An analysis of data from the European Prospective Investigation into Cancer and Nutrition cohort supports a role for hormonal pathways in upper gastrointestinal cancers.
The study published in the International Journal of Cancer investigated anthropometric and reproductive factors in relation to oesophageal and gastric cancer by sub-type and sub-site for 476,160 participants.
During a mean follow-up of 14 years, 220 oesophageal adenocarcinomas (EA), 195 oesophageal squamous cell carcinomas, 243 gastric cardia (GC) and 373 gastric non-cardia (GNC) cancers were diagnosed.
Body mass index (BMI) was associated with EA in men (BMI≥30 vs 18.5-25 kg/m2: HR 1.94; 95% CI 1.25-3.03) and women (HR 2.66; 95% CI 1.15-6.19). Adjustment for waist-to-hip ratio (WHR) attenuated these associations.
Both WHR and waist circumference (WC) were associated with EA in men and women. WHR was also positively associated with GC in women, and WC was positively associated with GC in men.
Inverse associations were observed between parity and EA (>2 vs 0; HR 0.38; 95% CI 0.14-0.99) and age at first pregnancy and GNC (>26 vs oophorectomy was positively associated with GNC (HR 1.87; 95% CI 1.04-3.36).