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Anthropometry and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition

Steffen, Annika; Schulze, Matthias B.; Pischon, Tobias; Dietrich, Thomas; Molina, Esther; Chirlaque, Maria-Dolores; Barricarte, Aurelio; Amiano, Pilar; Quiros, J. Ramon and Tumino, Rosario, et al. (2009) In Cancer Epidemiology Biomarkers & Prevention 18(7). p.2079-2089
Abstract
Background: Increasing evidence suggests that general obesity [measured by body mass index (BMI)] is positively associated with risk of esophageal adenocarcinoma (EAC). In contrast, previous studies have shown inverse relations with esophageal squamous cell carcinoma (ESCC). However, it is still unclear whether body fat distribution, particularly abdominal obesity, is associated with each type of esophageal cancer. Methods: We applied multivariable adjusted Cox proportional hazards regression to investigate the association between anthropometric measures and risk of EAC and ESCC among 346,554 men and women participating in the European Prospective Investigation into Cancer and Nutrition. All statistical tests were two sided. Results:... (More)
Background: Increasing evidence suggests that general obesity [measured by body mass index (BMI)] is positively associated with risk of esophageal adenocarcinoma (EAC). In contrast, previous studies have shown inverse relations with esophageal squamous cell carcinoma (ESCC). However, it is still unclear whether body fat distribution, particularly abdominal obesity, is associated with each type of esophageal cancer. Methods: We applied multivariable adjusted Cox proportional hazards regression to investigate the association between anthropometric measures and risk of EAC and ESCC among 346,554 men and women participating in the European Prospective Investigation into Cancer and Nutrition. All statistical tests were two sided. Results: During 8.9 years of follow-up, we documented 88 incident cases of EAC and 110 cases of ESCC. BMI, waist circumference, and waist-to-hip ratio (WHR) were positively associated with EAC risk [highest versus lowest quintile; relative risk (RR), 2.60; 95% confidence interval (95% CI), 1.23-5.51; P-trend < 0.01; RR, 3.07; 95% CI, 1.35-6.98; P-trend < 0.003; and RR, 2.12; 95% CI, 0.98-4.57; P-trend < 0.004]. In contrast, BMI and waist circumference were inversely related to ESCC risk, whereas WHR showed no association with ESCC. In stratified analyses, BMI and waist circumference were significantly inversely related to ESCC only among smokers but not among nonsmokers. However, when controlled for BMI, we found positive associations for waist circumference and WHR with ESCC, and these associations were observed among smokers and nonsmokers. Conclusion: General and abdominal obesity were associated with higher EAC risk. Further, our study suggests that particularly an abdominal body fat distribution might also be a risk factor for ESCC. (Cancer Epidemiol Biomarkers Prev 2009;18(7):2079-89) (Less)
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Cancer Epidemiology Biomarkers & Prevention
volume
18
issue
7
pages
2079 - 2089
publisher
American Association for Cancer Research
external identifiers
  • wos:000268059700020
  • scopus:67650541572
ISSN
1538-7755
DOI
10.1158/1055-9965.EPI-09-0265
language
English
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yes
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a5d34d86-dc20-49bf-9c28-5606232ecda8 (old id 1461760)
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2009-08-31 11:04:33
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2017-10-29 03:45:50
@article{a5d34d86-dc20-49bf-9c28-5606232ecda8,
  abstract     = {Background: Increasing evidence suggests that general obesity [measured by body mass index (BMI)] is positively associated with risk of esophageal adenocarcinoma (EAC). In contrast, previous studies have shown inverse relations with esophageal squamous cell carcinoma (ESCC). However, it is still unclear whether body fat distribution, particularly abdominal obesity, is associated with each type of esophageal cancer. Methods: We applied multivariable adjusted Cox proportional hazards regression to investigate the association between anthropometric measures and risk of EAC and ESCC among 346,554 men and women participating in the European Prospective Investigation into Cancer and Nutrition. All statistical tests were two sided. Results: During 8.9 years of follow-up, we documented 88 incident cases of EAC and 110 cases of ESCC. BMI, waist circumference, and waist-to-hip ratio (WHR) were positively associated with EAC risk [highest versus lowest quintile; relative risk (RR), 2.60; 95% confidence interval (95% CI), 1.23-5.51; P-trend &lt; 0.01; RR, 3.07; 95% CI, 1.35-6.98; P-trend &lt; 0.003; and RR, 2.12; 95% CI, 0.98-4.57; P-trend &lt; 0.004]. In contrast, BMI and waist circumference were inversely related to ESCC risk, whereas WHR showed no association with ESCC. In stratified analyses, BMI and waist circumference were significantly inversely related to ESCC only among smokers but not among nonsmokers. However, when controlled for BMI, we found positive associations for waist circumference and WHR with ESCC, and these associations were observed among smokers and nonsmokers. Conclusion: General and abdominal obesity were associated with higher EAC risk. Further, our study suggests that particularly an abdominal body fat distribution might also be a risk factor for ESCC. (Cancer Epidemiol Biomarkers Prev 2009;18(7):2079-89)},
  author       = {Steffen, Annika and Schulze, Matthias B. and Pischon, Tobias and Dietrich, Thomas and Molina, Esther and Chirlaque, Maria-Dolores and Barricarte, Aurelio and Amiano, Pilar and Quiros, J. Ramon and Tumino, Rosario and Mattiello, Amalia and Palli, Domenico and Vineis, Paolo and Agnoli, Claudia and Misirli, Gesthimani and Boffetta, Paolo and Kaaks, Rudolf and Rohrmann, Sabine and Bueno-de-Mesquita, H. Bas and Peeters, Petra H. M. and May, Anne M. and Spencer, Elizabeth A. and Allen, Naomi E. and Bingham, Sheila and Tjonneland, Anne and Halkjaer, Jytte and Overvad, Kim and Stegger, Jakob and Manjer, Jonas and Lindkvist, Bjorn and Hallmanns, Goran and Stenling, Roger and Lund, Eiliv and Riboli, Elio and Gonzalez, Carlos A. and Boeing, Heiner},
  issn         = {1538-7755},
  language     = {eng},
  number       = {7},
  pages        = {2079--2089},
  publisher    = {American Association for Cancer Research},
  series       = {Cancer Epidemiology Biomarkers & Prevention},
  title        = {Anthropometry and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition},
  url          = {http://dx.doi.org/10.1158/1055-9965.EPI-09-0265},
  volume       = {18},
  year         = {2009},
}