A case-control study of oesophageal adenocarcinoma in women: a preventable disease

Abstract

The incidence of adenocarcinoma of the oesophagus in British women is among the highest in the world. To investigate its aetiology, we conducted a multi-centre, population based case-control study in four regions in England and Scotland. We included 74 incident cases in women with histologically confirmed diagnoses of adenocarcinoma of the oesophagus, and 74 female controls matched by age and general practice. High body mass index (BMI) around the age of 20 years (highest vs lowest quartile, adjusted odds ratio (OR) = 6.04, 95% confidence interval (CI) 1.28-28.52) and low consumption of fruit (highest vs lowest quartile, adjusted OR = 0.08, 95% CI 0.01-0.49) were associated with increases in risk. Breastfeeding by women was associated with reduced risk of their subsequently developing this cancer (ever vs never, adjusted OR = 0.41, 95% CI 0.20-0.82) and there was a significant dose-response effect with total duration of breastfeeding. The summary population attributable risk from these three factors was 96% (90% if breastfeeding is excluded). We conclude that high BMI in early adulthood and low consumption of fruit are important risk factors for adenocarcinoma of the oesophagus. Breastfeeding may confer a protective effect but this needs confirmation. This cancer is a largely preventable disease in women.

References 13

1. 1.

   Black R. J., Bray F., Ferlay J., Parkin D. M. Cancer incidence and mortality in the European Union: cancer registry data and estimates of national incidence for 1990. Eur J Cancer. 1997;33(7):1075-1107.

   Not in our library10.1016/s0959-8049(96)00492-3

2. 2.

   Blot W. J., Devesa S. S., Kneller R. W., Fraumeni J. F. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA. 1991;265(10):1287-1289.

   Not in our library

3. 3.

   Brown L. M., Swanson C. A., Gridley G., Swanson G. M., Schoenberg J. B., Greenberg R. S., Silverman D. T., Pottern L. M., Hayes R. B., Schwartz A. G. Adenocarcinoma of the esophagus: role of obesity and diet. J Natl Cancer Inst. 1995;87(2):104-109.

   Not in our library10.1093/jnci/87.2.104

4. 4.

   Bruzzi P., Green S. B., Byar D. P., Brinton L. A., Schairer C. Estimating the population attributable risk for multiple risk factors using case-control data. Am J Epidemiol. 1985;122(5):904-914.

   Not in our library10.1093/oxfordjournals.aje.a114174

5. 5.

   Chow W. H., Blot W. J., Vaughan T. L., Risch H. A., Gammon M. D., Stanford J. L., Dubrow R., Schoenberg J. B., Mayne S. T., Farrow D. C. Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst. 1998;90(2):150-155.

   Not in our library10.1093/jnci/90.2.150

6. 6.

   Gammon M. D., Schoenberg J. B., Ahsan H., Risch H. A., Vaughan T. L., Chow W. H., Rotterdam H., West A. B., Dubrow R., Stanford J. L. Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst. 1997;89(17):1277-1284.

   Not in our library10.1093/jnci/89.17.1277

7. 7.

   Lagergren J., Bergström R., Nyrén O. Association between body mass and adenocarcinoma of the esophagus and gastric cardia. Ann Intern Med. 1999;130(11):883-890.

   Not in our library10.7326/0003-4819-130-11-199906010-00003

8. 8.

   Mearin F., Malagelada J. R. Gastroparesis and dyspepsia in patients with diabetes mellitus. Eur J Gastroenterol Hepatol. 1995;7(8):717-723.

   Not in our library

9. 9.
   Increasing incidence of adenocarcinoma of the gastric cardia and adjacent sites · 1990

   No notice
10. 10.

    Seidell J. C., Flegal K. M. Assessing obesity: classification and epidemiology. Br Med Bull. 1997;53(2):238-252.

    Not in our library10.1093/oxfordjournals.bmb.a011611

11. 11.

    Thompson R. L., Margetts B. M., Speller V. M., McVey D. The Health Education Authority's health and lifestyle survey 1993: who are the low fruit and vegetable consumers? J Epidemiol Community Health. 1999;53(5):294-299.

    Not in our library10.1136/jech.53.5.294

12. 12.

    Vaughan T. L., Davis S., Kristal A., Thomas D. B. Obesity, alcohol, and tobacco as risk factors for cancers of the esophagus and gastric cardia: adenocarcinoma versus squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev. 1995;4(2):85-92.

    Not in our library

13. 13.

    Zhang Z. F., Kurtz R. C., Yu G. P., Sun M., Gargon N., Karpeh M., Fein J. S., Harlap S. Adenocarcinomas of the esophagus and gastric cardia: the role of diet. Nutr Cancer. 1997;27(3):298-309.

    Not in our library10.1080/01635589709514541

Cited by papers we hold 2

• Non-steroidal anti-inflammatory drugs and risk of gastric and oesophageal adenocarcinomas: results from a cohort study and a meta-analysis · 2009
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• Oesophageal cancer incidence in the United States by race, sex, and histologic type, 1977–2005 · 2009
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