Comprehensive Analysis of Cancer Incidence and Mortality Trends in Costa Rica: Implications for Public Health

This commentary delves into the evolving landscape of cancer incidence and mortality in Costa Rica, presenting a comprehensive analysis of the data. Key findings reveal a concerning upward trajectory in cancer incidence rates, placing Costa Rica at the forefront within Central America. While prostate cancer and breast cancer dominate, disparities emerge when scrutinizing gender-specific trends. Notably, stomach and cervical cancers show declines, potentially attributed to targeted interventions. However, colorectal and liver cancers witness mortality increases, necessitating strategic responses. Geographical disparities persist across provinces, highlighting the need for equitable healthcare access. In conclusion, this commentary underscores the urgency of addressing the burgeoning cancer burden in Costa Rica, calling for evidence-based interventions and collaborative efforts on a global scale.

Consumption of soybean,soy foods,soy isoflavones and breast cancer incidence:Differences between Chinese women and women in Western countries and possible mechanisms

Breast cancer is one of the most lethal diseases world-wide.However,there is a large difference in breast cancer incidence among Caucasian,Hispanic,African and Asian(e.g.Chinese)women with Caucasian women being the highest and Asian women being the lowest.It has been suggested that the dietary factors may account for approximately 50%of the breast cancer.One of such dietary components which are typical to Asian but not Caucasian diet is soy foods.A number of epidemiological studies have suggested that increasing soy consumption could be related to the decreased risk of occurrence and/or mortality of breast cancer.In this review,we first described briefly different types of soy products and their nutritional functions and consumption.Then,we described briefly soybean isoflavones,i.e.genistein(GEN),daidzein,glycitein,and presented several lines of evidence to demonstrate the possible association of soy flavone food consumption with incidence and prognosis of breast cancer;finally,we summarized several possible molecular mechanisms,including the effects of GEN as an agonist of ER,epigenetic and genome-wide effects,activation of peroxisome proliferator-activated receptors,induction of apoptosis and stimulation of autophagy,involved in the chemo-preventive effects of GEN on breast cancer.©2013 Beijing Academy of Food Sciences.Production and hosting by Elsevier B.V.All rights reserved.

Comparison of cancer incidence and mortality in three GDP per capita levels in China, 2013

Objective：In this research,the patterns of cancer incidence and mortality in areas with different gross domestic product per capita（GDPPC）levels in China were explored,using data from population-based cancer registries in 2013,collected by the National Central Cancer Registry（NCCR）.Methods：Data from 255 cancer registries were qualified and included in this analysis.Based on the GDPPC data of 2014,cities/counties were divided into 3 levels：high-,middle-and low-GDPPC areas,with 40,000 and 80,000 RMB per year as cut points.We calculated cancer incidences and mortalities in these three levels,stratified by gender and age group.The national population of the Fifth Census in 2000 and Segi’s population were applied for age-standardized rates.Results：The crude incidence and mortality rates as well as age-standardized incidence rate（ASIR）showed positive associations with GDPPC level.The age-standardized mortality rate（ASMR）nevertheless showed a negative association with GDPPC level.The ASMR in high-,middle-and low-GDPPC areas was 103.12/100,000,112.49/100,000 and 117.43/100,000,respectively.Lung cancer was by far the most common cancer in all three GDPPC levels.It was also the leading cause of cancer death,regardless of gender and GDPPC level.Negative associations with GDPPC level were found for the ASIRs of lung,stomach,esophageal and liver cancer,whereas colorectal and breast cancer showed positive associations.Except for breast cancer,the ASMRs of the other five cancers were always higher in middle-and low-GDPPC areas than in high-GDPPC areas.Conclusions：The economic development is one of the main factors of the heavy cancer burden on Chinese population.It would be reasonable to implement cancer control strategies referring to the local GDPPC level.

