HIGHER SERUM SELENIUM CONCENTRATION IS ASSOCIATED WITH A HIGHER PREVALENCE OF ESOPHAGEAL SQUAMOUS DYSPLASIA IN BOMET, KENYA

Authors

• NR Pritchett
• MM Mwachiro
• SL Burgert
• JD Brockman
• CC Abnet
• SM Dawsey

Abstract

OBJECTIVE: Low serum selenium status has been associated with increased risk of esophageal squamous cell carcinoma (ESCC). East Africa is a region of high ESCC incidence and is known to have low soil selenium levels, but the association of serum selenium and ESCC has not previously been evaluated. The objective of this study was to assess the association of serum selenium concentration and the occurrence of esophageal squamous dysplasia (ESD), the precursor lesion of ESCC, in a cross-sectional study in Kenya. METHODS: 294 asymptomatic adult residents of Bomet, Kenya completed questionnaires and underwent endoscopy with Lugol’s iodine staining and biopsy for detection of ESD. Serum selenium concentrations were measured by instrumental neutron activation analysis. Odds ratios (OR) and confidence intervals (95% CI) for associations between serum selenium and ESD were calculated using unconditional logistic regression. RESULTS: The mean serum selenium concentration was 85.5 (+28.3) µg/L. Forty-two ESD cases were identified (14% of those screened). Higher serum selenium was associated with prevalence of ESD (Q4 vs Q1: OR: 3.87; 95% CI: 1.06-14.19). CONCLUSIONS: This is the first study to evaluate the association of serum selenium and ESD in an African population. We found a significant positive association between higher serum selenium concentration and the presence of ESD, an association contrary to our original hypothesis. This discrepancy may be due to the difference in endpoint of ESD rather than ESCC. Further work is needed to better understand the role of selenium in the etiology of ESCC in this region.

Scientific Focus Area: Epidemiology

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