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Epidemiology and policy
P1-263 A prospective study of obesity and risk of oesophageal and gastric adenocarcinoma
  1. M O'Doherty1,
  2. N Freedman2,
  3. A Hollenbeck3,
  4. C Abnet2
  1. 1Queens University Belfast, Belfast, UK
  2. 2National Cancer Institute, Rockville, Maryland, USA
  3. 3AARP, Washington, DC, USA

Abstract

Explanations for increasing rates of oesophageal adenocarcinoma (OAC) remain unclear, though the concurrent increase in the prevalence of obesity may be a partial explanation. Although obesity has emerged as a leading candidate risk factor for OAC, few studies have examined body fat distribution. Therefore, we evaluated the relation between overall (BMI) and abdominal (waist-to-hip ratio (WHR)) obesity with OAC (n=253) and gastric cardia adenocarcinoma (n=191) in 218 850 men and women of the NIH-AARP Diet and Health Study cohort. We used Cox proportional hazards regression to estimate HR and 95% CIs, with control for many potential confounders. Comparing the highest to the referent category, we observed that BMI and WHR were both positively associated with OAC [HR (95% CI); 2.11 (1.08 to 4.09) and 1.76 (1.22 to 2.54), respectively]. A positive association was also found for BMI and gastric cardia adenocarcinoma [HR (95% CI); 3.67 (2.00 to 6.71)], but not for WHR [HR (95% CI); 1.34 (0.91 to 1.97)]. Mutually adjusting models for BMI and WHR attenuated, but did not eliminate the associations for both BMI and WHR with OAC [highest vs referent category; HR (95% CI); 1.77 (0.90 to 3.49) and 1.44 (0.98 to 2.10), respectively]. Mutual adjustment had only minor influence on the BMI risk estimates for gastric cardia adenocarcinoma [HR (95% CI); 3.28 (1.76 to 6.11)], whereas WHR estimates were attenuated [HR (95% CI); 1.06 (0.71 to 1.58)]. Overall obesity and abdominal obesity were both related to a higher risk of OAC, but only overall obesity showed an association with gastric cardia adenocarcinoma.

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