Body mass index, smoking, and alcohol and risks of Barrett’s esophagus and esophageal adenocarcinoma: A UK prospective cohort study

Yates, Max ORCID: https://orcid.org/0000-0003-3977-8920, Cheong, Edward, Luben, Robert, Igali, Laszlo, Fitzgerald, Rebecca, Khaw, Kay-Tee and Hart, Andrew (2014) Body mass index, smoking, and alcohol and risks of Barrett’s esophagus and esophageal adenocarcinoma: A UK prospective cohort study. Digestive Diseases and Sciences, 59 (7). pp. 1552-1559. ISSN 0163-2116

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Abstract

Background The timing of the risk factors cigarette smoking, alcohol and obesity in the development of Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC) is unclear. Aims: To investigate these exposures in the aetiology of BE and EAC in the same population. Methods: The cohort included 24,068 men and women, aged 39–79 years, recruited between 1993 and 1997 into the prospective EPIC-Norfolk Study who provided information on anthropometry, smoking and alcohol intake. The cohort was monitored until December 2008 and incident cases identified. Results: One hundred and four participants were diagnosed with BE and 66 with EAC. A body mass index (BMI) above 23 kg/m2 was associated with a greater risk of BE [BMI ≥23 vs. 18.5 to <23, hazard ratio (HR) 3.73, 95 % CI 1.37–10.16], and within a normal BMI, the risk was greater in the higher category (HR 3.76, 95 % CI 1.30–10.85, BMI 23–25 vs. 18.5 to >23 kg/m2). Neither smoking nor alcohol intake were associated with risk for BE. For EAC, all BMI categories were associated with risk, although statistically significant for only the highest (BMI >35 vs. BMI 18.5 to <23, HR 4.95, 95 % CI 1.11–22.17). The risk was greater in the higher category of a normal BMI (HR 2.73, 95 % CI 0.93–8.00, p = 0.07, BMI 23–25 vs. 18.5 to >23 kg/m2). There was an inverse association with ≥7 units alcohol/week (HR 0.51, 95 % CI 0.29–0.88) and with wine (HR 0.49, 95 % CI 0.23–1.04, p = 0.06, drinkers vs. non-drinkers). Conclusions: Obesity may be involved early in carcinogenesis and the association with EAC and wine should be explored. The data have implications for aetiological investigations and prevention strategies.

Item Type: Article
Additional Information: The Author(s) 2014. This article is published with open access at Springerlink.com
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Gastroenterology and Gut Biology
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User: Pure Connector
Date Deposited: 05 Aug 2014 15:54
Last Modified: 19 Oct 2023 01:21
URI: https://ueaeprints.uea.ac.uk/id/eprint/49741
DOI: 10.1007/s10620-013-3024-z

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