A meta-analysis of body mass index and esophageal and gastric cardia adenocarcinoma.
BACKGROUND
The incidence rates of esophageal and gastric cardia adenocarcinoma (EGCA) have increased over recent years in several countries, and overweight/obesity has been suggested to play a major role in these trends. In fact, higher body mass index (BMI) has been positively associated with EGCA in several studies.


METHODS
We conducted a meta-analysis of case-control and cohort studies on the BMI and EGCA updated to March 2011. We estimated overall relative risks (RRs) and 95% confidence intervals (CI) for BMI between 25 and 30 and BMI ≥ 30 kg/m(2), when compared with normo-weight subjects, using random-effects models.


RESULTS
We identified 22 studies, including almost 8000 EGCA cases. The overall RR was 1.71 (95% CI 1.50-1.96) for BMI between 25 and 30, and was 2.34 (95% CI 1.95-2.81) for BMI ≥ 30 kg/m(2). The continuous RR for an increment of 5 kg/m(2) of BMI was 1.11 (95% CI 1.09-1.14). The association was stronger for esophageal adenocarcinoma (RR for BMI ≥ 30 kg/m(2) = 2.73, 95% CI 2.16-3.46) than for gastric cardia adenocarcinoma (RR for BMI ≥ 30 kg/m(2) = 1.93, 95% CI 1.52-2.45). No substantial differences emerged across strata of sex and geographic areas.


CONCLUSIONS
Overweight and obesity are strongly related to EGCA, particularly to espophageal adenocarcinoma.
Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, 20156 Milan, Italy.
F
F
Turati
I
I
Tramacere
C
C
La Vecchia
E
E
Negri
D000230:Adenocarcinoma / Q000209:etiology*; D015992:Body Mass Index; D002299:Cardia / Q000473:pathology*; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000209:etiology*; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000473:pathology; D011446:Prospective Studies; D012306:Risk; D013274:Stomach Neoplasms / Q000209:etiology*