Combined effects of obesity, acid reflux and smoking on adenocarcinomas of the oesophagus

Whiteman, D. C., Sadeghi, S., Pandeya, N., Smithers, B. M., Gotley, D. C., Bain, C. J., Webb, P. M. and Green, A. C. (2008) Combined effects of obesity, acid reflux and smoking on adenocarcinomas of the oesophagus. Gut, 57 2: 173-180. doi:10.1136/gut.2007.131375

Author Whiteman, D. C.
Sadeghi, S.
Pandeya, N.
Smithers, B. M.
Gotley, D. C.
Bain, C. J.
Webb, P. M.
Green, A. C.
Title Combined effects of obesity, acid reflux and smoking on adenocarcinomas of the oesophagus
Journal name Gut   Check publisher's open access policy
ISSN 0017-5749
Publication date 2008
Year available 2007
Sub-type Article (original research)
DOI 10.1136/gut.2007.131375
Volume 57
Issue 2
Start page 173
End page 180
Total pages 8
Place of publication United Kingdom
Publisher B M J Publishing Group
Collection year 2008
Language eng
Subject C1
321202 Epidemiology
730108 Cancer and related disorders
111799 Public Health and Health Services not elsewhere classified
Abstract Objective: To measure the relative risks of adenocarcinomas of the oesophagus and gastro-oesophageal junction associated with measures of obesity, and their interactions with age, sex, gastro-oesophageal reflux symptoms and smoking. Design and setting: Population-based case-control study in Australia. Patients: Patients with adenocarcinomas of the oesophagus (n = 367) or gastro-oesophageal junction (n = 426) were compared with control participants (n = 1580) sampled from a population register. Main outcome measure: Relative risk of adenocarcinoma of the oesophagus or gastro-oesophageal junction. Results: Risks of oesophageal adenocarcinoma increased monotonically with body mass index (BMI) (p(trend) < 0.001). Highest risks were seen for BMI >= 40 kg/m(2) (odds ratio (OR) = 6.1, 95% Cl 2.7 to 13.6) compared with "healthy'' BMI (18.5-24.9 kg/m(2)). Adjustment for gastro-oesophageal reflux and other factors modestly attenuated risks. Risks associated with obesity were substantially higher among men (OR = 2.6, 95% Cl 1.8 to 3.9) than women (OR = 1.4, 95% Cl 0.5 to 3.5), and among those aged <50 years (OR = 7.5, 95% Cl 1.7 to 33.0) than those aged >= 50 years (OR = 2.2, 95% Cl 1.5 to 3.1). Obese people with frequent symptoms of gastro-oesophageal reflux had significantly higher risks (OR = 16.5, 95% Cl 8.9 to 30.6) than people with obesity but no reflux (OR = 2.2, 95% Cl 1.1 to 4.3) or reflux but no obesity (OR = 5.6, 95% 2.8 to 11.3), consistent with a synergistic interaction between these factors. Similar associations, but of smaller magnitude, were seen for gastro-oesophageal junction adenocarcinomas. Conclusions: Obesity increases the risk of oesophageal adenocarcinoma independently of other factors, particularly among men. From a clinical perspective, these data suggest that patients with obesity and frequent symptoms of gastro-oesophageal reflux are at especially increased risk of adenocarcinoma.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

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Created: Fri, 28 Mar 2008, 17:04:03 EST