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Tanja Stocks

Tanja Stocks

Researcher

Tanja Stocks

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

Author

  • Harinakshi Sanikini
  • David C. Muller
  • Marisa Sophiea
  • Sabina Rinaldi
  • Antonio Agudo
  • Eric J. Duell
  • Elisabete Weiderpass
  • Kim Overvad
  • Anne Tjønneland
  • Jytte Halkjær
  • Marie Christine Boutron-Ruault
  • Franck Carbonnel
  • Iris Cervenka
  • Heiner Boeing
  • Rudolf Kaaks
  • Tilman Kühn
  • Antonia Trichopoulou
  • Georgia Martimianaki
  • Anna Karakatsani
  • Valeria Pala
  • Domenico Palli
  • Amalia Mattiello
  • Rosario Tumino
  • Carlotta Sacerdote
  • Guri Skeie
  • Charlotta Rylander
  • María Dolores Chirlaque López
  • Maria Jose Sánchez
  • Eva Ardanaz
  • Sara Regnér
  • Tanja Stocks
  • Bas Bueno-de-Mesquita
  • Roel C.H. Vermeulen
  • Dagfinn Aune
  • Tammy Y.N. Tong
  • Nathalie Kliemann
  • Neil Murphy
  • Marc Chadeau-Hyam
  • Marc J. Gunter
  • Amanda J. Cross

Summary, in English

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.

Department/s

  • Surgery
  • LUCC: Lund University Cancer Centre
  • Register-based epidemiology
  • EpiHealth: Epidemiology for Health

Publishing year

2020

Language

English

Pages

929-942

Publication/Series

International Journal of Cancer

Volume

146

Issue

4

Document type

Journal article

Publisher

John Wiley and Sons

Topic

  • Cancer and Oncology
  • Public Health, Global Health, Social Medicine and Epidemiology

Keywords

  • cancer
  • esophageal
  • gastric
  • hormones
  • obesity
  • reproductive

Status

Published

Research group

  • Surgery
  • Register-based epidemiology

ISBN/ISSN/Other

  • ISSN: 0020-7136