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

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...

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Detalhes bibliográficos
Autores: Sanikini, Harinakshi, Muller, David C., Sophiea, Marisa, Rinaldi, Sabina, Agudo, Antonio, Duell, Eric J., Weiderpass, Elisabete, Overvad, Kim, Tjønneland, Anne, Halkjær, Jytte, Boutron-Ruault, Marie-Christine, Carbonnel, Franck, Cervenka, Iris, Boeing, Heiner, Kaaks, Rudolf, Kühn, Tilman, Trichopoulou, Antonia, Martimianaki, Georgia, Karakatsani, Anna, Pala, Valeria, Palli, Domenico, Mattiello, Amalia, Tumino, Rosario, Sacerdote, Carlotta, Skeie, Guri, Rylander, Charlotta, Chirlaque, María Dolores, Sánchez, María José, Ardanaz, Eva, Regnér, Sara, Stocks, Tanja, Bueno de Mesquita, H. Bas, Vermeulen, Roel C. H., Aune, Dagfinn, Tong, Tammy Y. N., Kliemann, Nathalie, Murphy, Neil, Chadeau-Hyam, Marc, Gunter, Marc J., Cross, Amanda J.
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/171698
Acesso em linha:https://hdl.handle.net/2445/171698
Access Level:acceso abierto
Palavra-chave:Càncer
Nutrició
Cancer
Nutrition
Descrição
Resumo: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.

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