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

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 unc...

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Published in:	Cancer epidemiology, biomarkers & prevention Vol. 18; no. 7; pp. 2079 - 2089
Main Authors:	STEFFEN, Annika, SCHULZE, Matthias B, MATTIELLO, Amalia, PALLI, Domenico, VINEIS, Paolo, AGNOLI, Claudia, MISIRLI, Gesthimani, BOFFETTA, Paolo, KAAKS, Rudolf, ROHRMANN, Sabine, BAS BUENO-DE-MESQUITA, H, PEETERS, Petra H. M, PISCHON, Tobias, MAY, Anne M, SPENCER, Elizabeth A, ALLEN, Naomi E, BINGHAM, Sheila, TJØNNELAND, Anne, HALKJAER, Jytte, OVERVAD, Kim, STEGGER, Jakob, MANJER, Jonas, LINDKVIST, Bjöm, DIETRICH, Thomas, HALLMANNS, Göran, STENLING, Roger, LUND, Eiliv, RIBOLI, Elio, GONZALEZ, Carlos A, BOEING, Heiner, MOLINA, Esther, CHIRLAQUE, Maria-Dolores, BARRICARTE, Aurelio, AMIANO, Pilar, QUIROS, J. Ramón, TUMINO, Rosario
Format:	Journal Article
Language:	English
Published:	Philadelphia, PA American Association for Cancer Research 01-07-2009
Subjects:	Adenocarcinoma - complications Adenocarcinoma - epidemiology Adult Aged Anthropometry Biological and medical sciences Body Composition Body Mass Index Cancer and Oncology Cancer och onkologi Carcinoma, Squamous Cell - complications Carcinoma, Squamous Cell - epidemiology Clinical Medicine Esophageal cancer Esophageal Neoplasms - complications Esophageal Neoplasms - epidemiology Esophagus Europe - epidemiology Feeding Behavior Female Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Humans Klinisk medicin Life Style Male Medical and Health Sciences Medical sciences Medicin och hälsovetenskap Middle Aged Obesity Obesity - epidemiology Proportional Hazards Models Prospective Studies Risk Smoking Surveys and Questionnaires Tumors Waist circumference Waist-Hip Ratio Europe Nutrition Anthropometry Esophageal disease Risk Malignant tumor European Esophagus cancer Feeding Prospective Cancerology Diet Risk factor Digestive diseases Public health Cancer
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Summary:	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)
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1055-9965 1538-7755 1538-7755
DOI:	10.1158/1055-9965.EPI-09-0265