期刊
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
卷 18, 期 7, 页码 2079-2089出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-09-0265
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资金
- European Commission (SANCO)
- Deutsche Krebshilfe
- German Cancer Research Center
- German Federal Ministry of Education and Research
- Danish Cancer Society
- Health Research Fund of the Spanish Ministry of Health [C03/09]
- Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra
- ISCIII, Red de Centros [RETIC(RD06/0020)]
- Cancer Research UK
- Medical Research Council, United Kingdom
- Stroke Association
- British Heart Foundation
- Department of Health, United Kingdom
- Food Standards Agency, United Kingdom
- Wellcome Trust, United Kingdom
- Italian Association for Research on Cancer
- Compagnia di San Paolo
- Dutch Ministry Public Health, Welfare and Sports
- National Cancer Registry
- Regional Cancer Registries Amsterdam, East and Maastricht of the Netherlands
- World Cancer Research Fund
- Swedish Cancer Society
- Swedish Scientific Council
- Regional Government of Skane and Vasterbotten, Sweden.
Background: Increasing evidence suggests that general obesity [measured by body mass index (BMI)] is positively associated with risk of esophageal adenocarcinoma (EAC). In contrast, previous studies have shown inverse relations with esophageal squamous cell carcinoma (ESCC). However, it is still unclear whether body fat distribution, particularly abdominal obesity, is associated with each type of esophageal cancer. Methods: We applied multivariable adjusted Cox proportional hazards regression to investigate the association between anthropometric measures and risk of EAC and ESCC among 346,554 men and women participating in the European Prospective Investigation into Cancer and Nutrition. All statistical tests were two sided. Results: During 8.9 years of follow-up, we documented 88 incident cases of EAC and 110 cases of ESCC. BMI, waist circumference, and waist-to-hip ratio (WHR) were positively associated with EAC risk [highest versus lowest quintile; relative risk (RR), 2.60; 95% confidence interval (95% CI), 1.23-5.51; P-trend < 0.01; RR, 3.07; 95% CI, 1.35-6.98; P-trend < 0.003; and RR, 2.12; 95% CI, 0.98-4.57; P-trend < 0.004]. In contrast, BMI and waist circumference were inversely related to ESCC risk, whereas WHR showed no association with ESCC. In stratified analyses, BMI and waist circumference were significantly inversely related to ESCC only among smokers but not among nonsmokers. However, when controlled for BMI, we found positive associations for waist circumference and WHR with ESCC, and these associations were observed among smokers and nonsmokers. Conclusion: General and abdominal obesity were associated with higher EAC risk. Further, our study suggests that particularly an abdominal body fat distribution might also be a risk factor for ESCC. (Cancer Epidemiol Biomarkers Prev 2009;18(7):2079-89)
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