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One suspected promoter is a group of minuscule needle\u2010shaped glass fragments as outgrowths on edible weeds, millet bran, and wheat bracts, which in a bolus of food could scarify a narrowed gullet in high\u2010risk regions of South Africa, Iran, and northern China. Repeated injuries and chronic inflammation of esophageal epithelium caused by these glass needles are analogous to cosmetic micro\u2010needling in dermatology\u2010stimulating collagen and elastin via wound\u2010healing cascades. While tumors can be unhealed wounds and siliceous \u201cmicro\u2010needles\u201d from wheat bracts have been linked to the high ESCC risk in wheat\u2010based eaters in semi\u2010arid northern China, we here report abundant needle\u2010shaped diatom frustules (siliceous cell walls of diatoms, aka \u201cglass boxes\u201d) in trash fish\u2010related food samples from high\u2010ESCC regions of coastal southeastern China. Through a preliminary feeding trial conducted\u00a0on rats, we found that needle\u2010shaped diatom frustules may be more likely to lodge in the esophageal epithelium of rodents than round\u2010shaped ones. Diatom needle contaminants in the diet may underlie the ESCC epidemic in coastal southeastern China, where dietary culture allows the guts of trash fish to enter human food.<\/jats:p>","DOI":"10.1002\/ijc.70394","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:05:22Z","timestamp":1772996722000},"page":"2822-2828","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Needle\u2010shaped diatom frustules in food as a possible promoter of esophageal squamous cell carcinoma in coastal southeastern China: A pilot study"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4011-0704","authenticated-orcid":false,"given":"Haisheng","family":"Wu","sequence":"first","affiliation":[{"name":"School of Public Health The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Ran","sequence":"additional","affiliation":[{"name":"Key Laboratory of Marine Ecosystem Dynamics, Second Institute of Oceanography Ministry of Natural Resources  Hangzhou Zhejiang China"},{"name":"State Key Laboratory of Satellite Ocean Environment Dynamics Second Institute of Oceanography, Ministry of Natural Resources  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiying","family":"Xia","sequence":"additional","affiliation":[{"name":"Key Laboratory of Marine Ecosystem Dynamics, Second Institute of Oceanography Ministry of Natural Resources  Hangzhou Zhejiang 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Wheat Research, State Key Laboratory of Sustainable Dryland Agriculture Shanxi Agricultural University  Linfen Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huachen","family":"Zhu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Emerging Infectious Diseases The University of Hong Kong  Hong Kong SAR China"},{"name":"Joint Institute of Virology (Shantou University and The University of Hong Kong), Guangdong\u2010Hongkong Joint Laboratory of Emerging Infectious Diseases Shantou University  Shantou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linwei","family":"Tian","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-021-00928-6"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-021-00958-0"},{"issue":"11","key":"e_1_2_11_4_1","first-page":"2390","article-title":"The effects of soil and diet on disease","volume":"28","author":"Rose EF","year":"1968","journal-title":"Cancer Res"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910260514"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(82)92335-2"},{"key":"e_1_2_11_7_1","first-page":"214","article-title":"Silica and oesophageal cancer","volume":"121","author":"O'Neill C","year":"1986","journal-title":"Ciba Found 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