Cancer incidence in Beijing, 2014

Objective： To analyze cancer incidence data in Beijing in 2014 and temporal trends for selected common cancers during 2005 and 2014.Methods： A total of 144 secondary and tertiary hospitals reported newly diagnosed cancer cases to Beijing Cancer Registry, which covers 13 million residents in Beijing. The cancer incidence rate was calculated in strata by cancer type, sex, age group and area. The population composition of China in 1982 and Segi＇s population structure were used to calculate age-standardized rates. Extensive procedures were used to assure the quality of the data.Results： The overall data quality indicators of the percentage of morphology verification（MV）（%）, the percentage of death certificate-only（DCO）（%） and the mortality to incidence ratio（M/I） were 72.15%, 0.94% and0.54 respectively. A total of 45,300 new cancer cases were diagnosed in Beijing in 2014. The incidence rate was341.92/100,000（343.50/100,000 in males, 340.33/100,000 in females）, and the age-standardized incidence rates by Chinese standard population（ASIRC） and by world standard population（ASIRW） were 143.48/100,000 and182.99/100,000, respectively. The cumulative incidence rate for cancer before 75 years was 20.61%. Cancers of lung, colorectum, liver, stomach and prostate were the top five common cancer types for males, while cancers of breast, lung, thyroid, colorectum and uterus were the top five common cancer types for females. The different patterns were also observed between rural and urban areas. Regarding temporal trends, the incidence of thyroid cancer has the fastest growth between 2005 and 2014. The incidence of liver cancer decreased, and stomach and esophageal cancer also decreased significantly for males in the last decade. Incidence rate for lung cancer was relatively stable during that period of time.Conclusions： With more than 45,000 new cases in Beijing in 2014, cancer remains an important public health problem. Actions should be taken to diminish total cancer incidence in Beijing.

Bayesian adjustment for over-estimation and under-estimation of gastric cancer incidence across Iranian provinces

AIM To correct the misclassification in registered gastric cancer incidence across Iranian provinces in cancer registry data. METHODS Gastric cancer data is extracted from Iranian annual of national cancer registration report 2008. A Bayesian method with beta prior is implemented to estimate the rate of misclassification in registering patient'spermanent residence in neighboring province. Each time two neighboring provinces with lower and higher than 100% expected coverage of cancer cases are selected to be entered in the model. The expected coverage of cancerous patient is reported by medical university of each province. It is assumed that some cancer cases from a province with a lower than 100% expected coverage are registered in their neighboring province with more than 100% expected coverage. RESULTS The condition was true for 21 provinces from a total of 30 provinces of Iran. It was estimated that 43% of gastric cancer cases of North and South Khorasan provinces in north-east of Iran was registered in Razavi Khorasan as the neighboring facilitate province; also 72% misclassification was estimated between Sistan and balochestan province and Razavi Khorasan. The misclassification rate was estimated to be 36% between West Azerbaijan province and East Azerbaijan province, 21% between Ardebil province and East Azerbaijan, 63% between Hormozgan province and Fars province, 8% between Chaharmahal and bakhtyari province and Isfahan province, 8% between Kogiloye and boyerahmad province and Isfahan, 43% Golestan province and Mazandaran province, 54% between Bushehr province and Khozestan province, 26% between Ilam province and Khuzestan province, 32% between Qazvin province and Tehran province(capital of Iran), 43% between Markazi province and Tehran, and 37% between Qom province and Tehran. CONCLUSION Policy makers should consider the regional misclassification in the time of programming for cancer control, prevention and resource allocation.

Cancer incidence and mortality in China, 2014

Background： National Central Cancer Registry of China（NCCRC） updated nationwide cancer statistics using population-based cancer registry data in 2014 collected from all available cancer registries.Methods： In 2017, 449 cancer registries submitted cancer registry data in 2014, among which 339 registries＇ data met the criteria of quality control and were included in analysis. These cancer registries covered 288,243,347 population, accounting for about 21.07% of the national population in 2014. Numbers of nationwide new cancer cases and deaths were estimated using calculated incidence and mortality rates and corresponding national population stratified by area, sex, age group and cancer type. The world Segi＇s population was applied for agestandardized rates.Results： A total of 3,804,000 new cancer cases were diagnosed, the crude incidence rate was 278.07/100,000（301.67/100,000 in males, 253.29/100,000 in females） and the age-standardized incidence rate by world standard population（ASIRW） was 186.53/100,000. Calculated age-standardized incidence rate was higher in urban areas than in rural areas（191.6/100,000 vs. 179.2/100,000）. South China had the highest cancer incidence rate while Southwest China had the lowest incidence rate. Cancer incidence rate was higher in female for population between20 to 54 years but was higher in male for population younger than 20 years or over 54 years. A total of 2,296,000 cancer deaths were reported, the crude mortality rate was 167.89/100,000（207.24/100,000 in males,126.54/100,000 in females） and the age-standardized mortality rate by world standard population（ASMRW） was106.09/100,000. Calculated age-standardized mortality rate was higher in rural areas than in urban areas（110.3/100,000 vs. 102.5/100,000）. East China had the highest cancer mortality rate while North China had the lowest mortality rate. The mortality rate in male was higher than that in female. Common cancer types and major causes of cancer death differed between age group and sex.Conclusions： Heavy cancer burden and its disparities between area, sex and age group pose a major challenge to public health in China. Nationwide cancer registry plays a crucial role in cancer prevention and control.

