TY - JOUR

T1 - Anthropometric and reproductive factors and risk of esophageal and gastric cancer by subtype and subsite

T2 - Results from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

AU - Sanikini, Harinakshi

AU - Muller, David C.

AU - Sophiea, Marisa

AU - Rinaldi, Sabina

AU - Agudo, Antonio

AU - Duell, Eric J.

AU - Weiderpass, Elisabete

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Halkjær, Jytte

AU - Boutron-Ruault, Marie Christine

AU - Carbonnel, Franck

AU - Cervenka, Iris

AU - Boeing, Heiner

AU - Kaaks, Rudolf

AU - Kühn, Tilman

AU - Trichopoulou, Antonia

AU - Martimianaki, Georgia

AU - Karakatsani, Anna

AU - Pala, Valeria

AU - Palli, Domenico

AU - Mattiello, Amalia

AU - Tumino, Rosario

AU - Sacerdote, Carlotta

AU - Skeie, Guri

AU - Rylander, Charlotta

AU - Chirlaque López, María Dolores

AU - Sánchez, Maria Jose

AU - Ardanaz, Eva

AU - Regnér, Sara

AU - Stocks, Tanja

AU - Bueno-de-Mesquita, Bas

AU - Vermeulen, Roel C.H.

AU - Aune, Dagfinn

AU - Tong, Tammy Y.N.

AU - Kliemann, Nathalie

AU - Murphy, Neil

AU - Chadeau-Hyam, Marc

AU - Gunter, Marc J.

AU - Cross, Amanda J.

N1 - Publisher Copyright: © 2019 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC

PY - 2020

Y1 - 2020

N2 - 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.

AB - 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.

KW - cancer

KW - esophageal

KW - gastric

KW - hormones

KW - obesity

KW - reproductive

U2 - 10.1002/ijc.32386

DO - 10.1002/ijc.32386

M3 - Journal article

C2 - 31050823

AN - SCOPUS:85066132112

VL - 146

SP - 929

EP - 942

JO - Acta - Unio Internationalis Contra Cancrum

JF - Acta - Unio Internationalis Contra Cancrum

SN - 0898-6924

IS - 4

ER -