TY - JOUR
T1 - Anthropometric and reproductive factors and risk of esophageal and gastric cancer by subtype and subsite
T2 - Results from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort
AU - Sanikini, Harinakshi
AU - Muller, David C.
AU - Sophiea, Marisa
AU - Rinaldi, Sabina
AU - Agudo, Antonio
AU - Duell, Eric J.
AU - Weiderpass, Elisabete
AU - Overvad, Kim
AU - Tjønneland, Anne
AU - Halkjær, Jytte
AU - Boutron-Ruault, Marie Christine
AU - Carbonnel, Franck
AU - Cervenka, Iris
AU - Boeing, Heiner
AU - Kaaks, Rudolf
AU - Kühn, Tilman
AU - Trichopoulou, Antonia
AU - Martimianaki, Georgia
AU - Karakatsani, Anna
AU - Pala, Valeria
AU - Palli, Domenico
AU - Mattiello, Amalia
AU - Tumino, Rosario
AU - Sacerdote, Carlotta
AU - Skeie, Guri
AU - Rylander, Charlotta
AU - Chirlaque López, María Dolores
AU - Sánchez, Maria Jose
AU - Ardanaz, Eva
AU - Regnér, Sara
AU - Stocks, Tanja
AU - Bueno-de-Mesquita, Bas
AU - Vermeulen, Roel C.H.
AU - Aune, Dagfinn
AU - Tong, Tammy Y.N.
AU - Kliemann, Nathalie
AU - Murphy, Neil
AU - Chadeau-Hyam, Marc
AU - Gunter, Marc J.
AU - Cross, Amanda J.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - cancer
KW - esophageal
KW - gastric
KW - hormones
KW - obesity
KW - reproductive
U2 - 10.1002/ijc.32386
DO - 10.1002/ijc.32386
M3 - Article
C2 - 31050823
AN - SCOPUS:85066132112
SN - 0020-7136
VL - 146
SP - 929
EP - 942
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 4
ER -