[[en/index|English]] · [[zh/index|中文]] # Thorny Cancer = ESCC **ESCC: Esophageal Squamous Cell Carcinoma** ![[thornycancer-20251111.jpeg]] > Age-adjusted mortality rates of esophageal cancer among Chinese women, 1973–1975 (National Cancer Control Office, Ministry of Health, and the Nanjing Institute of Geography, Chinese Academy of Sciences, 1980). Although nationwide survey data are lacking in recent decades, the geographic patterns disclosed by these early maps have not changed substantially over the past decades (Kou et al., 2018). The similar geographic pattern between men and women further points to the importance of geographic-environmental factors. There are multiple high-risk areas of esophageal cancer in China from north to south, namely North China, northern Jiangsu, eastern Guangdong, etc. The persistently high rates and geographic patterns of esophageal cancer in China could not be explained by initiator exposure, such as the ubiquitous exposure to nitrosamines in the nation and the world. Instead, we find that the three high-risk areas of China have one thing in common: vitric (siliceous, of glass), needle-like, micron-scale debris contaminants in food. These siliceous needles contaminate wheat flour, freshwater trash fish (directly introduced into dishes), and marine trash fish (made into fish sauce and fish rice), in the three high-risk areas respectively. ![[thornycancer-20251111-1.jpeg]] > Siliceous needle contamination of food in representative high-risk areas of esophageal cancer in China. Shown are: wheat seeds and inflorescence bracts (palea, lemma and glume) from North China (A), with sharp siliceous prickles on the surface of wheat glumes observed under electron microscopy (B); trash fish collected from Huai'an, northern Jiangsu (C), with needle-shaped diatoms detected in their guts (D); fish rice (yufan) made from trash fish on Nan'ao Island, Shantou, eastern Guangdong (E), with needle-shaped diatoms detected therein (F). Consistent with the emerging evidence of non-mutagenic promoters such as silica underlying the geographic patterns of esophageal cancer in the world, we hypothesize that region-specific dietary exposure to siliceous needles, as a promoter, accounts for the distinct geographical pattern of esophageal cancer in China; siliceous needles contaminate food in particular regions, injure the esophageal epithelium repeatedly, and promote the development of esophageal cancer via chronic inflammation. Our three project tasks are: 1) comparing the abundance of siliceous needles in food samples between the high-risk epicenters and the peripheral areas via ecological studies; 2) simulating the process of food contamination by siliceous needles and injuries of the esophagus in rats; and 3) investigating the pathological mechanisms of diet contaminated by siliceous needles promoting esophageal cancer by mucosa injury and chronic inflammation in animal experiments. --- ## Explore - [[en/classics/classics|Classic papers]] - [[en/papers/papers|Publications of the group]] - [[en/trash_fish/trash-fish|Trash fish]] - [[en/phytolith_植硅体/wheat-phytolith|Wheat phytoliths]] - [[en/phytolith_植硅体/rice-husk-phytolith|Rice husk phytoliths]] - [[en/frustule_硅藻壳/diatom-frustule|Diatoms and their frustules]] - [[en/global_ESCC_epidemics/global-escc-epidemics|Global ESCC epidemics]]