Investigating Influence of Multiple Risk Factors on Survival Likelihood in Esophageal Cancer Patients: Evidence from Assam, North-East India

Background: To comprehend the complex interplay of multiple risk factors impacting survival at a localized level is imperative. This study aimed to explore survival patterns and identify the underlying causal factors linked to mortality risk in the region. Methodology: Data from 200 patients with esophageal cancer treated at three prominent hospitals over the course of one year is collected for the study purpose. The Kaplan‒Meier curve and Cox proportional hazard regression model were employed. Results: This study identified smokeless tobacco consumption habits showing a 6-fold elevated mortality risk (HR 6.22, p<0.001). Subsequently, cultivator (HR 4.85, p=0.001) and male gender (HR 4.24, p=0.001) showed higher mortality risk. Additionally, a significantly higher prevalence of death among smokers with comorbidity (66.0%) is found compared to smokers without comorbidity (44.1%), p=0.043. The survival probability shows a declining trend, i.e. 84.50% in the first year to 13% in the 6th year. With an 82% change, this variation was greatest between the 3rd and 4th years. Conclusions: To better understand mortality risk, certain risk factors, such as salted fish, fertilizer and pesticide exposure, and length of marriage, need to be thoroughly investigated in future studies due to limited knowledge about this exposure at a localized level.