title: Anthropometry and esophageal cancer risk in the European prospective investigation into cancer and nutrition.
abstract: BACKGROUND
  Increasing evidence suggests that general obesity [measured by body mass index (BMI)] is positively associated with risk of esophageal adenocarcinoma (EAC). In contrast, previous studies have shown inverse relations with esophageal squamous cell carcinoma (ESCC). However, it is still unclear whether body fat distribution, particularly abdominal obesity, is associated with each type of esophageal cancer.
  
  
  METHODS
  We applied multivariable adjusted Cox proportional hazards regression to investigate the association between anthropometric measures and risk of EAC and ESCC among 346,554 men and women participating in the European Prospective Investigation into Cancer and Nutrition. All statistical tests were two sided.
  
  
  RESULTS
  During 8.9 years of follow-up, we documented 88 incident cases of EAC and 110 cases of ESCC. BMI, waist circumference, and waist-to-hip ratio (WHR) were positively associated with EAC risk [highest versus lowest quintile; relative risk (RR), 2.60; 95% confidence interval (95% CI), 1.23-5.51; P(trend) < 0.01; RR, 3.07; 95% CI, 1.35-6.98; P(trend) < 0.003; and RR, 2.12; 95% CI, 0.98-4.57; P(trend) < 0.004]. In contrast, BMI and waist circumference were inversely related to ESCC risk, whereas WHR showed no association with ESCC. In stratified analyses, BMI and waist circumference were significantly inversely related to ESCC only among smokers but not among nonsmokers. However, when controlled for BMI, we found positive associations for waist circumference and WHR with ESCC, and these associations were observed among smokers and nonsmokers.
  
  
  CONCLUSIONS
  General and abdominal obesity were associated with higher EAC risk. Further, our study suggests that particularly an abdominal body fat distribution might also be a risk factor for ESCC.
authors: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. annika.steffen@dife.de
authors: Annika
authors: A
authors: Steffen
authors: Matthias B
authors: MB
authors: Schulze
authors: Tobias
authors: T
authors: Pischon
authors: Thomas
authors: T
authors: Dietrich
authors: Esther
authors: E
authors: Molina
authors: Maria-Dolores
authors: MD
authors: Chirlaque
authors: Aurelio
authors: A
authors: Barricarte
authors: Pilar
authors: P
authors: Amiano
authors: J Ramón
authors: JR
authors: Quirós
authors: Rosario
authors: R
authors: Tumino
authors: Amalia
authors: A
authors: Mattiello
authors: Domenico
authors: D
authors: Palli
authors: Paolo
authors: P
authors: Vineis
authors: Claudia
authors: C
authors: Agnoli
authors: Gesthimani
authors: G
authors: Misirli
authors: Paolo
authors: P
authors: Boffetta
authors: Rudolf
authors: R
authors: Kaaks
authors: Sabine
authors: S
authors: Rohrmann
authors: H Bas
authors: HB
authors: Bueno-de-Mesquita
authors: Petra H M
authors: PH
authors: Peeters
authors: Anne M
authors: AM
authors: May
authors: Elizabeth A
authors: EA
authors: Spencer
authors: Naomi E
authors: NE
authors: Allen
authors: Sheila
authors: S
authors: Bingham
authors: Anne
authors: A
authors: Tjønneland
authors: Jytte
authors: J
authors: Halkjaer
authors: Kim
authors: K
authors: Overvad
authors: Jakob
authors: J
authors: Stegger
authors: Jonas
authors: J
authors: Manjer
authors: Björn
authors: B
authors: Lindkvist
authors: Göran
authors: G
authors: Hallmanns
authors: Roger
authors: R
authors: Stenling
authors: Eiliv
authors: E
authors: Lund
authors: Elio
authors: E
authors: Riboli
authors: Carlos A
authors: CA
authors: Gonzalez
authors: Heiner
authors: H
authors: Boeing
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000453:epidemiology*; D004938:Esophageal Neoplasms / Q000150:complications / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D011795:Surveys and Questionnaires; D049629:Waist-Hip Ratio