Selenium in soil, grain, human hair and drinking water in relation to esophageal cancer in the Cixian area, Hebei Province, People's Republic of China

Selenium deficiency was suspected to be a factor in the aetiology of esophageal cancer in the Linxian and Cixian regions of the People’s Republic of China and vitamin trials in the Linxian area indicated that combined supplementation with β-carotene, vitamin E and Se reduced the mortality rate. In order to further evaluate the role of Se, the distribution of total Se in cultivated topsoils, grain, human hair and drinking water was studied in 15 villages in the Cixian area, People’s Republic of China, which in the 1980–1990s had one of the highest mortality rates from esophageal cancer in the world. This study demonstrated that total Se concentrations in drinking water, soil, grain and hair increase from the low esophageal cancer area to the high cancer area, contrary to the expected trend. This suggests that Se deficiency does not play a major role in the aetiology of esophageal cancer in the study area. Nitrate in drinking water is much higher in the area with high esophageal cancer mortality rate than in the low mortality rate area, and this may be a significant factor. Mycotoxins (especially fumonisin), nitrosamine and nitrosamine precursors in grain, in drinking water, and dietary β-carotene and Vitamin E remain as potential factors which need to be evaluated further.