Trend analysis of cancer incidence and mortality in China

The National Central Cancer Registry of China （NCCRC） up- dated their nationwide statistics of cancer incidence and mor- tality in China according to 2013 population-based cancer registration data （due to the time required for data collection, quality control and analysis, the latest cancer statistics avail- able in China have a 3-year lag behind the current year）.

Incidence and mortality of gastric cancer in China

Gastric cancer is one of the most frequent cancers in the world; almost two-thirds of gastric cancer cases and deaths occur in less developed regions. In China, based on two national mortality surveys conducted in 1970s and 1990s, there is an obvious clustering of geographical distribution of gastric cancer in the country, with the high mortality being mostly located in rural areas, especially in Gansu, Henan, Hebei, Shanxi and Shaanxi Provinces in the middle-western part of China. Despite a slight increase from the 1970s to early 1990s, remarkable declines in gastric cancer mortality were noticed in almost the entire population during the last decade in China. These declines were largely due to the dramatic improvements in the social-economic environment, lifestyle, nutrition, education and health care system after economic reforms started two decades ago. Nevertheless, gastric cancer will remain a significant cancer burden currently and be one of the key issues in cancer prevention and control strategy in China. It was predicted that, in 2005, 0.3 million deaths and 0.4 million new cases from gastric cancer would rank the third most common cancer. The essential package of the prevention and control strategy for gastric cancer in China would focus on controlling Helicobacter pylori （H pylori infection, improving educational levels, advocating healthy diet and anti-tobacco campaign, searching for cost-effective early detection, diagnosis and treatment programs including approaches for curable management and palliative care.

Incidence and mortality of female breast cancer in the AsiaPacific region

Objective: To provide an overview of the incidence and mortality of female breast cancer for countries in the Asia-Pacific region.Methods: Statistical information about breast cancer was obtained from publicly available cancer registry and mortality databases(such as GLOBOCAN), and supplemented with data requested from individual cancer registries. Rates were directly age-standardised to the Segi World Standard population and trends were analysed using joinpoint models.Results: Breast cancer was the most common type of cancer among females in the region, accounting for 18% of all cases in 2012, and was the fourth most common cause of cancer-related deaths(9%). Although incidence rates remain much higher in New Zealand and Australia, rapid rises in recent years were observed in several Asian countries. Large increases in breast cancer mortality rates also occurred in many areas, particularly Malaysia and Thailand, in contrast to stabilising trends in Hong Kong and Singapore, while decreases have been recorded in Australia and New Zealand. Mortality trends tended to be more favourable for women aged under 50 compared to those who were 50 years or older. Conclusion: It is anticipated that incidence rates of breast cancer in developing countries throughout the Asia-Pacific region will continue to increase. Early detection and access to optimal treatment are the keys to reducing breast cancerrelated mortality, but cultural and economic obstacles persist. Consequently, the challenge is to customise breast cancer control initiatives to the particular needs of each country to ensure the best possible outcomes.

Repeatedly elevatedγ-glutamyltransferase levels are associated with an increased incidence of digestive cancers:A population-based cohort study

