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Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus.
Gut 2008; 57(2):173-80Gut

Abstract

OBJECTIVE

To measure the relative risks of adenocarcinomas of the oesophagus and gastro-oesophageal junction associated with measures of obesity, and their interactions with age, sex, gastro-oesophageal reflux symptoms and smoking.

DESIGN AND SETTING

Population-based case-control study in Australia.

PATIENTS

Patients with adenocarcinomas of the oesophagus (n = 367) or gastro-oesophageal junction (n = 426) were compared with control participants (n = 1580) sampled from a population register.

MAIN OUTCOME MEASURE

Relative risk of adenocarcinoma of the oesophagus or gastro-oesophageal junction.

RESULTS

Risks of oesophageal adenocarcinoma increased monotonically with body mass index (BMI) (p(trend) <0.001). Highest risks were seen for BMI >or=40 kg/m2 (odds ratio (OR) = 6.1, 95% CI 2.7 to 13.6) compared with "healthy" BMI (18.5-24.9 kg/m2). Adjustment for gastro-oesophageal reflux and other factors modestly attenuated risks. Risks associated with obesity were substantially higher among men (OR = 2.6, 95% CI 1.8 to 3.9) than women (OR = 1.4, 95% CI 0.5 to 3.5), and among those aged <50 years (OR = 7.5, 95% CI 1.7 to 33.0) than those aged >or=50 years (OR = 2.2, 95% CI 1.5 to 3.1). Obese people with frequent symptoms of gastro-oesophageal reflux had significantly higher risks (OR = 16.5, 95% CI 8.9 to 30.6) than people with obesity but no reflux (OR = 2.2, 95% CI 1.1 to 4.3) or reflux but no obesity (OR = 5.6, 95% 2.8 to 11.3), consistent with a synergistic interaction between these factors. Similar associations, but of smaller magnitude, were seen for gastro-oesophageal junction adenocarcinomas.

CONCLUSIONS

Obesity increases the risk of oesophageal adenocarcinoma independently of other factors, particularly among men. From a clinical perspective, these data suggest that patients with obesity and frequent symptoms of gastro-oesophageal reflux are at especially increased risk of adenocarcinoma.

Authors+Show Affiliations

Division of Population Studies and Human Genetics, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Queensland 4029, Australia. david.whiteman@qimr.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17932103

Citation

Whiteman, D C., et al. "Combined Effects of Obesity, Acid Reflux and Smoking On the Risk of Adenocarcinomas of the Oesophagus." Gut, vol. 57, no. 2, 2008, pp. 173-80.
Whiteman DC, Sadeghi S, Pandeya N, et al. Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus. Gut. 2008;57(2):173-80.
Whiteman, D. C., Sadeghi, S., Pandeya, N., Smithers, B. M., Gotley, D. C., Bain, C. J., ... Green, A. C. (2008). Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus. Gut, 57(2), pp. 173-80.
Whiteman DC, et al. Combined Effects of Obesity, Acid Reflux and Smoking On the Risk of Adenocarcinomas of the Oesophagus. Gut. 2008;57(2):173-80. PubMed PMID: 17932103.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus. AU - Whiteman,D C, AU - Sadeghi,S, AU - Pandeya,N, AU - Smithers,B M, AU - Gotley,D C, AU - Bain,C J, AU - Webb,P M, AU - Green,A C, AU - ,, Y1 - 2007/10/11/ PY - 2007/10/13/pubmed PY - 2008/2/13/medline PY - 2007/10/13/entrez SP - 173 EP - 80 JF - Gut JO - Gut VL - 57 IS - 2 N2 - OBJECTIVE: To measure the relative risks of adenocarcinomas of the oesophagus and gastro-oesophageal junction associated with measures of obesity, and their interactions with age, sex, gastro-oesophageal reflux symptoms and smoking. DESIGN AND SETTING: Population-based case-control study in Australia. PATIENTS: Patients with adenocarcinomas of the oesophagus (n = 367) or gastro-oesophageal junction (n = 426) were compared with control participants (n = 1580) sampled from a population register. MAIN OUTCOME MEASURE: Relative risk of adenocarcinoma of the oesophagus or gastro-oesophageal junction. RESULTS: Risks of oesophageal adenocarcinoma increased monotonically with body mass index (BMI) (p(trend) <0.001). Highest risks were seen for BMI >or=40 kg/m2 (odds ratio (OR) = 6.1, 95% CI 2.7 to 13.6) compared with "healthy" BMI (18.5-24.9 kg/m2). Adjustment for gastro-oesophageal reflux and other factors modestly attenuated risks. Risks associated with obesity were substantially higher among men (OR = 2.6, 95% CI 1.8 to 3.9) than women (OR = 1.4, 95% CI 0.5 to 3.5), and among those aged <50 years (OR = 7.5, 95% CI 1.7 to 33.0) than those aged >or=50 years (OR = 2.2, 95% CI 1.5 to 3.1). Obese people with frequent symptoms of gastro-oesophageal reflux had significantly higher risks (OR = 16.5, 95% CI 8.9 to 30.6) than people with obesity but no reflux (OR = 2.2, 95% CI 1.1 to 4.3) or reflux but no obesity (OR = 5.6, 95% 2.8 to 11.3), consistent with a synergistic interaction between these factors. Similar associations, but of smaller magnitude, were seen for gastro-oesophageal junction adenocarcinomas. CONCLUSIONS: Obesity increases the risk of oesophageal adenocarcinoma independently of other factors, particularly among men. From a clinical perspective, these data suggest that patients with obesity and frequent symptoms of gastro-oesophageal reflux are at especially increased risk of adenocarcinoma. SN - 1468-3288 UR - https://www.unboundmedicine.com/medline/citation/17932103/Combined_effects_of_obesity_acid_reflux_and_smoking_on_the_risk_of_adenocarcinomas_of_the_oesophagus_ L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&amp;pmid=17932103 DB - PRIME DP - Unbound Medicine ER -