Role of obesity in Barrett's esophagus and cancer.
The incidence of esophageal adenocarcinoma (EAC) has increased dramatically in the western world, and there also appears to have been an increase in the incidence of Barrett's esophagus and gastroesophageal reflux disease in recent years. The contemporaneous increase in obesity has focused interest on whether obesity is a risk factor for EAC and its precursors. This article reviews current evidence for the role that overweight/obesity and body fat distribution have in development of the esophagitis metaplasia-dysplasia-adenocarcinoma sequence. Particular attention is paid to the stage at which adiposity may act to influence the risk of EAC, because this determines the importance of weight control and weight loss at each stage in the disease spectrum for the prevention of EAC.
Murray
Liam
L
Centre for Public Health, The Queen's University of Belfast, Mulhouse Building, Grosvenor Road, Belfast B12 6BJ, UK. murray@qub.ac.uk
Romero
Yvonne
Y
D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology*; D054392:Adipokines / Q000502:physiology; D001471:Barrett Esophagus / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D050218:Body Fat Distribution; D003043:Cocarcinogenesis; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D004942:Esophagitis, Peptic / Q000209:etiology; D055317:Evidence-Based Practice; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D054439:Ghrelin / Q000502:physiology; D006801:Humans; D015994:Incidence; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control; D011230:Precancerous Conditions / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D055105:Waist Circumference; D015431:Weight Loss
D054392:Adipokines; D054439:Ghrelin