BACKGROUND The association between elevatedγ-glutamyltransferase(GGT)at a certain point and incident cancer has been suggested;however,no study has evaluated the association between repeatedly elevated GGT and cancer incidence.AIM To investigate the effects of repeatedly elevated GGT on the incidence of digestive cancers.METHODS Participants who had undergone health screening from 2009 to 2012 and 4 consecutive previous examinations were enrolled.GGT points were calculated as the number of times participants met the criteria of quartile 4 of GGT in four serial measurements(0-4 points).Multivariable Cox proportional hazard regression models were applied.RESULTS In total,3559109 participants were included;among them,43574 digestive cancers developed during a median of 6.8 years of follow-up.The incidence of total digestive cancers increased in a dose-response manner in men[adjusted hazard ratio(aHR)compared with those with 0 GGT points=1.28 and 95%confidence interval(CI)=1.24-1.33 in those with 1 point;aHR=1.40 and 95%CI=1.35-1.46 in those with 2 points;aHR=1.52 and 95%CI=1.46-1.58 in those with 3 points;aHR=1.88 and 95%CI=1.83-1.94 in those with 4 points;P for trend<0.001].This trend was more prominent in men than in women and those with healthy habits(no smoking,no alcohol consumption,and a low body mass index)than in those with unhealthy habits.CONCLUSION Repeatedly elevated GGT levels were associated with an increased risk of incident digestive cancer in a dose-responsive manner,particularly in men and those with healthy habits.Repeated GGT measurements may be a good biomarker of incident digestive cancer and could help physicians identify high-risk populations.

CHEMOPREVENTION OF LUNG CANCER IN THE HIGH INCIDENCE AREA

Since 1984, mass screening for cancer and chemopreventive trials in the two high incidence areas of lung cancer have been carried out. Chemo preventive trials on the subjects having moderate or severe atypical hyperplasia cells in the sputum were done by treatment with R1 [N-(p-ethoxycarbophenyl) retinamide] and R2 [N-(p-carboxyphenyl) retina-mide]. Results showed that the general status of the patients had improved. IgA and IgM in the serum were increased and the arsenic skin lesions were relieved after the treatment with Rl and R2. The ratio of the incidence of lung cancer for the treated group and the control group was 1:4, and the mean degree of hyperplasia in the sputum had dropped. It is suggested that these drugs are both safe and effective in the chemoprevention of lung cancer.

Characteristics of gastric cancer in Asia

Gastric cancer(GC)is the fourth most common cancer in the world with more than 70%of cases occur in the developing world.More than 50%of cases occur in Eastern Asia.GC is the second leading cause of cancer death in both sexes worldwide.In Asia,GC is the third most common cancer after breast and lung and is the second most common cause of cancer death after lung cancer.Although the incidence and mortality rates are slowly declining in many countries of Asia,GC still remains a significant public health problem.The incidence and mortality varies according to the geographic area in Asia.These variations are closely related to the prevalence of GC risk factors;especially Helicobacter pylori(H.pylori)and its molecular virulent characteristics.The gradual and consistent improvements in socioeconomic conditions in Asia have lowered the H.pylori seroprevalence rates leading to a reduction in the GC incidence.However,GC remains a significant public health and an economic burden in Asia.There has been no recent systemic review of GC incidence,mortality,and H.pylori molecular epidemiology in Asia.The aim of this report is to review the GC incidence,mortality,and linkage to H.pylori in Asia.

Cancers in Eastern Libya: First results from Benghazi Medical Center

AIM: To study the pattern of cancer incidence and determine the incidence rates in Eastern Libya (for the first time in a decade).

Trend of hepatocellular carcinoma incidence after Bayesian correction for misclassified data in Iranian provinces

To study the trend of hepatocellular carcinoma incidence after correcting the misclassification in registering cancer incidence across Iranian provinces in cancer registry data. METHODSIncidence data of hepatocellular carcinoma were extracted from Iranian annual of national cancer registration reports 2004 to 2008. A Bayesian method was implemented to estimate the rate of misclassification in registering cancer incidence in neighboring province. A beta prior is considered for misclassification parameter. Each time two neighboring provinces were selected to be entered in the Bayesian model based on their expected coverage of cancer cases which is reported by medical university of the province. It is assumed that some cancer cases from a province that has an expected coverage of cancer cases lower than 100% are registered in their neighboring facilitate province with more than 100% expected coverage. RESULTSThere is an increase in the rate of hepatocellular carcinoma in Iran. Among total of 30 provinces of Iran, 21 provinces were selected to be entered to the Bayesian model for correcting the existed misclassification. Provinces with more medical facilities of Iran are Tehran (capital of the country), Razavi Khorasan in north-east of Iran, East Azerbaijan in north-west of the country, Isfahan in central part and near to Tehran, Khozestan and Fars in south and Mazandaran in north of the Iran, had an expected coverage more than their expectation. Those provinces had significantly higher rates of hepatocellular carcinoma than their neighboring provinces. In years 2004 to 2008, it was estimated to be on average 34% misclassification between North Khorasan province and Razavi Khorasan, 43% between South Khorasan province and Razavi Khorasan, 47% between Sistan and balochestan province and Razavi Khorasan, 23% between West Azerbaijan province and East Azerbaijan province, 25% between Ardebil province and East Azerbaijan province, 41% between Hormozgan province and Fars province, 22% betweenChaharmahal and bakhtyari province and Isfahan province, 22% between Kogiloye and boyerahmad province and Isfahan, 22% between Golestan province and Mazandaran province, 43% between Bushehr province and Khozestan province, 41% between Ilam province and Khuzestan province, 42% between Qazvin province and Tehran province, 44% between Markazi province and Tehran, and 30% between Qom province and Tehran. CONCLUSIONAccounting and correcting the regional misclassification is necessary for identifying high risk areas and planning for reducing the cancer incidence.

