Experimental evidence is available for red chillies which contain capsaicin, mutagenic in a bacterial test system 14,15 tumour promoting in vivo 16 . Alcohol and tobacco are known major risk factors for oesophageal cancer 17 . Earlier studies from India have identified bidi smoking, paan chewing and paan with tobacco chewing as major risk factors for oesophageal cancer 18,19 . The present study supports previous findings. Alcohol consumption is a risk factor for oesophageal cancer, in part because it has adverse effect on nutritional status for a number of reasons.
Alcohol consumption can lead to deficiency of certain micronutrients.
Certain dietary deficiencies increase the vulnerability of the oesophagus to carcinogens 20 . A mechanism by which betel quid could cause cancer is by nitrosation in the mouth of certain components of the quid to form nitrosamines. The major constituents which are likely to be involved in carcinogenesis are the alkaloids, nitrosamines which may be formed in the oral cavity from alkaloids, polyphenols and tannins. In addition, the effect of quid chewing in humans could be potentiated by malnutrition and poor oral hygiene 20 . To summarise, the present case-control study revealed significant differences in the food consumption pattern between cancer patients and controls indicating the importance of nutritional factors in the aetiology of oesophageal cancer.