General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition

Steffen, Annika; Huerta, José María; Weiderpass, Elisabete; Bueno-de-Mesquita, H. Bas; May, Anne M.; Siersema, Peter D.; Kaaks, Rudolf; Neamat-Allah, Jasmine; Pala, Valeria; Panico, Salvatore; Saieva, Calogero; Tumino, Rosario; Naccarati, Alessio; Dorronsoro, Miren; Sánchez‐Cantalejo, Emilio; Ardanaz, Eva; Quiŕos, J. Ramón; Ohlsson, Bodil; Johansson, Mattias; Wallner, Bengt; Overvad, Kim; Halkjær, Jytte; Tjønneland, Anne; Fagherazzi, Guy; Racine, Antoine; Clavel‐Chapelon, Françoise; Key, Tim; Khaw, Kay‐Tee; Wareham, Nick; Λάγιου, Παγώνα; Bamia, Christina; Trichopoulou, Antonia; Ferrari, Pietro; Freisling, Heinz; Lu, Yunxia; Riboli, Elio; Cross, Amanda J.; González, Carlos; Boeing, Heiner

doi:10.1002/ijc.29432

Cited by 90 publications

(82 citation statements)

References 45 publications

(111 reference statements)

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“…Previous study on EAC by Steffen et al [35] was excluded. Instead, we included the updated study [27], which also investigated the association between abdominal obesity and GC. Furthermore, six studies [36][37][38][39][40][41] were excluded because the risk estimate for the association of interest was not available.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, six studies [36][37][38][39][40][41] were excluded because the risk estimate for the association of interest was not available. Finally, seven prospective cohort studies [24][25][26][27][28][29] -one publication [28] included two separate cohorts -from six publications were included in the final analysis. The characteristics of the included studies are summarised and listed in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 2130 gastroesophageal cancer cases were diagnosed amongst 913182 participants. Two prospective cohort studies were conducted in the United States [25,26] and Norway [28], and one each in Australia [24], multiple European countries [27], and China [29]. Regarding the sex of the participants, one study [29] evaluated only women and the remaining six [24][25][26][27][28] included both sexes.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, intra-abdominal fat has been hypothesised to be biologically different from fat in other areas with regard to tumor angiogenesis and cell proliferation [22,23]. Although general obesity has emerged as a potential risk factor for gastroesophageal cancer, but the association between abdominal obesity and gastroesophageal cancer is still poorly understood, partly because of sparse evidence from prospective studies available at that time, which limited the strength of the conclusions [24][25][26][27][28][29]. Given these considerations, providing clear evidence regarding potentially detrimental effect of abdominal obesity on gastroesophageal cancer would be important for clinical interventions, including weight loss program or weight management program and gastroesophageal cancer screening guidelines for obese individuals.…”

Section: Introductionmentioning

confidence: 99%

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Abdominal Obesity and Gastroesophageal Cancer Risk: Systematic Review and Meta-Analysis of Prospective Studies

Hidayat¹,

Du²,

Shi³

2016

Preprint

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Correspondence: To systematically and quantitatively review the relation of abdominal obesity, as measured by waist circumference (WC) and waist to hip ratio (WHR), to total gastroesophageal cancer, gastric cancer (GC), and esophageal cancer. PubMed and Web of Science databases were searched for studies assessing the association between abdominal obesity and gastroesophageal cancer (GC and/or esophageal cancer) up to August 2016. A random-effect model was used to calculate the summary relative risks (RRs) and 95% confidence intervals (CIs). Seven prospective cohort studies -one publication included two separate cohorts -from six publications were included in the final analysis. A total of 2130 gastroesophageal cancer cases diagnosed amongst 913182 participants. Higher WC and WHR were significantly associated with increased risk of total gastroesophageal cancer (WC: RR 1.68, 95% CI: 1.38, 2.04; WHR: RR 1.49, 95% CI: 1.19, 1.88), GC (WC: RR 1.48, 95% CI: 1.24, 1.78; WHR: 1.33, 95% CI: 1.04, 1.70), and esophageal cancer (WC: RR 2.06, 95% CI: 1.30, 3.24; WHR: RR 1.99, 95% CI: 1.05, 3.75).Findings from our subgroup analyses showed non-significant positive associations between gastric non-cardia adenocarcinoma (GNCA) and both measures of abdominal adiposity, while gastric cardia adenocarcinoma (GCA) was positively associated with WC but not with WHR. On analysis restricted to studies that adjusted for body mass index (BMI), WC was positively associated with GC and esophageal cancer, whereas WHR was positively associated with risk of GC only. Although limited, the findings from our meta-analysis suggest the potential role of abdominal obesity in the etiology of gastric and esophageal cancers.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Abdominal Obesity and Gastroesophageal Cancer Risk: Systematic Review and Meta-Analysis of Prospective Studies

Hidayat¹,

Du²,

Shi³

2016

Preprint

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“…In addition, abdominal obesity was associated with risk of Barrett's oesophagus independent of GERD, while no association was observed with general obesity after adjustment for GERD symptoms. The association between both general and abdominal obesity and risk of oesophageal and gastric adenocarcinoma was investigated in the EPIC study [15]. In this prospective study with measured anthropometry at baseline, general obesity represented by BMI as well as abdominal obesity represented by waist circumference or waist-to-hip ratio were strongly positively associated with risk of oesophageal adenocarcinoma.…”

Section: Abdominal Obesitymentioning

confidence: 99%

Obesity and Oesophageal Cancer

Nimptsch

Steffen

Pischon

2016

Recent Results in Cancer Research

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(150-250 words)A substantial increase in the incidence of oesophageal adenocarcinoma has been observed in western countries during the past 30 years, which may be related to the parallel rise of the obesity prevalence. On the other hand, incidence rates of oesophageal squamous cell carcinomas, the other major histological type of oesophageal cancer, have remained relatively stable.Epidemiological research of the past decades has identified obesity as risk factor for oesophageal adenocarcinoma. Studies investigating general obesity as assessed by body mass index provide evidence for a strong positive association with oesophageal adenocarcinoma. Studies investigating abdominal obesity in relation to oesophageal adenocarcinoma observed also positive associations, which may be independent of general obesity. Some studies indicate that early life obesity is also associated with higher risk of oesophageal adenocarcinoma, but it is as to date unclear whether these associations are independent of adult obesity. Part of the positive association between obesity and oesophageal adenocarcinoma may be explained through obesityrelated mechanical promotion of gastrooesophageal reflux disease, which is one of the main risk factors for oesophageal adenocarcinoma. Other lines of evidence point to an independent role of metabolic pathways modulating cell proliferation, apoptosis and cell growth such as proinflammatory cytokines, adipokines and insulin resistance, the role of which in oesophageal carcinogenesis is, however, as to date insufficiently understood. Studies investigating obesity in 2 relation to squamous cell carcinoma observed inverse relationships, but the underlying mechanisms remain unclear.

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Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015

Fitzmaurice¹,

Akinyemiju²,

Lami³

et al. 2017

JAMA Oncol

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4,331

1,586

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IMPORTANCE Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. EVIDENCE REVIEW Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results. FINDINGS In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (−6.1% [95% uncertainty interval (UI), −10.6% to −1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant. CONCLUSION AND RELEVANCE As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against ca...

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General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition

Cited by 90 publications

References 45 publications

Abdominal Obesity and Gastroesophageal Cancer Risk: Systematic Review and Meta-Analysis of Prospective Studies

Abdominal Obesity and Gastroesophageal Cancer Risk: Systematic Review and Meta-Analysis of Prospective Studies

Obesity and Oesophageal Cancer

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015

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