Abdominal obesity increased risk for esophageal adenocarcinoma
Risk for esophageal adenocarcinoma was greater among patients with abdominal obesity, regardless of BMI, while overall obesity increased the risk for esophageal and gastric adenocarcinoma in a recent study.
Researchers evaluated data from 218,854 AARP members aged 50 to 71 years who had participated between 1995 and 1996 in the NIH-AARP Diet and Health Study. Participants responded to a questionnaire covering demographics and dietary and health-related behavior, as well as a subsequent questionnaire regarding waist and hip measurements.
Esophageal adenocarcinoma (EAC) and gastric adenocarcinoma incidence within the cohort were recorded during follow-up through December 2006. EAC occurred in 253 patients, gastric cardia adenocarcinoma in 191 and gastric non-cardia adenocarcinoma in 125 patients. Investigators observed an association between a BMI of 35 kg/m2 or greater and risk for both EAC (HR=2.11; 95% CI, 1.09-4.09 compared with normal BMI) and gastric cardia adenocarcinoma (HR=3.67; 95% CI, 2.00-6.71) though multivariate analysis.
Both illnesses were associated with waist circumference (HR=2.01; 95% CI, 1.35-3.00 for EAC and HR=2.22; 95% CI, 1.43-3.47 for gastric cardia, comparing 4th quartile to 1st quartile within the cohort) and weight (HR=2.66; 95% CI, 1.76-4.02 for EAC and HR=2.52; 95% CI, 1.55-4.11 for gastric cardia, comparing 4th and 1st quartiles). EAC risk also was associated with waist-to-hip ratio (WHR) (HR=1.81; 95% CI, 1.24-2.64, comparing 4th and 1st quartiles), and this association remained in both patients with normal BMI (HR=1.33; 95% CI, 0.85-2.07) and overweight participants (HR=1.23; 95% CI, 0.99-1.53) with WHR viewed continuously in 0.1-unit increments.
Investigators observed a borderline association between risk for the gastric non-cardia adenocarcinoma and weight (HR=1.93; 95% CI, 1.05-3.54) and WHR (HR=1.56; 95% CI, 0.94-2.59), but no associations were found between gastric non-cardia adenocarcinoma and other anthropometric variables.
“In the prospective NIH-AARP cohort, we found that overall obesity, as measured by BMI, was related to a higher risk of EAC and gastric cardia adenocarcinoma,” the researchers wrote. “We also observed an increased risk of EAC with increasing abdominal obesity, as measured by waist circumference and WHR. Associations between obesity and both cancer types suggest that interventions to reduce the prevalence of obesity may help to prevent adenocarcinomas of the esophagus and gastric cardia.”