Body Mass Index and Risk of Adenocarcinomas of the Esophagus and Gastric Cardia

Chow, Wong Ho; Blot, William J.; Vaughan, Thomas L.; Risch, Harvey A.; Gammon, Marilie D.; Stanford, Janet L.; Dubrow, Robert; Schoenberg, Janet B.; Mayne, Susan T.; Farrow, Diana C.; Ahsan, Habibul; West, A. Brian; Rotterdam, Heidi; Niwa, Shelley; Fraumeni, Joseph F.

doi:10.1093/jnci/90.2.150

Cited by 545 publications

(357 citation statements)

References 25 publications

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“…Familial clustering of Barrett's oesophagus has been described (Crabb et al, 1985;Jochem et al, 1992), suggesting that the hereditary components for Barrett's oesophagus could be related to both cardia and oesophageal adenocarcinomas. Other factors, either genetic or environmental, may be also related to the family aggregations of cardia cancer (Chow et al, 1998;Zhang et al, 2006). The histological classification used by the Swedish Cancer Registry does not specify intestinal and diffuse types of the Lauren classification and we were thus unable to contribute to the existing literature (Lehtola, 1978;Palli et al, 1994;Lissowska et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Familial risk for gastric carcinoma: an updated study from Sweden

Hemminki

Sundquist

2007

Br J Cancer

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Reliable data on familial risks are important for clinical counselling and cancer genetics. However, the estimates of familial risk of gastric cancer vary widely. We examined the risk of familial gastric cancer using the updated Swedish Family-Cancer Database with 5358 patients among offspring and 36 486 patients among parents. There were 133 families with one parent and one offspring diagnosed with gastric cancer, and 20 families with two affected offspring. Familial standardised incidence ratios (SIRs) were 1.63 and 2.93 when parents and siblings presented with gastric cancer, respectively. The high sibling risk was owing to cancer in the corpus (SIR 7.28). The SIR for cardia cancer was 1.54 when parents were diagnosed with any gastric cancer. Cardia cancer associated with oesophageal cancer, particularly with oesophageal adenocarcinoma. Among specific histologies, signet ring cancer showed an increase. A few associations were noted for discordant sites, including the urinary bladder and the endometrium. H. pylori infection, although not measured in the present study, is probably an important risk factor for the high sibling risk of corpus cancer. Familial clustering of cardia cancer is independent of H. pylori infection, and may have a genetic basis. The familial association of cardia cancer with oesophageal adenocarcinoma may provide aetiological clues.

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Section: Discussionmentioning

confidence: 99%

Familial risk for gastric carcinoma: an updated study from Sweden

Hemminki

Sundquist

2007

Br J Cancer

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“…Dietary fats and high caloric intake are associated with an increased risk of AC, while a protective role seem to be linked with high fiber diet, some vitamins, iron and zinc. 36 Obesity is a significant independent risk factor for hiatal hernia and is associated with esophagitis 37 and it is probably the greatest risk factor for AC 38 and the steadily increase of its prevalence parallels with the rise of esophageal and cardia AC.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for Barrett's esophagus: A case‐control study

Conio¹,

Filiberti²,

Blanchi³

et al. 2001

Intl Journal of Cancer

139

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Barrett's esophagus (BE) is an acquired disorder due to chronic gastroesophageal reflux. Environmental factors seem to play an important role in the pathogenesis of BE, especially in Western society. A multicenter case-control study was carried out between February 1995 and April 1999 in 8 Italian Departments of Gastroenterology gathered in a study group (GOSPE), in order to analyze the influence of some individual characteristics and life-style habits on the occurrence of BE. Three groups of patients were studied: 149 patients with BE, 143 patients with esophagitis (E) and 308 hospital controls (C) with acute, non-neoplastic, non-gastroenterological conditions. The diagnosis of BE was based on endoscopy and histology. E was defined by the Savary classification (grade I-III). Data collection was performed by using a questionnaire that focused on smoking, coffee and alcohol consumption, medical history, drugs history, gastroesophageal reflux disease (GERD) symptoms (heartburn, regurgitation) and socio-economic status. Multivariate analysis showed that the frequency of weekly GERD symptoms was significantly associated with both BE and E (p<0.0001), such as the presence of hiatal hernia (p<0.001). Ulcer was significantly associated with BE (p‫.)100.0؍‬ Among patients with E, the risk was directly related to spirits consumption (p‫.)30.0؍‬ Patients with GERD symptoms that lasted more than 13 years were more likely to have BE than E (p‫.)10.0؍‬ In conclusion, results from our study point out that long-standing GERD symptoms, hiatal hernia and possibly alcohol consumption are risk factors in the development of the BE and E.

