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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  • Harinakshi Sanikini, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom, Storbritannien
  • David C Muller, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom, Storbritannien
  • Marisa Sophiea, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom, Storbritannien
  • Sabina Rinaldi, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., Frankrig
  • Antonio Agudo, Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), 08908 Barcelona, Spain., Spanien
  • Eric J Duell, Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), 08908 Barcelona, Spain., Spanien
  • Elisabete Weiderpass, Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, and Faculty of Medicine, University of Helsinki, Helsinki, Finland., Norge
  • Kim Overvad
  • Anne Tjønneland, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark., Danmark
  • Jytte Halkjaer, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark., Danmark
  • Marie-Christine Boutron-Ruault, CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France., Frankrig
  • Franck Carbonnel, CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France; Department of Gastroenterology, Bicêtre University Hospital, Assistance Publique des Hôpitaux de Paris, Le Kremlin Bicêtre, France., Frankrig
  • Iris Cervenka, CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France., Frankrig
  • Heiner Boeing, Department of Epidemiology, German Institute for Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany., Tyskland
  • Rudolf Kaaks, German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, 69120 Heidelberg, Germany. V.Katzke@Dkfz-Heidelberg.de., Tyskland
  • Tilman Kühn, German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, 69120 Heidelberg, Germany. V.Katzke@Dkfz-Heidelberg.de., Tyskland
  • Antonia Trichopoulou, Hellenic Health Foundation, Athens, Greece., Grækenland
  • Georgia Martimianaki, Hellenic Health Foundation, Athens, Greece., Grækenland
  • Anna Karakatsani, Hellenic Health Foundation, Athens, Greece; 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece., Grækenland
  • Valeria Pala, Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Italien
  • Domenico Palli, Cancer Risk Factors and Life-Style Epidemiology Unit. Institute for Cancer Research, Prevention and Clinical Network - ISPRO, 50141, Florence, Italy., Italien
  • Amalia Mattiello, Department of Clinical Medicine and Surgery, Federico II University, 80138 Naples, Italy. spanico@unina.it., Italien
  • Rosario Tumino, Cancer Registry and Histopathology Department, "Civic M.P. Arezzo" Hospital, ASP, Ragusa, Italy., Italien
  • Carlotta Sacerdote, Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy., Italien
  • Guri Skeie, Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, N-9037 Tromsø, Norway., Norge
  • Charlotta Rylander, Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, N-9037 Tromsø, Norway., Norge
  • María Dolores Chirlaque López, Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain. CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain. Department of Health and Social Sciences, Murcia University, Murcia, Spain., Spanien
  • Maria-Jose Sánchez, Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs. GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Spanien
  • Eva Ardanaz, Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain., Spanien
  • Sara Regnér, Institution of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Sweden., Sverige
  • Tanja Stocks, Department of Cardiothoracic Surgery, Skane University Hospital, Lund, Sweden; Clinical Sciences, Lund University, Lund, Sweden., Sverige
  • Bas Bueno-de-Mesquita, Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. Department of Epidemiology and Biostatistics, the School of Public Health, Imperial College London, United Kingdom. Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands. Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Holland
  • Roel C H Vermeulen, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands; Julius Centre for Public Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands., Holland
  • Dagfinn Aune, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom. Department of Nutrition, Bjørknes University College, Oslo, Norway. Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway., Norge
  • Tammy Y N Tong, Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Storbritannien
  • Nathalie Kliemann, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., Frankrig
  • Neil Murphy, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., Frankrig
  • Marc Chadeau-Hyam, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom, Storbritannien
  • Marc J Gunter, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France., Frankrig
  • Amanda J Cross, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom, Storbritannien

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 non-cardia (GNC) cancers were diagnosed. Body mass index (BMI) was associated with EA in men (BMI≥30 vs 18.5-25kg/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. 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 <90cm), 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 >83 vs <74cm). 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. This article is protected by copyright. All rights reserved.

OriginalsprogEngelsk
TidsskriftInternational Journal of Cancer
Vol/bind146
Nummer4
Sider (fra-til)929-942
Antal sider14
ISSN0020-7136
DOI
StatusUdgivet - 2020

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This article is protected by copyright. All rights reserved.

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