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Risk factors for Esophageal cancer in Northeast India: A Case-Control Study (ECCS)

Study design / Type : Questionnaire based survey 

Principal Investigator
 Dr. Caleb Harris
Participating Centres
  1. North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong
  2. Civil Hospital, Shillong
  3. Cachar Cancer Hospital and Research Centre, Silchar
Number of participants
 Cases-180 to 200; Controls-3 times the cases
To be initiated 

Meghalaya has the highest incidence of Esophageal cancer in the country( more than 10 times the national AAR). This could be attributed to the high prevalence of betel nut chewing behaviour in the state. The form of betel nut used in Meghalaya is called 'kwai' and is said to be more potent than other forms used elsewhere. While betel nut(areca nut) is a known carcinogen as proven in studies done in other places, including neighboring Assam, no studies have been done on 'kwai' use and its relationship with cancer in human subjects. Pre-clinical studies have proved the role of Kwai in causing cancer. 

Since the use of Kwai is entrenched in the social milieu of Meghalaya, a case control study to pin the putative role for esophageal cancer on Kwai is essential to create awareness and to attempt a behavioural change in the society. 

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