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“…6 -11 In addition to male gender, obesity has emerged as a major risk factor. [12][13][14] The alarming increase in the incidence of adenocarcinoma of the oesophagus and gastric cardia has triggered many studies focused on antiulcer drugs that were gradually introduced during the last 25 years, including H 2 receptor antagonists and proton pump inhibitors. These studies have been reviewed, 15 and no incriminating evidence against any of these drugs has emerged.…”

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confidence: 99%

Oesophageal adenocarcinoma: A paradigm of mechanical carcinogenesis?

Vecchia

Negri

Λάγιου

et al. 2002

Intl Journal of Cancer

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Incidence of adenocarcinoma of the oesophagus and gastric cardia is increasing in most developed countries and strongly associated with obesity and male gender. An underlying increase in the prevalence of gastro-oesophageal reflux has generally been postulated. We suggest that the increase in frequency of reflux and the 2 associated forms of cancer can be explained by growing abdominal pressure brought about by increasing central obesity, most common among men, and sedentary lifestyle, including car use. Abdominal pressure is further accentuated mainly in men by the shift in Western male dressing towards the general use of belts. © 2002 Wiley-Liss, Inc. Key words: oesophageal adenocarcinoma; carcinogenesis; riskA rising incidence of adenocarcinoma of the oesophagus and gastric cardia, mostly in males, has been reported for most developed countries. 1-5 These forms of cancer have been linked to gastro-oesophageal reflux in several studies. 6 -11 In addition to male gender, obesity has emerged as a major risk factor. [12][13][14] The alarming increase in the incidence of adenocarcinoma of the oesophagus and gastric cardia has triggered many studies focused on antiulcer drugs that were gradually introduced during the last 25 years, including H 2 receptor antagonists and proton pump inhibitors. These studies have been reviewed, 15 and no incriminating evidence against any of these drugs has emerged. In the absence of such evidence, an explanation for the increasing trend of adenocarcinoma of the oesophagus and gastric cardia should accommodate the 3 salient risk factors for this disease: obesity, male gender and the sharply increasing incidence in developed countries (with the exception of some central and western European registries) 16 -18 rather than in developing ones, 1-5 though data from the latter are limited. 5 THE HYPOTHESISWe postulate that the increasing frequency over time of gastro-oesophageal reflux and adenocarcinomas of the oesophagus and gastric cardia is due to growing abdominal pressure brought about by obesity, the sitting position and the constraining influence of tight belts. The mechanisms by which obesity increases the risk of oesophageal adenocarcinoma remain open for discussion but may be linked to the predisposition of obese individuals to gastro-oesophageal reflux, hiatal hernia and consequent Barrett's oesophagus. [7][8][9][10][11]18,19 Obesity has increased in most developed countries and is gradually affecting developing countries as well. Central obesity, the type of obesity likely to be involved in the postulated pathogenic process, is particularly common among men, though no adequate information is available on type of obesity and oesophageal adenocarcinoma risk. The sitting position characterises sedentary occupations as well as car transportation, both features that tend to increase with time and to be more frequent in economically developed countries. Lastly, belts, particularly among overweight men, have a constraining influence that did not exist in the past, when suspenders...

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Body Mass Index and Risk of Adenocarcinomas of the Esophagus and Gastric Cardia

Cited by 545 publications

References 25 publications

Familial risk for gastric carcinoma: an updated study from Sweden

Familial risk for gastric carcinoma: an updated study from Sweden

Risk factors for Barrett's esophagus: A case‐control study

Oesophageal adenocarcinoma: A paradigm of mechanical carcinogenesis?

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