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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@article{0e09c420e5ed417d9e76db0c4a391c3a,
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",
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.",
keywords = "cancer, esophageal, gastric, hormones, obesity, reproductive",
author = "Harinakshi Sanikini and Muller, {David C.} and Marisa Sophiea and Sabina Rinaldi and Antonio Agudo and Duell, {Eric J.} and Elisabete Weiderpass and Kim Overvad and Anne Tj{\o}nneland and Jytte Halkj{\ae}r and Boutron-Ruault, {Marie Christine} and Franck Carbonnel and Iris Cervenka and Heiner Boeing and Rudolf Kaaks and Tilman K{\"u}hn and Antonia Trichopoulou and Georgia Martimianaki and Anna Karakatsani and Valeria Pala and Domenico Palli and Amalia Mattiello and Rosario Tumino and Carlotta Sacerdote and Guri Skeie and Charlotta Rylander and {Chirlaque L{\'o}pez}, {Mar{\'i}a Dolores} and S{\'a}nchez, {Maria Jose} and Eva Ardanaz and Sara Regn{\'e}r and Tanja Stocks and Bas Bueno-de-Mesquita and Vermeulen, {Roel C.H.} and Dagfinn Aune and Tong, {Tammy Y.N.} and Nathalie Kliemann and Neil Murphy and Marc Chadeau-Hyam and Gunter, {Marc J.} and Cross, {Amanda J.}",
year = "2019",
month = "5",
day = "3",
doi = "10.1002/ijc.32386",
language = "English",
journal = "Acta - Unio Internationalis Contra Cancrum",
issn = "0020-7136",
publisher = "John Wiley & Sons",

}