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General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition

Steffen, Annika; Huerta, Jose-Maria; Weiderpass, Elisabete; Bueno-de-Mesquita, H. B(As); May, Anne M.; Siersema, Peter D.; Kaaks, Rudolf; Neamat-Allah, Jasmine; Pala, Valeria and Panico, Salvatore, et al. (2015) In International Journal of Cancer 137(3). p.646-657
Abstract
General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumference (WC), relates to these cancers remains largely unexplored. Using measured anthropometric data from 391,456 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) study and 11 years of follow-up, we comprehensively assessed the association of anthropometric measures with risk of EAC, GCC and GNCC using multivariable proportional hazards regression. One hundred twenty-four incident EAC, 193 GCC and 224 GNCC... (More)
General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumference (WC), relates to these cancers remains largely unexplored. Using measured anthropometric data from 391,456 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) study and 11 years of follow-up, we comprehensively assessed the association of anthropometric measures with risk of EAC, GCC and GNCC using multivariable proportional hazards regression. One hundred twenty-four incident EAC, 193 GCC and 224 GNCC were accrued. After mutual adjustment, BMI was unrelated to EAC, while WC showed a strong positive association (highest vs. lowest quintile HR=1.19; 95% CI, 0.63-2.22 and HR=3.76; 1.72-8.22, respectively). Hip circumference (HC) was inversely related to EAC after controlling for WC, while WC remained positively associated (HR=0.35; 0.18-0.68, and HR=4.10; 1.94-8.63, respectively). BMI was not associated with GCC or GNCC. WC was related to higher risks of GCC after adjustment for BMI and more strongly after adjustment for HC (highest vs. lowest quintile HR=1.91; 1.09-3.37, and HR=2.23; 1.28-3.90, respectively). Our study demonstrates that abdominal, rather than general, obesity is an indisputable risk factor for EAC and also provides evidence for a protective effect of gluteofemoral (subcutaneous) adipose tissue in EAC. Our study further shows that general obesity is not a risk factor for GCC and GNCC, while the role of abdominal obesity in GCC needs further investigation. What's new? While mainly general obesity, as measured by body mass index, has been investigated in relation to gastric and esophageal cancer, the effect of a large waist on these cancer sites is unknown. In this article, the authors report results of extensive analysis of measured anthropometry, including measures of general (BMI) and abdominal obesity (waist circumference), collected by the European Prospective Investigation into Cancer and Nutrition (EPIC). They show that general obesity is not a risk factor for esophageal and gastric cancer, while waist circumference strongly increases risk of esophageal cancer and may potentially be related to gastric cardia cancer. (Less)
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keywords
general obesity, abdominal obesity, body mass index, waist, circumference, gastric cancer, esophageal cancer
in
International Journal of Cancer
volume
137
issue
3
pages
646 - 657
publisher
John Wiley & Sons
external identifiers
  • wos:000354639200017
  • scopus:84929508529
ISSN
0020-7136
DOI
10.1002/ijc.29432
language
English
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yes
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f1dd5c4a-08d3-48d8-a5f2-4e7862ed3045 (old id 7411411)
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2015-07-03 07:03:11
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2017-10-22 03:05:35
@article{f1dd5c4a-08d3-48d8-a5f2-4e7862ed3045,
  abstract     = {General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumference (WC), relates to these cancers remains largely unexplored. Using measured anthropometric data from 391,456 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) study and 11 years of follow-up, we comprehensively assessed the association of anthropometric measures with risk of EAC, GCC and GNCC using multivariable proportional hazards regression. One hundred twenty-four incident EAC, 193 GCC and 224 GNCC were accrued. After mutual adjustment, BMI was unrelated to EAC, while WC showed a strong positive association (highest vs. lowest quintile HR=1.19; 95% CI, 0.63-2.22 and HR=3.76; 1.72-8.22, respectively). Hip circumference (HC) was inversely related to EAC after controlling for WC, while WC remained positively associated (HR=0.35; 0.18-0.68, and HR=4.10; 1.94-8.63, respectively). BMI was not associated with GCC or GNCC. WC was related to higher risks of GCC after adjustment for BMI and more strongly after adjustment for HC (highest vs. lowest quintile HR=1.91; 1.09-3.37, and HR=2.23; 1.28-3.90, respectively). Our study demonstrates that abdominal, rather than general, obesity is an indisputable risk factor for EAC and also provides evidence for a protective effect of gluteofemoral (subcutaneous) adipose tissue in EAC. Our study further shows that general obesity is not a risk factor for GCC and GNCC, while the role of abdominal obesity in GCC needs further investigation. What's new? While mainly general obesity, as measured by body mass index, has been investigated in relation to gastric and esophageal cancer, the effect of a large waist on these cancer sites is unknown. In this article, the authors report results of extensive analysis of measured anthropometry, including measures of general (BMI) and abdominal obesity (waist circumference), collected by the European Prospective Investigation into Cancer and Nutrition (EPIC). They show that general obesity is not a risk factor for esophageal and gastric cancer, while waist circumference strongly increases risk of esophageal cancer and may potentially be related to gastric cardia cancer.},
  author       = {Steffen, Annika and Huerta, Jose-Maria and Weiderpass, Elisabete and Bueno-de-Mesquita, H. B(As) and May, Anne M. and Siersema, Peter D. and Kaaks, Rudolf and Neamat-Allah, Jasmine and Pala, Valeria and Panico, Salvatore and Saieva, Calogero and Tumino, Rosario and Naccarati, Alessio and Dorronsoro, Miren and Sanchez-Cantalejo, Emilio and Ardanaz, Eva and Ramon Quiros, J. and Ohlsson, Bodil and Johansson, Mattias and Wallner, Bengt and Overvad, Kim and Halkjaer, Jytte and Tjonneland, Anne and Fagherazzi, Guy and Racine, Antoine and Clavel-Chapelon, Francoise and Key, Tim J. and Khaw, Kay-Tee and Wareham, Nick and Lagiou, Pagona and Bamia, Christina and Trichopoulou, Antonia and Ferrari, Pietro and Freisling, Heinz and Lu, Yunxia and Riboli, Elio and Cross, Amanda J. and Gonzalez, Carlos A. and Boeing, Heiner},
  issn         = {0020-7136},
  keyword      = {general obesity,abdominal obesity,body mass index,waist,circumference,gastric cancer,esophageal cancer},
  language     = {eng},
  number       = {3},
  pages        = {646--657},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition},
  url          = {http://dx.doi.org/10.1002/ijc.29432},
  volume       = {137},
  year         = {2015},
}