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

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Title: General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition
Authors: Steffen, A
Huerta, J-M
Weiderpass, E
Bueno-de-Mesquita, HBA
May, AM
Siersema, PD
Kaaks, R
Neamat-Allah, J
Pala, V
Panico, S
Saieva, C
Tumino, R
Naccarati, A
Dorronsoro, M
Sanchez-Cantalejo, E
Ardanaz, E
Ramon Quiros, J
Ohlsson, B
Johansson, M
Wallner, B
Overvad, K
Halkjaer, J
Tjonneland, A
Fagherazzi, G
Racine, A
Clavel-Chapelon, F
Key, TJ
Khaw, K-T
Wareham, N
Lagiou, P
Bamia, C
Trichopoulou, A
Ferrari, P
Freisling, H
Lu, Y
Riboli, E
Cross, AJ
Gonzalez, CA
Boeing, H
Item Type: Journal Article
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.
Issue Date: 9-Feb-2015
Date of Acceptance: 27-Nov-2014
ISSN: 1097-0215
Publisher: Wiley
Start Page: 646
End Page: 657
Journal / Book Title: International Journal of Cancer
Volume: 137
Issue: 3
Copyright Statement: © 2015 UICC. This is the accepted version of the following article: Steffen, A., Huerta, J.-M., Weiderpass, E., Bueno-de-Mesquita, H.B(as)., May, A. M., Siersema, P. D., Kaaks, R., Neamat-Allah, J., Pala, V., Panico, S., Saieva, C., Tumino, R., Naccarati, A., Dorronsoro, M., Sánchez-Cantalejo, E., Ardanaz, E., Quirós, J. R., Ohlsson, B., Johansson, M., Wallner, B., Overvad, K., Halkjær, J., Tjønneland, A., Fagherazzi, G., Racine, A., Clavel-Chapelon, F., Key, T. J., Khaw, K.-T., Wareham, N., Lagiou, P., Bamia, C., Trichopoulou, A., Ferrari, P., Freisling, H., Lu, Y., Riboli, E., Cross, A. J., Gonzalez, C. A. and Boeing, H. (2015), General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition. Int. J. Cancer, 137: 646–657. doi:10.1002/ijc.29432, which has been published in final form at
Keywords: Science & Technology
Life Sciences & Biomedicine
general obesity
abdominal obesity
body mass index
waist circumference
gastric cancer
esophageal cancer
Body Mass Index
Body Weights and Measures
Esophageal Neoplasms
Follow-Up Studies
Middle Aged
Obesity, Abdominal
Population Surveillance
Prospective Studies
Risk Factors
Stomach Neoplasms
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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