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A prospective cohort study of obesity and risk of oesophageal and gastric adenocarcinoma in the NIH-AARP Diet and Health Study.

Abstract

OBJECTIVE

The incidence of oesophageal adenocarcinoma (EAC) has increased rapidly over the past 40 years and accumulating evidence suggests that obesity, as measured by body mass index (BMI), is a major risk factor. It remains unclear whether abdominal obesity is associated with EAC and gastric adenocarcinoma.

DESIGN

Cox proportional hazards regression was used to examine associations between overall and abdominal obesity with EAC and gastric adenocarcinoma among 218 854 participants in the prospective NIH-AARP cohort.

RESULTS

253 incident EAC, 191 gastric cardia adenocarcinomas and 125 gastric non-cardia adenocarcinomas accrued to the cohort. Overall obesity (BMI) was positively associated with EAC and gastric cardia adenocarcinoma risk (highest (≥35 kg/m(2)) vs referent (18.5-<25 kg/m(2)); HR 2.11, 95% CI 1.09 to 4.09 and HR 3.67, 95% CI 2.00 to 6.71, respectively). Waist circumference was also positively associated with EAC and gastric cardia adenocarcinoma risk (highest vs referent; HR 2.01, 95% CI 1.35 to 3.00 and HR 2.22, 95% CI 1.43 to 3.47, respectively), whereas waist-to-hip ratio (WHR) was positively associated with EAC risk only (highest vs referent; HR 1.81, 95% CI 1.24 to 2.64) and persisted in patients with normal BMI (18.5-<25 kg/m(2)). Mutual adjustment of WHR and BMI attenuated both, but did not eliminate the positive associations for either with risk of EAC. In contrast, the majority of the anthropometric variables were not associated with adenocarcinomas of the gastric non-cardia.

CONCLUSION

Overall obesity was associated with a higher risk of EAC and gastric cardia adenocarcinoma, whereas abdominal obesity was found to be associated with increased EAC risk; even in people with normal BMI.

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  • Authors+Show Affiliations

    ,

    Cancer Epidemiology Health Services Research Group, Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland, UK. m.odoherty@qub.ac.uk

    , , ,

    Source

    Gut 61:9 2012 Sep pg 1261-8

    MeSH

    Adenocarcinoma
    Aged
    Body Mass Index
    Cohort Studies
    Esophageal Neoplasms
    Female
    Follow-Up Studies
    Humans
    Incidence
    Male
    Middle Aged
    National Institutes of Health (U.S.)
    Obesity, Abdominal
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Stomach Neoplasms
    Surveys and Questionnaires
    United States
    Waist Circumference
    Waist-Hip Ratio

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    22174193

    Citation

    O'Doherty, Mark G., et al. "A Prospective Cohort Study of Obesity and Risk of Oesophageal and Gastric Adenocarcinoma in the NIH-AARP Diet and Health Study." Gut, vol. 61, no. 9, 2012, pp. 1261-8.
    O'Doherty MG, Freedman ND, Hollenbeck AR, et al. A prospective cohort study of obesity and risk of oesophageal and gastric adenocarcinoma in the NIH-AARP Diet and Health Study. Gut. 2012;61(9):1261-8.
    O'Doherty, M. G., Freedman, N. D., Hollenbeck, A. R., Schatzkin, A., & Abnet, C. C. (2012). A prospective cohort study of obesity and risk of oesophageal and gastric adenocarcinoma in the NIH-AARP Diet and Health Study. Gut, 61(9), pp. 1261-8. doi:10.1136/gutjnl-2011-300551.
    O'Doherty MG, et al. A Prospective Cohort Study of Obesity and Risk of Oesophageal and Gastric Adenocarcinoma in the NIH-AARP Diet and Health Study. Gut. 2012;61(9):1261-8. PubMed PMID: 22174193.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A prospective cohort study of obesity and risk of oesophageal and gastric adenocarcinoma in the NIH-AARP Diet and Health Study. AU - O'Doherty,Mark G, AU - Freedman,Neal D, AU - Hollenbeck,Albert R, AU - Schatzkin,Arthur, AU - Abnet,Christian C, Y1 - 2011/12/15/ PY - 2011/12/17/entrez PY - 2011/12/17/pubmed PY - 2012/11/7/medline SP - 1261 EP - 8 JF - Gut JO - Gut VL - 61 IS - 9 N2 - OBJECTIVE: The incidence of oesophageal adenocarcinoma (EAC) has increased rapidly over the past 40 years and accumulating evidence suggests that obesity, as measured by body mass index (BMI), is a major risk factor. It remains unclear whether abdominal obesity is associated with EAC and gastric adenocarcinoma. DESIGN: Cox proportional hazards regression was used to examine associations between overall and abdominal obesity with EAC and gastric adenocarcinoma among 218 854 participants in the prospective NIH-AARP cohort. RESULTS: 253 incident EAC, 191 gastric cardia adenocarcinomas and 125 gastric non-cardia adenocarcinomas accrued to the cohort. Overall obesity (BMI) was positively associated with EAC and gastric cardia adenocarcinoma risk (highest (≥35 kg/m(2)) vs referent (18.5-<25 kg/m(2)); HR 2.11, 95% CI 1.09 to 4.09 and HR 3.67, 95% CI 2.00 to 6.71, respectively). Waist circumference was also positively associated with EAC and gastric cardia adenocarcinoma risk (highest vs referent; HR 2.01, 95% CI 1.35 to 3.00 and HR 2.22, 95% CI 1.43 to 3.47, respectively), whereas waist-to-hip ratio (WHR) was positively associated with EAC risk only (highest vs referent; HR 1.81, 95% CI 1.24 to 2.64) and persisted in patients with normal BMI (18.5-<25 kg/m(2)). Mutual adjustment of WHR and BMI attenuated both, but did not eliminate the positive associations for either with risk of EAC. In contrast, the majority of the anthropometric variables were not associated with adenocarcinomas of the gastric non-cardia. CONCLUSION: Overall obesity was associated with a higher risk of EAC and gastric cardia adenocarcinoma, whereas abdominal obesity was found to be associated with increased EAC risk; even in people with normal BMI. SN - 1468-3288 UR - https://www.unboundmedicine.com/medline/citation/22174193/A_prospective_cohort_study_of_obesity_and_risk_of_oesophageal_and_gastric_adenocarcinoma_in_the_NIH_AARP_Diet_and_Health_Study_ L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&amp;pmid=22174193 DB - PRIME DP - Unbound Medicine ER -