Burden of female breast and five gynecological cancers in China and worldwide

Background:Female breast and five gynecological cancers remain substantial burden in China and worldwide.GLOBOCAN 2022 has recently updated the estimates of cancer burden.This study aims to depict the profiles of disease burden and to compare the age-specific rates of female breast and five gynecological cancers in China with those in other countries.Methods:The latest estimates of incidence and mortality of female breast and five gynecological cancers from various regions and countries were extracted from the GLOBOCAN 2022 database.We compared the proportion of total cases or deaths for cancers affecting female breast and five gynecological cancers and other tumor types in China and globally.Correlation analysis was conducted to evaluate the relationship between age-standardized incidence rate(ASIR)or age-standardized mortality rate(ASMR)and the Human Development Index(HDI).Additionally,age-specific rate curves were plotted for ten exemplary countries with different income levels.Results:Female breast and five gynecological cancers in China accounted for 30.2%of all newly diagnosed cancer cases.Breast cancer and cervical cancer are the most commonly diagnosed,with nearly 507,000 new cases,representing 23.48%of the new cases.The incidence rates of breast,uterine corpus,ovarian,and vulvar cancers were positively associated with HDI tiers.Chinese women aged 50-54 years are experiencing high incidence rates of breast,cervix uteri,corpus uteri,and ovarian cancers.Conclusions:Female breast and five gynecological cancers continue to be a significant health concern for women in China and worldwide.It is crucial to implement comprehensive prevention strategies tailored to address the increasing trend among younger individuals and reduce regional disparities.

Cancer statistics and trends in China:the potential of natural product application

Cancer presents a significant global challenge,impacting individuals,communities,and healthcare systems worldwide[1,2].Fundamentally,cancer involves the uncontrolled growth and proliferation of cells,driven by genetic and epigenetic alterations orchestrated by a complex array of molecular entities,including oncogenes,tumor suppressor genes,and various regulatory factors[3-5].This intricate interplay complicates early detection,often resulting in a significant mortality burden.Accounting for nearly 30%of premature deaths globally,cancer is a major barrier to increasing human life expectancy[6,7].The urgent need for continued research,innovation,and collaborative efforts highlights the importance of combating this relentless disease.

Meta-analysis of Barrett's esophagus in China

AIM: To investigate the epidemiology and characteristics of Barrett&#x02019;s esophagus (BE) in China and compare with cases in the west.

Analysis of Clinicopathologic Features of Esophageal Carcinoma Patients Undergoing Surgery-a Report of 4,329 Cases

OBJECTIVE To investigate the clinicopathological features of esophageal carcinoma （EC） patients, and to analyze epidemiologic characteristics and the current situation of esophageal cancioma in the southern area of Hebei Province. METHODS A total of 4329 patients with esophageal cancinoma, undergoing surgery in the Fourth Hospital of Hebei Medical University during a period from January 1996 to December 2005, were selected. Collection and statistical analysis of the pathologic data were performed using a SAS 6.0 software package. RESULTS Over the past ten years, there has been a tendency for an increase in the mean age of EC onset （P 〈 0.05）, a downtrend in the percentage of squamous cancer （SqCa） （P 〈 0.05） and an uptrend in the frequency of small cell carcinoma （P 〈 0.05）. In clinical stages, there was a drop in the percentage of Stage-Ⅱ squamous EC patients （P 〈 0.05）, and an increase in that of Stage-Ⅳ patients （P 〈 0.05）. There were statistical differences in sex, age, pathologic types, depth of infiltration, ratio of stages and lymph node metastasis, etc. among the superior, middle and inferior segments of the EC diseased region （P 〈 0.05）. CONCLUSION It was relatively late for the EC patients from this area to see a doctor, resulting in a drop in the ratio of SqCa and an ascensus in that of small cell cancer. However, due to a low incidence of adenocarcinoma, no obvious ascending tendency was found in the frequency of this carcinoma over the past ten years.

Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020

Background:Cancer is one of the leading causes of death globally,but its burden is not uniform.GLOBOCAN 2020 has newly updated the estimates of cancer burden.This study summarizes the most recent changing profiles of cancer burden worldwide and in China and compares the cancer data of China with those of other regions.Methods:We conducted a descriptive secondary analysis of the GLOBOCAN 2020 data.To depict the changing global profile of the leading cancer types in 2020 compared with 2018,we extracted the numbers of cases and deaths in 2018 from GLOBOCAN 2018.We also obtained cancer incidence and mortality from the 2015 National Cancer Registry Report in China when sorting the leading cancer types by new cases and deaths.For the leading cancer types according to sex in China,we summarized the estimated numbers of incidence and mortality,and calculated China’s percentage of the global new cases and deaths.Results:Breast cancer displaced lung cancer to become the most leading diagnosed cancer worldwide in 2020.Lung,liver,stomach,breast,and colon cancers were the top five leading causes of cancer-related death,among which liver cancer changed from the third-highest cancer mortality in 2018 to the second-highest in 2020.China accounted for 24%of newly diagnosed cases and 30%of the cancer-related deaths worldwide in 2020.Among the 185 countries included in the database,China’s age-standardized incidence rate(204.8 per 100,000)ranked 65th and the age-standardized mortality rate(129.4 per 100,000)ranked 13th.The two rates were above the global average.Lung cancer remained the most common cancer type and the leading cause of cancer death in China.However,breast cancer became the most frequent cancer type among women if the incidence was stratified by sex.Incidences of colorectal cancer and breast cancer increased rapidly.The leading causes of cancer death varied minimally in ranking from 2015 to 2020 in China.Gastrointestinal cancers,including stomach,colorectal,liver,and esophageal cancers,contributed to a massive burden of cancer for both sexes.Conclusions:The burden of breast cancer is increasing globally.China is undergoing cancer transition with an increasing burden of lung cancer,gastrointestinal cancer,and breast cancers.The mortality rate of cancer in China is high.Comprehensive strategies are urgently needed to target China’s changing profiles of the cancer burden.

High Spicy Food Intake and Risk of Cancer： A Meta-analysis of Case-control Studies

Background：Studies on the association between spicy food intake and cancer risk have reported inconsistent results.We quantitatively assessed this association by conducting a meta-analysis based on evidence from case-control studies.Methods：PubMed,EMBASE,and the Cochrane Library were searched for eligible publications.Combined odds ratios （ORs） with their 95% confidence interval （CI） were calculated using a random-or fixed-effects model.The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale （NOS）.All data were analyzed using STATA 1 1.0 software （version 11.0;StataCorp.,College Station,TX,USA）.Subgroup analyses were also performed with stratification by region,sex,number of cases,cancer subtype,source of the control group,and NOS score.Results：A total 39 studies from 28 articles fulfilled the inclusion criteria for the meta-analysis （7884 patients with cancer and 10,142 controls）.Comparison of the highest versus lowest exposure category in each study revealed a significant OR of 1.76 （95% CI =1.35-2.29） in spite of significant heterogeneity （P 〈 0.00l）.In the subgroup analyses,this positive correlation was still found for gastric cancer,different regions,different numbers of cases,different sources of the control group,and high-quality articles （NOS score of≥ 7）.However,no statistically significant association was observed for women,esophageal cancer,gallbladder cancer,or low-quality articles （NOS score of〈7）.No evidence of publication bias was found.Conclusions：Evidence from case-control studies suggested that a higher level of spicy food intake may be associated with an increased incidence of cancer despite significant heterogeneity.More studies are warranted to clarify our understanding of the association between high spicy food intake and the risk of cancer.