification using microfabricated silicon structures显示文摘 | Nathaniel C C Scott S Carl A B | 2003 | Biosensors and Bioelectronics2003，19，1： | 1 |
| 16 | Morphogenetic signals from chondrocytes promote chondrogenic and osteogenic differentiation of mesenchymal stem cells 显示文摘 | Nathaniel S Shyni VA Christopher PU | 2007 | Cell Physiol2007，212，4： | 1 |
| 17 | Measuring the Self-Stigma Associated With Seeking Psychological Help显示文摘 | Vogel D L Nathaniel G.W Haake S | | 0，，03： | 1 |
| 18 | Hemoglobin and albumin adduets of benzene oxide among workers exposed to high levels of benzene 显示文摘 | KAREN Y NATHANIEL R MARTYN T S | 1998 | Carcinogenesis1998，19，9： | 1 |
| 19 | Interdependent networks with identical degrees of mutually dependent nodes显示文摘 | Buldyrev S V Nathaniel S Gabriel A C | 2011 | Phys Rev E2011，83，1： | 1 |
| 20 | Phase trans- formations in cast super austenitic stainless steels显示文摘 | Nathaniel S Phillips L Chambly S L | 2009 | J Mater Eng Perform2009，18，9： | 1 |
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