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Anthropometric and reproductive factors and risk of esophageal and gastric cancer by subtype and subsite: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

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Title: Anthropometric and reproductive factors and risk of esophageal and gastric cancer by subtype and subsite: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort
Authors: Sanikini, H
Muller, DC
Sophiea, M
Rinaldi, S
Agudo, A
Duell, EJ
Weiderpass, E
Overvad, K
Tjønneland, A
Halkjaer, J
Boutron-Ruault, M-C
Carbonnel, F
Cervenka, I
Boeing, H
Kaaks, R
Kühn, T
Trichopoulou, A
Martimianaki, G
Karakatsani, A
Pala, V
Palli, D
Mattiello, A
Tumino, R
Sacerdote, C
Skeie, G
Rylander, C
López, MDC
Sánchez, M-J
Ardanaz, E
Regnér, S
Stocks, T
Bueno-de-Mesquita, B
Vermeulen, RCH
Aune, D
Tong, TYN
Kliemann, N
Murphy, N
Chadeau-Hyam, M
Gunter, MJ
Cross, AJ
Item Type: Journal Article
Abstract: Obesity has been associated with upper gastrointestinal cancers; however, there are limited prospective data on associations by subtype/subsite. Obesity can impact hormonal factors, which have been hypothesized to play a role in these cancers. We investigated anthropometric and reproductive factors in relation to esophageal and gastric cancer by subtype and subsite for 476,160 participants from the European Prospective Investigation into Cancer and Nutrition cohort. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox models. During a mean follow‐up of 14 years, 220 esophageal adenocarcinomas (EA), 195 esophageal squamous cell carcinomas, 243 gastric cardia (GC) and 373 gastric noncardia (GNC) cancers were diagnosed. Body mass index (BMI) was associated with EA in men (BMI ≥30 vs. 18.5–25 kg/m2: HR = 1.94, 95% CI: 1.25–3.03) and women (HR = 2.66, 95% CI: 1.15–6.19); however, adjustment for waist‐to‐hip ratio (WHR) attenuated these associations. After mutual adjustment for BMI and HC, respectively, WHR and waist circumference (WC) were associated with EA in men (HR = 3.47, 95% CI: 1.99–6.06 for WHR >0.96 vs. <0.91; HR = 2.67, 95% CI: 1.52–4.72 for WC >98 vs. <90 cm) and women (HR = 4.40, 95% CI: 1.35–14.33 for WHR >0.82 vs. <0.76; HR = 5.67, 95% CI: 1.76–18.26 for WC >84 vs. <74 cm). WHR was also positively associated with GC in women, and WC was positively associated with GC in men. Inverse associations were observed between parity and EA (HR = 0.38, 95% CI: 0.14–0.99; >2 vs. 0) and age at first pregnancy and GNC (HR = 0.54, 95% CI: 0.32–0.91; >26 vs. <22 years); whereas bilateral ovariectomy was positively associated with GNC (HR = 1.87, 95% CI: 1.04–3.36). These findings support a role for hormonal pathways in upper gastrointestinal cancers.
Issue Date: 3-May-2019
Date of Acceptance: 28-Mar-2019
URI: http://hdl.handle.net/10044/1/69857
DOI: https://dx.doi.org/10.1002/ijc.32386
ISSN: 0020-7136
Publisher: Wiley
Journal / Book Title: International Journal of Cancer
Copyright Statement: © 2019 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Sponsor/Funder: Cancer Research UK
Funder's Grant Number: 20189
Keywords: Obesity
cancer
esophageal
gastric
hormones
reproductive
Oncology & Carcinogenesis
1112 Oncology and Carcinogenesis
Publication Status: Published online
Online Publication Date: 2019-05-03
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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