Demographic and lifestyle predictors of survival in patients with esophageal or gastric cancers.
OBJECTIVE
Risk factors for subtypes of esophageal and gastric cancer recently have been identified, but their effect on survival is unknown.


METHODS
Incident cases (n = 1142) from a population-based case-control study were followed-up from diagnosis (1993-1995) until 2000. Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for esophageal and gastric cancer in relation to prediagnostic factors.


RESULTS
Relative to distant stage, esophageal adenocarcinoma (EA) patients with localized disease had a decreased risk for death (HR, .22; 95% CI, .15-.31), followed by those with regional spread (HR, .32; 95% CI, .23-.45). Similar patterns were seen for the other tumor types. Except for other (non-cardia) gastric adenocarcinomas (OGA), higher household income (> or =15,000 US dollars/y vs. <15,000 US dollars/y) was associated with a 33%-38% decrease in risk for death. Prediagnosis body mass index (BMI) between 25 and 29.9 kg/m 2 was associated with longer survival for EA and OGA patients (EA: HR, .67; 95% CI, .51-.88) vs. BMI <25 kg/m(2). Women with esophageal squamous cell carcinoma (ES) and OGA experienced longer survival compared with men. Age, education, cigarette smoking, alcohol intake, gastroesophageal reflux disease, and nonsteroidal anti-inflammatory drug use did not consistently predict survival.


CONCLUSIONS
Predictors of lengthened esophageal and gastric cancer survival included higher income (except in OGA), overweight (among EA and OGA patients), and female sex (among ES and OGA patients).
Trivers
Katrina F
KF
Department of Epidemiology, University of North Carolina at Chapel Hill, CB #7435, Chapel Hill, North Carolina 27599-7435, USA. trivers@unc.edu
De Roos
Anneclaire J
AJ
Gammon
Marilie D
MD
Vaughan
Thomas L
TL
Risch
Harvey A
HA
Olshan
Andrew F
AF
Schoenberg
Janet B
JB
Mayne
Susan T
ST
Dubrow
Robert
R
Stanford
Janet L
JL
Abrahamson
Page
P
Rotterdam
Heidi
H
West
A Brian
AB
Fraumeni
Joseph F
JF
Chow
Wong-Ho
WH
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology; D016022:Case-Control Studies; D003237:Connecticut; D003710:Demography; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009515:New Jersey; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology; D016019:Survival Analysis; D014861:Washington