Use of tight belts and risk of esophageal adenocarcinoma

Abstract

It has recently been hypothesized that the general shift in use from suspenders to belts among men might be a factor that could promote reflux, particularly among overweight men, and thereby contribute to the alarmingly increasing incidence of esophageal and cardia adenocarcinoma. We addressed this hypothesis in a nationwide Swedish population-based case-control study, conducted in 1995-1997. Included were 189 patients with esophageal adenocarcinoma and 262 patients with cardia adenocarcinoma, who were compared with 167 patients with esophageal squamous cell carcinoma and 820 population-based control participants. Data were collected at structured face-to-face interviews with all study participants. Tumor classification was uniform and thorough. Odds ratios (OR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated in multivariable logistic regression models. Daily use of tight belts 20 years earlier did not entail an increased risk of adenocarcinoma of the esophagus (OR 1.1, 95% CI 0.7-1.8) or cardia (OR 0.8, 95% CI 0.5-1.3) compared to never use. Adjustment for reflux symptoms, body mass and other potentially relevant covariates did not influence the results. Similarly, in analyses restricted to overweight men, no associations were identified. No association with esophageal squamous cell carcinoma was found. In conclusion, this study provided no support for the hypothesis that use of tight belts is associated with an increased risk of developing esophageal or cardia adenocarcinoma. ' 2006 Wiley-Liss, Inc.Key words: tight garments; neoplasm; esophagus; gastric cardia Research aiming at identifying the reasons for the alarming increase in the incidence of adenocarcinoma of the esophagus and gastric cardia in industrialized countries during recent decades 1-4 is urgent and intense. Gastroesophageal reflux, 5-7 overweight 6,8,9 and male sex 3 have been established as the main known risk factors, but it remains uncertain why the incidence of these tumors is rising. 10,11 The rapidity of the increase suggests that environmental exposures are likely to be key factors. 10,11 Recently, an interesting hypothesis was proposed by La Vecchia et al., suggesting that the increasing secular trends of adenocarcinoma of the esophagus and gastric cardia, particularly among overweight men, is explained by the use of tight belts. 12 Such belts have a constraining influence on the abdomen, which in turn might promote reflux, and belts did not exist in the past when suspenders were in use. 12 This proposed mechanical exposure seems to fit well with all the above-presented prerequisites: increased and widespread use in industrialized populations, particularly among males, an environmental exposure and a possible combination with overweight to promote reflux, i.e., the established risk factors. As we had already included this hypothesis as part of the planning of a Swedish case-control study in the late 1990s, we investigated the relation between use of tight belts and risk of adenocarcinoma of the es...

Epidemiology and Clinical Presentation in Esophageal Cancer

“…While a number of factors including race, obesity, use of esophageal sphincter-relaxing drugs, smoking, and alcohol consumption have all been incriminated as possible etiological factors in esophageal adenocarcinoma [34,35,36,37,38], many cohort studies have pointed strongly to gastroesophageal reflux and Barrett's disease (Barrett's esophagus) as a causative factor [39,40]. There is a strong dose-response relationship between previous gastroesophageal reflux symptoms and esophageal adenocarcinoma, but the relationship to cardia cancer is weaker [40].…”

“…The relationship to smoking is less clear than that for SCC. Increased abdominal pressure brought about by central obesity, sedentary posture, and tight belts has also been implicated [37,65], although a high body mass index appears to be an independent risk factor for adenocarcinoma but not SCC [38].…”

Effect of tight clothes on cervical and thoracic spine muscles during shoulder abduction

“…In modern society, the practice of wearing tight-fitting clothing to show off stylish and fashionable clothes has spread widely 1 ) . However, a number of studies have reported that when excessive pressure is exerted constantly on specific parts of the human body, it can lead to many health problems in the cardiovascular system and internal organs 1 , 2 ) . Experts have expressed a negative view on the effect of tight-fitting clothing on health 2 , 3 ) .…”

“…However, a number of studies have reported that when excessive pressure is exerted constantly on specific parts of the human body, it can lead to many health problems in the cardiovascular system and internal organs 1 , 2 ) . Experts have expressed a negative view on the effect of tight-fitting clothing on health 2 , 3 ) . Furthermore, it has been suggested that wearing a waist belt frequently for a long time, can cause back pain and that this pain is due to imbalance between forces of muscles around the abdomen and waist muscles; the authors also suggested that this should be studied in the future 3 ) .…”

Effects of Wearing a Tight Skirt on the VMO, VL, and TFL Muscles during Walking

“…Some studies have examined the risks associated with tight clothes. They reported that tight clothes such as tight belts, ties, and jeans, which are becoming increasingly popular, have a constraining influence on the abdomen, which in turn might promote reflux 4,5) . Recently, wearing tight skirts has become fashionable.…”