In this issue, Mmbaga and colleagues present results of a case-control study to investigate environmental and lifestyle risk factors for esophageal cancer in Tanzania, East Africa. The results contribute to the early stage of a growing evidence base aimed to inform primary prevention of a major poor prognosis cancer in East Africa. In this commentary, we first discuss considerations needed to evaluate causality of associations, a feature needed for primary prevention. There is a need for further studies across the African esophageal cancer corridor, for more refined exposure assessment and a careful consideration of potential epidemiologic biases within study designs for real-life situations in the setting. This study also forms a prime example of the broader research needs for cancer in low- and middle-income countries and in Sub-Saharan Africa, a setting with distinct and underresearched cancers and exposure patterns. While this etiologic research is challenging, it is an essential component of the ground-shot approach to global health research needed to inform primary prevention.
McCormack, V., Kaimila, B., Mmbaga, B. T., & Schüz, J. (2021). Esophageal cancer in Tanzania: A welcome stimulus in primary prevention research. Cancer Epidemiology Biomarkers and Prevention, 30(2), 248–251. https://doi.org/10.1158/1055-9965.EPI-20-1518