Height and Body Mass Index in Relation to Esophageal Cancer; 23-year Follow-up of Two Million Norwegian Men and Women

Engeland, Anders; Tretli, Steinar; Bjørge, Tone

doi:10.1023/b:caco.0000043434.21558.ea

Cited by 83 publications

(70 citation statements)

References 29 publications

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“…The study population has been described in detail elsewhere, (Engeland et al, 2004).Briefly in a series of health surveys during 1963 -2001, height and weight were measured in a standardised way by a trained staff in 2 001 727 persons (963 709 men and 1 038 018 women) aged 20 -74 years. Deaths, emigrations and cases of cancer of the small intestine (International Classification of Diseases, seventh revision (ICD-7): 152) in this cohort were identified by linkage to the Death Registry at Statistics Norway (Statistics Norway, 2005) and to the Cancer Registry of Norway (The Cancer Registry of Norway, 2005).…”

Section: Study Populationmentioning

confidence: 99%

Height and body mass index in relation to cancer of the small intestine in two million Norwegian men and women

2005

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The present study aimed at exploring the relations between body mass index (BMI, (weight in kilograms)/(height in meters) 2 ) and stature and cancer of the small intestine (1162 cases) in a large Norwegian cohort (of two million) with measured height and weight. Elevated BMI in males and increasing height in both sexes were associated with a moderately increased risk of cancer of the small intestine. Overweight or obesity has been linked to an increased risk of several site-specific cancers, including colorectal cancers (Engeland et al, 2005). A large cohort study of male US veterans found a significant excess risk of small intestine cancer, especially of the duodenum, among obese white veterans (Samanic et al, 2004). Also, a recent cohort study of obese individuals in Sweden reported a significantly elevated risk of cancer of the small intestine, but only among men (Wolk et al, 2001).The aim of the present study was to explore the associations between body mass index (BMI) and height and the risk of cancers of the small intestine in a very large Norwegian cohort of both men and women with a long follow-up. STUDY POPULATIONThe study population has been described in detail elsewhere, (Engeland et al, 2004).Briefly in a series of health surveys during 1963 -2001, height and weight were measured in a standardised way by a trained staff in 2 001 727 persons (963 709 men and 1 038 018 women) aged 20 -74 years. Deaths, emigrations and cases of cancer of the small intestine (International Classification of Diseases, seventh revision (ICD-7): 152) in this cohort were identified by linkage to the Death Registry at Statistics Norway (Statistics Norway, 2005) and to the Cancer Registry of Norway (The Cancer Registry of Norway, 2005). Both these registries are population based and are covering the entire Norwegian population. A unique 11-digit identification number assigned to all individuals living in Norway after 1960 simplified the linkages.In the present study, only histologically verified cancers of the small intestine were included. Persons with a diagnosis of cancer of the small intestine, prior to the height and weight measurements, were excluded. Consequently, 32 persons were excluded in the analyses. In the analyses, the persons in the cohort were followed up from the date of measurement until the date of cancer diagnosis, emigration, age 100 years, death or until 31 December 2003. Altogether, 2 001 695 persons were eligible for the study. A small number of these (39 men and 32 women) were lost to follow-up. STATISTICAL METHODSCox's proportional-hazards regression models (Cox and Oakes, 1984), with time since measurement as the time variable, were fitted to obtain relative risk (RR) estimates of cancer. In the analyses, categorised variables for age at measurement, year of birth, BMI ((weight in kilograms)/(height in meters) 2 ) and height were included. BMI was categorised using the WHO categorisation (World Health Organization Consultation on Obesity, 1998): BMI o18.5 (underweight), 18.5 -24.9 (normal), 25.0 -2...

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Section: Study Populationmentioning

confidence: 99%

Height and body mass index in relation to cancer of the small intestine in two million Norwegian men and women

2005

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“…The incidence of esophageal adenocarcinoma has risen more rapidly than that of any other malignancy in the United States in the last three decades; obesity has been associated with cancer risk, but its mechanism of action is unknown (1)(2)(3)(4)(5)(6). Simple obesity alone is unlikely to explain the sex and ethnic distributions of esophageal adenocarcinoma: the incidence of the cancer is 6-fold higher in men than in women and 5-fold higher in Caucasians than in African Americans (7).…”

Section: Introductionmentioning

confidence: 99%

Abdominal Obesity and the Risk of Esophageal and Gastric Cardia Carcinomas

Corley

Kubo

Zhao

2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

195

138

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Background: Esophageal adenocarcinoma is rapidly increasing in incidence. Body mass index (BMI) is a risk factor, but its distribution does not reflect the demographic distribution of the cancer (which is highest among White men). Abdominal obesity patterns may explain this discordance, but no studies exist to date. Methods: Nested case-control study within 206,974 members of the Kaiser Permanente multiphasic health checkup cohort; subjects received detailed questionnaires, a standardized examination including BMI and anthropometric measurements, and follow-up of esophageal and cardia cancers using registry data. Results: 101 incident esophageal adenocarcinomas, 105 cardia adenocarcinomas, and 144 esophageal squamous cell carcinomas were detected (BMI data available for all cases; abdominal measurements for a subset). Increasing abdominal diameter was strongly associated with an increased risk of esophageal adenocarcinoma [odds ratio (OR), 3.47; 95% confidence interval (95% CI), 1.29-9.33; abdominal diameter, z25 versus <20 cm].

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“…To our knowledge, only three prospective studies have examined the association (14)(15)(16). Two of these studies could not control for important potential confounders (14), such as cigarette smoking, and the other two had incomplete information on confounders (15;16). All these studies have also relied primarily on categorical analyses of BMI and estimated the risks associated with being overweight or obese (12).…”

Section: Introductionmentioning

confidence: 99%

A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma

Abnet

Freedman

Hollenbeck

et al. 2008

European Journal of Cancer

137

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The incidence of esophageal adenocarcinoma (EADC) is rapidly increasing in Western countries and obesity is thought to be a major risk factor. We examined the association between BMI and EADC, gastric cardia adenocarcinoma, and gastric noncardia adenocarcinoma in a cohort of approximately 500,000 people in the US. We used Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) with control for many potential confounders. We found that compared to people with a BMI of 18.5-25 Kg/m 2 , a BMI ≥35 was associated with significantly increased risk of EADC, HR (95% CI) = 2.27 (1.44-3.59), and gastric cardia adenocarcinoma 2.46 (1.60-3.80), but not gastric noncardia adenocarcinoma 0.84 (0.50-1.42). Using nonlinear models, we found that higher BMI was associated with increased risk of EADC even within the normal BMI. Increased adiposity was associated with higher risk of EADC even within the normal weight range.

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Height and Body Mass Index in Relation to Esophageal Cancer; 23-year Follow-up of Two Million Norwegian Men and Women

Abstract: BMI had opposite relations to the two most common histological groups of esophageal cancer. While low BMI increased the risk of OSCC, high BMI increased the risk of OA. An increased risk of esophageal cancer was found in the lowest men.

Cited by 83 publications

References 29 publications

Height and body mass index in relation to cancer of the small intestine in two million Norwegian men and women

Height and body mass index in relation to cancer of the small intestine in two million Norwegian men and women

Abdominal Obesity and the Risk of Esophageal and Gastric Cardia Carcinomas

A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma

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