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Title: 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: Sanikini, Harinakshi
Muller, David C.
Sophiea, Marisa
Rinaldi, Sabina
Agudo, Antonio
Duell, Eric J.
Weiderpass, Elisabete
Overvad, Kim
Tjønneland, Anne
Halkjær, Jytte
Boutron-Ruault, Marie-Christine
Carbonnel, Franck
Cervenka, Iris
Boeing, Heiner
Kaaks, Rudolf
Kühn, Tilman
Trichopoulou, Antonia
Martimianaki, Georgia
Karakatsani, Anna
Pala, Valeria
Palli, Domenico
Mattiello, Amalia
Tumino, Rosario
Sacerdote, Carlotta
Skeie, Guri
Rylander, Charlotta
Chirlaque, María Dolores
Sánchez, María José
Ardanaz, Eva
Regnér, Sara
Stocks, Tanja
Bueno de Mesquita, H. Bas
Vermeulen, Roel C. H.
Aune, Dagfinn
Tong, Tammy Y. N.
Kliemann, Nathalie
Murphy, Neil
Chadeau-Hyam, Marc
Gunter, Marc J.
Cross, Amanda J.
Keywords: Càncer
Issue Date: 21-May-2019
Publisher: John Wiley & Sons, Inc.
Abstract: 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.
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It is part of: International Journal of Cancer, 2019, vol. 146, num. 4, p. 929-942
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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