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Anthropometric and reproductive factors and risk of esophageal and gastric cancer by subtype and subsite : Results from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Sanikini, Harinakshi; Muller, David C.; Sophiea, Marisa; Rinaldi, Sabina; Agudo, Antonio; Duell, Eric J.; Weiderpass, Elisabete; Overvad, Kim; Tjønneland, Anne and Halkjær, Jytte, et al. (2019) In International Journal of Cancer
Abstract

Obesity has been associated with upper gastrointestinal cancers; however, there are limited prospective data on associations by subtype/subsite. Obesity can impact hormonal factors, which have been hypothesized to play a role in these cancers. We investigated anthropometric and reproductive factors in relation to esophageal and gastric cancer by subtype and subsite for 476,160 participants from the European Prospective Investigation into Cancer and Nutrition cohort. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox models. During a mean follow-up of 14 years, 220 esophageal adenocarcinomas (EA), 195 esophageal squamous cell carcinomas, 243 gastric cardia (GC) and 373 gastric noncardia (GNC)... (More)

Obesity has been associated with upper gastrointestinal cancers; however, there are limited prospective data on associations by subtype/subsite. Obesity can impact hormonal factors, which have been hypothesized to play a role in these cancers. We investigated anthropometric and reproductive factors in relation to esophageal and gastric cancer by subtype and subsite for 476,160 participants from the European Prospective Investigation into Cancer and Nutrition cohort. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox models. During a mean follow-up of 14 years, 220 esophageal adenocarcinomas (EA), 195 esophageal squamous cell carcinomas, 243 gastric cardia (GC) and 373 gastric noncardia (GNC) cancers were diagnosed. Body mass index (BMI) was associated with EA in men (BMI ≥30 vs. 18.5–25 kg/m2: HR = 1.94, 95% CI: 1.25–3.03) and women (HR = 2.66, 95% CI: 1.15–6.19); however, adjustment for waist-to-hip ratio (WHR) attenuated these associations. After mutual adjustment for BMI and HC, respectively, WHR and waist circumference (WC) were associated with EA in men (HR = 3.47, 95% CI: 1.99–6.06 for WHR >0.96 vs. <0.91; HR = 2.67, 95% CI: 1.52–4.72 for WC >98 vs. <90 cm) and women (HR = 4.40, 95% CI: 1.35–14.33 for WHR >0.82 vs. <0.76; HR = 5.67, 95% CI: 1.76–18.26 for WC >84 vs. <74 cm). WHR was also positively associated with GC in women, and WC was positively associated with GC in men. Inverse associations were observed between parity and EA (HR = 0.38, 95% CI: 0.14–0.99; >2 vs. 0) and age at first pregnancy and GNC (HR = 0.54, 95% CI: 0.32–0.91; >26 vs. <22 years); whereas bilateral ovariectomy was positively associated with GNC (HR = 1.87, 95% CI: 1.04–3.36). These findings support a role for hormonal pathways in upper gastrointestinal cancers.

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epub
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keywords
cancer, esophageal, gastric, hormones, obesity, reproductive
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International Journal of Cancer
publisher
John Wiley & Sons
external identifiers
  • scopus:85066132112
ISSN
0020-7136
DOI
10.1002/ijc.32386
language
English
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yes
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0e09c420-e5ed-417d-9e76-db0c4a391c3a
date added to LUP
2019-06-18 07:50:21
date last changed
2019-07-02 04:48:29
@article{0e09c420-e5ed-417d-9e76-db0c4a391c3a,
  abstract     = {<p>Obesity has been associated with upper gastrointestinal cancers; however, there are limited prospective data on associations by subtype/subsite. Obesity can impact hormonal factors, which have been hypothesized to play a role in these cancers. We investigated anthropometric and reproductive factors in relation to esophageal and gastric cancer by subtype and subsite for 476,160 participants from the European Prospective Investigation into Cancer and Nutrition cohort. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox models. During a mean follow-up of 14 years, 220 esophageal adenocarcinomas (EA), 195 esophageal squamous cell carcinomas, 243 gastric cardia (GC) and 373 gastric noncardia (GNC) cancers were diagnosed. Body mass index (BMI) was associated with EA in men (BMI ≥30 vs. 18.5–25 kg/m<sup>2</sup>: HR = 1.94, 95% CI: 1.25–3.03) and women (HR = 2.66, 95% CI: 1.15–6.19); however, adjustment for waist-to-hip ratio (WHR) attenuated these associations. After mutual adjustment for BMI and HC, respectively, WHR and waist circumference (WC) were associated with EA in men (HR = 3.47, 95% CI: 1.99–6.06 for WHR &gt;0.96 vs. &lt;0.91; HR = 2.67, 95% CI: 1.52–4.72 for WC &gt;98 vs. &lt;90 cm) and women (HR = 4.40, 95% CI: 1.35–14.33 for WHR &gt;0.82 vs. &lt;0.76; HR = 5.67, 95% CI: 1.76–18.26 for WC &gt;84 vs. &lt;74 cm). WHR was also positively associated with GC in women, and WC was positively associated with GC in men. Inverse associations were observed between parity and EA (HR = 0.38, 95% CI: 0.14–0.99; &gt;2 vs. 0) and age at first pregnancy and GNC (HR = 0.54, 95% CI: 0.32–0.91; &gt;26 vs. &lt;22 years); whereas bilateral ovariectomy was positively associated with GNC (HR = 1.87, 95% CI: 1.04–3.36). These findings support a role for hormonal pathways in upper gastrointestinal cancers.</p>},
  author       = {Sanikini, Harinakshi and Muller, David C. and Sophiea, Marisa and Rinaldi, Sabina and Agudo, Antonio and Duell, Eric J. and Weiderpass, Elisabete and Overvad, Kim and Tjønneland, Anne and Halkjær, Jytte and Boutron-Ruault, Marie Christine and Carbonnel, Franck and Cervenka, Iris and Boeing, Heiner and Kaaks, Rudolf and Kühn, Tilman and Trichopoulou, Antonia and Martimianaki, Georgia and Karakatsani, Anna and Pala, Valeria and Palli, Domenico and Mattiello, Amalia and Tumino, Rosario and Sacerdote, Carlotta and Skeie, Guri and Rylander, Charlotta and Chirlaque López, María Dolores and Sánchez, Maria Jose and Ardanaz, Eva and Regnér, Sara and Stocks, Tanja and Bueno-de-Mesquita, Bas and Vermeulen, Roel C.H. and Aune, Dagfinn and Tong, Tammy Y.N. and Kliemann, Nathalie and Murphy, Neil and Chadeau-Hyam, Marc and Gunter, Marc J. and Cross, Amanda J.},
  issn         = {0020-7136},
  keyword      = {cancer,esophageal,gastric,hormones,obesity,reproductive},
  language     = {eng},
  month        = {05},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Anthropometric and reproductive factors and risk of esophageal and gastric cancer by subtype and subsite : Results from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort},
  url          = {http://dx.doi.org/10.1002/ijc.32386},
  year         = {2019},
}