Dysphagia in Endoscopic Practice: Etiologies and Factors Associated with Esophageal Cancer in Bouaké (Côte d’Ivoire)

Abstract

Objective: To determine the etiologies of dysphagia and identify factors associated with the occurrence of esophageal cancer in Bouaké. Methods: This was a retrospective descriptive and analytical study conducted over a five-year period in three digestive endoscopy centers in Bouaké. All patients aged over 18 years who underwent upper gastrointestinal endoscopy for dysphagia were included. Sociodemographic, clinical, and endoscopic data were collected and analyzed using SPSS software. Univariate analysis followed by multivariate logistic regression was performed to identify factors associated with esophageal cancer, with a significance level set at p < 0.05. Results: A total of 163 patients were included out of 6,183 endoscopies performed, corresponding to a prevalence of 2.6%. The mean age was 49.8 ± 17.6 years, with a male predominance (54%). Inflammatory lesions were the most common etiology (21.5%), followed by esophageal cancer (15.3%). Esophageal cancer was significantly associated with age ≥ 50 years (adjusted OR = 6.84; 95% CI: 1.82 - 25.68; p = 0.004), smoking (adjusted OR = 3.91; 95% CI: 1.36 - 11.21; p = 0.011), and undernutrition (adjusted OR = 2.87; 95% CI: 1.08 - 7.63; p = 0.034). Alcohol consumption was not independently associated after adjustment. Conclusion: Dysphagia is mainly caused by inflammatory conditions but remains frequently associated with esophageal cancer. Age, smoking, and poor nutritional status appear to be major factors associated with esophageal cancer. These findings highlight the importance of early upper gastrointestinal endoscopy in patients presenting with dysphagia, particularly in the presence of risk factors.