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Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort

Lu, Yunxia; Cross, Amanda J.; Murphy, Neil; Freisling, Heinz; Travis, Ruth C.; Ferrari, Pietro; Katzke, Verena A.; Kaaks, Rudolf; Olsson, Åsa LU and Johansson, Ingegerd, et al. (2016) In Cancer Causes and Control 27(7). p.919-927
Abstract

Background: The etiology of small intestinal cancer (SIC) is largely unknown, and there are very few epidemiological studies published to date. No studies have investigated abdominal adiposity in relation to SIC. Methods: We investigated overall obesity and abdominal adiposity in relation to SIC in the European Prospective Investigation into Cancer and Nutrition (EPIC), a large prospective cohort of approximately half a million men and women from ten European countries. Overall obesity and abdominal obesity were assessed by body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Multivariate Cox proportional hazards regression modeling was performed to estimate... (More)

Background: The etiology of small intestinal cancer (SIC) is largely unknown, and there are very few epidemiological studies published to date. No studies have investigated abdominal adiposity in relation to SIC. Methods: We investigated overall obesity and abdominal adiposity in relation to SIC in the European Prospective Investigation into Cancer and Nutrition (EPIC), a large prospective cohort of approximately half a million men and women from ten European countries. Overall obesity and abdominal obesity were assessed by body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Multivariate Cox proportional hazards regression modeling was performed to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). Stratified analyses were conducted by sex, BMI, and smoking status. Results: During an average of 13.9 years of follow-up, 131 incident cases of SIC (including 41 adenocarcinomas, 44 malignant carcinoid tumors, 15 sarcomas and 10 lymphomas, and 21 unknown histology) were identified. WC was positively associated with SIC in a crude model that also included BMI (HR per 5-cm increase = 1.20, 95 % CI 1.04, 1.39), but this association attenuated in the multivariable model (HR 1.18, 95 % CI 0.98, 1.42). However, the association between WC and SIC was strengthened when the analysis was restricted to adenocarcinoma of the small intestine (multivariable HR adjusted for BMI = 1.56, 95 % CI 1.11, 2.17). There were no other significant associations. Conclusion: WC, rather than BMI, may be positively associated with adenocarcinomas but not carcinoid tumors of the small intestine. Impact: Abdominal obesity is a potential risk factor for adenocarcinoma in the small intestine.

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@article{30caa6cb-bfba-407b-91ee-18c05442da9a,
  abstract     = {<p>Background: The etiology of small intestinal cancer (SIC) is largely unknown, and there are very few epidemiological studies published to date. No studies have investigated abdominal adiposity in relation to SIC. Methods: We investigated overall obesity and abdominal adiposity in relation to SIC in the European Prospective Investigation into Cancer and Nutrition (EPIC), a large prospective cohort of approximately half a million men and women from ten European countries. Overall obesity and abdominal obesity were assessed by body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Multivariate Cox proportional hazards regression modeling was performed to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). Stratified analyses were conducted by sex, BMI, and smoking status. Results: During an average of 13.9 years of follow-up, 131 incident cases of SIC (including 41 adenocarcinomas, 44 malignant carcinoid tumors, 15 sarcomas and 10 lymphomas, and 21 unknown histology) were identified. WC was positively associated with SIC in a crude model that also included BMI (HR per 5-cm increase = 1.20, 95 % CI 1.04, 1.39), but this association attenuated in the multivariable model (HR 1.18, 95 % CI 0.98, 1.42). However, the association between WC and SIC was strengthened when the analysis was restricted to adenocarcinoma of the small intestine (multivariable HR adjusted for BMI = 1.56, 95 % CI 1.11, 2.17). There were no other significant associations. Conclusion: WC, rather than BMI, may be positively associated with adenocarcinomas but not carcinoid tumors of the small intestine. Impact: Abdominal obesity is a potential risk factor for adenocarcinoma in the small intestine.</p>},
  author       = {Lu, Yunxia and Cross, Amanda J. and Murphy, Neil and Freisling, Heinz and Travis, Ruth C. and Ferrari, Pietro and Katzke, Verena A. and Kaaks, Rudolf and Olsson, Åsa and Johansson, Ingegerd and Renström, Frida and Panico, Salvatore and Pala, Valeria and Palli, Domenico and Tumino, Rosario and Peeters, Petra H. and Siersema, Peter D. and Bueno-de-Mesquita, H. B. and Trichopoulou, Antonia and Klinaki, Eleni and Tsironis, Christos and Agudo, Antonio and Navarro, Carmen and Sánchez, María José and Barricarte, Aurelio and Boutron-Ruault, Marie Christine and Fagherazzi, Guy and Racine, Antoine and Weiderpass, Elisabete and Gunter, Marc J. and Riboli, Elio},
  issn         = {0957-5243},
  keyword      = {Abdominal obesity,Cancer,Obesity,Small intestine},
  language     = {eng},
  month        = {07},
  number       = {7},
  pages        = {919--927},
  publisher    = {Springer},
  series       = {Cancer Causes and Control},
  title        = {Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort},
  url          = {http://dx.doi.org/10.1007/s10552-016-0772-z},
  volume       = {27},
  year         = {2016},
}