Body mass index in relation to oesophageal and oesophagogastric junction adenocarcinomas: a pooled analysis from the International BEACON Consortium

Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA, Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA, Queensland Institute of Medical Research, Brisbane, Australia, School of Population Health, University of Queensland, Brisbane, Australia, Division of Cancer Etiology, Department of Population Sciences, City of Hope, Duarte, CA, USA, RTI International, Rockville, MD, USA, Department of Epidemiology and Public Health, Yale University School of Public Health, New Haven, CT, USA, Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden, National Cancer Registry Ireland, Cork, Ireland, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA, Department of Surgery and the Genomic Medicine and Pathobiology Group, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, Centre for Public Health, Queen's University, Belfast, Northern Ireland, Division of Research and Oakland Medical Center, Kaiser Permanente, Northern California, Oakland, CA, USA, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA and Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, NC, USA.
International Journal of Epidemiology (Impact Factor: 9.2). 11/2012; 41(6). DOI: 10.1093/ije/dys176
Source: PubMed

ABSTRACT Background Previous studies suggest an association between obesity and oesophageal (OA) and oesophagogastric junction adenocarcinomas (OGJA). However, these studies have been limited in their ability to assess whether the effects of obesity vary by gender or by the presence of gastro-oesophageal reflux (GERD) symptoms.
Methods Individual participant data from 12 epidemiological studies (8 North American, 3 European and 1 Australian) comprising 1997 OA cases, 1900 OGJA cases and 11 159 control subjects were pooled. Logistic regression was used to estimate study-specific odds ratios (ORs) and 95% confidence intervals (CIs) for the association between body mass index (BMI, kg/m2) and the risk of OA and OGJA. Random-effects meta-analysis was used to combine these ORs. We also investigated effect modification and synergistic interaction of BMI with GERD symptoms and gender.
Results The association of OA and OGJA increased directly with increasing BMI (P for trend <0.001). Compared with individuals with a BMI <25, BMI ≥40 was associated with both OA (OR 4.76, 95% CI 2.96–7.66) and OGJA (OR 3.07, 95% CI 1.89–4.99). These associations were similar when stratified by gender and GERD symptoms. There was evidence for synergistic interaction between BMI and GERD symptoms in relation to OA/OGJA risk.
Conclusions These data indicate that BMI is directly associated with OA and OGJA risk in both men and women and in those with and without GERD symptoms. Disentangling the relationship between BMI and GERD will be important for understanding preventive efforts for OA and OGJA.

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Available from: Linda Sharp, Jan 31, 2014