Socio-economic status and lifestyle factors are associated with achalasia risk: A population-based case-control study

AIM: To evaluate the association between various lifestyle factors and achalasia risk.METHODS: A population-based case-control study was conducted in Northern Ireland, including n = 151 achalasia cases and n = 117 age- and sexmatched controls. Lifestyle factors were assessed via a face-to-face struc...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2016-04, Vol.22 (15), p.4002-4008
Main Authors: Coleman, Helen G, Gray, Ronan T, Lau, Kar W, McCaughey, Conall, Coyle, Peter V, Murray, Liam J, Johnston, Brian T
Format: Article
Language:English
Subjects:
Achalasia
Risk
Adult
Aged
Animals
Case Control Study
Case-Control Studies
Chi-Square Distribution
Esophageal Achalasia - diagnosis
Esophageal Achalasia - epidemiology
Esophageal Achalasia - prevention & control
factors
Epidemiology
Lifestyle
Socio-economic
Female
Health Status Disparities
Humans
Interviews as Topic
Life Style
Logistic Models
Male
Middle Aged
Northern Ireland - epidemiology
Occupations
Odds Ratio
Pets
Protective Factors
Risk Assessment
Risk Factors
Social Class
Socioeconomic Factors
status
Travel
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Summary:AIM: To evaluate the association between various lifestyle factors and achalasia risk.METHODS: A population-based case-control study was conducted in Northern Ireland, including n = 151 achalasia cases and n = 117 age- and sexmatched controls. Lifestyle factors were assessed via a face-to-face structured interview. The association between achalasia and lifestyle factors was assessed by unconditional logistic regression, to produce odds ratios(OR) and 95% confidence interval(CI).RESULTS: Individuals who had low-class occupations were at the highest risk of achalasia(OR = 1.88, 95%CI: 1.02-3.45), inferring that high-class occupation holders have a reduced risk of achalasia. A history of foreign travel, a lifestyle factor linked to upper socioeconomic class, was also associated with a reduced risk of achalasia(OR = 0.59, 95%CI: 0.35-0.99). Smoking and alcohol consumption carried significantly reduced risks of achalasia, even after adjustment for socio-economic status. The presence of pets in the house was associated with a two-fold increased risk of achalasia(OR = 2.00, 95%CI: 1.17-3.42). Nochildhood household factors were associated with achalasia risk.CONCLUSION: Achalasia is a disease of inequality, and individuals from low socio-economic backgrounds are at highest risk. This does not appear to be due to corresponding alcohol and smoking behaviours. An observed positive association between pet ownership and achalasia risk suggests an interaction between endotoxin and viral infection exposure in achalasia aetiology.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v22.i15.4002