Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort

Publication

Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort

Journal Paper/Review - Jun 13, 2016

Lu Yunxia, Bueno-de-Mesquita H B, Trichopoulou Antonia, Klinaki Eleni, Tsironis Christos, Agudo Antonio, Navarro Carmen, Sánchez María-José, Barricarte Aurelio, Boutron-Ruault Marie-Christine, Fagherazzi Guy, Racine Antoine, Weiderpass Elisabete, Gunter Marc J, Siersema Peter D, Peeters Petra H, Tumino Rosario, Cross Amanda J, Murphy Neil, Freisling Heinz, Travis Ruth C, Ferrari Pietro, Katzke Verena A, Kaaks Rudolf, Olsson Åsa, Johansson Ingegerd, Renström Frida, Panico Salvatore, Pala Valeria, Palli Domenico, Riboli Elio

Citation

Lu Y, Bueno-de-Mesquita H, Trichopoulou A, Klinaki E, Tsironis C, Agudo A, Navarro C, Sánchez M, Barricarte A, Boutron-Ruault M, Fagherazzi G, Racine A, Weiderpass E, Gunter M, Siersema P, Peeters P, Tumino R, Cross A, Murphy N, Freisling H, Travis R, Ferrari P, Katzke V, Kaaks R, Olsson Å, Johansson I, Renström F, Panico S, Pala V, Palli D, Riboli E. Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort. Cancer Causes Control 2016; 27:919-27.

Type

Journal Paper/Review (English)

Journal

Cancer Causes Control 2016; 27

Publication Date

Jun 13, 2016

Issn Electronic

1573-7225

Pages

919-27

Brief description/objective

BACKGROUND
The etiology of small intestinal cancer (SIC) is largely unknown, and there are very few epidemiological studies published to date. No studies have investigated abdominal adiposity in relation to SIC.

METHODS
We investigated overall obesity and abdominal adiposity in relation to SIC in the European Prospective Investigation into Cancer and Nutrition (EPIC), a large prospective cohort of approximately half a million men and women from ten European countries. Overall obesity and abdominal obesity were assessed by body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Multivariate Cox proportional hazards regression modeling was performed to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). Stratified analyses were conducted by sex, BMI, and smoking status.

RESULTS
During an average of 13.9 years of follow-up, 131 incident cases of SIC (including 41 adenocarcinomas, 44 malignant carcinoid tumors, 15 sarcomas and 10 lymphomas, and 21 unknown histology) were identified. WC was positively associated with SIC in a crude model that also included BMI (HR per 5-cm increase = 1.20, 95 % CI 1.04, 1.39), but this association attenuated in the multivariable model (HR 1.18, 95 % CI 0.98, 1.42). However, the association between WC and SIC was strengthened when the analysis was restricted to adenocarcinoma of the small intestine (multivariable HR adjusted for BMI = 1.56, 95 % CI 1.11, 2.17). There were no other significant associations.

CONCLUSION
WC, rather than BMI, may be positively associated with adenocarcinomas but not carcinoid tumors of the small intestine.

IMPACT
Abdominal obesity is a potential risk factor for adenocarcinoma in the small intestine.