Association between body mass index and oesophageal cancer mortality: a pooled analysis of prospective cohort studies with >800 000 individuals in the Asia Cohort Consortium-Reference-Cited by-同舟云学术

Association between body mass index and oesophageal cancer mortality: a pooled analysis of prospective cohort studies with >800 000 individuals in the Asia Cohort Consortium

Published:2022-03-01 Issue:4 Volume:51 Page:1190-1203
ISSN:0300-5771
Container-title:International Journal of Epidemiology
language:en
Short-container-title:

Author:

Lee Sangjun¹²³,Jang Jieun¹²³,Abe Sarah Krull⁴,Rahman Shafiur⁴⁵,Saito Eiko⁶^ORCID,Islam Rashedul⁴⁷,Gupta Prakash C⁸,Sawada Norie⁹^ORCID,Tamakoshi Akiko¹⁰,Shu Xiao-Ou¹¹^ORCID,Koh Woon-Puay¹²¹³^ORCID,Sadakane Atsuko¹⁴^ORCID,Tsuji Ichiro¹⁵^ORCID,Kim Jeongseon¹⁶^ORCID,Oze Isao¹⁷^ORCID,Nagata Chisato¹⁸,You San-Lin¹⁹,Shin Myung-Hee²⁰,Pednekar Mangesh S⁸,Tsugane Shoichiro⁹^ORCID,Cai Hui¹¹,Yuan Jian-Min²¹²²^ORCID,Wen Wanqing¹¹,Ozasa Kotaro¹⁴^ORCID,Matsuyama Sanae¹⁵,Kanemura Seiki¹⁵,Shin Aesun¹²²³,Ito Hidemi²⁴²⁵,Wada Keiko¹⁸^ORCID,Sugawara Yumi¹⁵^ORCID,Chen Chien-Jen²⁶,Ahn Yoon-Ok¹,Chen Yu²⁷,Ahsan Habibul²⁸,Boffetta Paolo²⁹³⁰,Chia Kee Seng¹³,Matsuo Keitaro¹⁷³¹^ORCID,Qiao You-Lin³²,Rothman Nathaniel³³,Zheng Wei¹¹^ORCID,Inoue Manami⁴^ORCID,Kang Daehee¹²²³,Park Sue K¹²²³^ORCID

Affiliation:

1. Department of Preventive Medicine, Seoul National University College of Medicine , Seoul, Korea

2. Cancer Research Institute, Seoul National University College of Medicine , Seoul, Korea

3. Department of Biomedical Sciences, Seoul National University Graduate School , Seoul, Korea

4. Division of Prevention, Center for Public Health Sciences, National Cancer Center , Tokyo, Japan

5. Research Center for Child Mental Development, Hamamatsu University School of Medicine , Hamamatsu, Shizuoka, Japan

6. Division of Cancer Statistics Integration, Center for Cancer Control & Information Services, National Cancer Center , Tokyo, Japan

7. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo , Tokyo, Japan

8. Healis—Sekhsaria Institute for Public Health , Mahape, Navi Mumbai, India

9. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center , Tokyo, Japan

10. Department of Public Health, Hokkaido University Graduate School of Medicine , Sapporo, Japan

11. Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center , Nashville, USA

12. Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine , Singapore, Singapore

13. Saw Swee Hock School of Public Health, National University of Singapore , Singapore, Singapore

14. Radiation Effects Research Foundation , Hiroshima, Japan

15. Tohoku University Graduate School of Medicine , Miyagi Prefecture, Miyagi, Japan

16. Graduate School of Science and Policy, National Cancer Center , Goyang, Korea

17. Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute , Naogya, Japan

18. Graduate School of Medicine, Gifu University , Gifu, Japan

19. School of Medicine & Big Data Research Center, Fu Jen Catholic University , Taipei, Taiwan

20. Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine , Seoul, Korea

21. Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh , Pittsburgh, PA, USA

22. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, PA, USA

23. Integrated Major in Innovative Medical Science, Seoul National University College of Medicine , Seoul, Republic of Korea

24. Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute , Nagoya, Japan

25. Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine , Nagoya, Japan

26. Genomics Research Center, Academia Sinica , Taipei, Taiwan

27. Departments of Population Health and Environmental Medicine, New York University School of Medicine , New York, USA

28. Department of Public Health Sciences, University of Chicago , Chicago, IL, USA

29. Stony Brook Cancer Center, Stony Brook University , Stony Brook, NY, USA

30. Department of Medical and Surgical Sciences, University of Bologna , Bologna, Italy

31. Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine , Nagoya, Japan

32. Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

33. Division of Cancer Epidemiology & Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA

Abstract

Abstract Background The association between body mass index (BMI) and oesophageal cancer (OC) has been consistently negative among Asians, whereas different associations based on histological OC subtypes have been observed in Europeans and North Americans. We examined the association between BMI and OC mortality in the Asia Cohort Consortium. Methods We performed a pooled analysis to evaluate the association between BMI and OC mortality among 842 630 Asians from 18 cohort studies. Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs. Results A wide J-shaped association between BMI and overall OC mortality was observed. The OC mortality risk was increased for underweight (BMI <18.5 kg/m2: HR = 2.20, 95% CI 1.80–2.70) and extreme obesity (BMI ≥35 kg/m2: HR = 4.38, 95% CI 2.25–8.52) relative to the reference BMI (23–25 kg/m2). This association pattern was confirmed by several alternative analyses based on OC incidence and meta-analysis. A similar wide J-shaped association was observed in oesophageal squamous cell carcinoma (OSCC). Smoking and alcohol synergistically increased the OC mortality risk in underweight participants (HR = 6.96, 95% CI 4.54–10.67) relative to that in reference BMI participants not exposed to smoking and alcohol. Conclusion Extreme obesity and being underweight were associated with an OC mortality risk among Asians. OC mortality and BMI formed a wide J-shaped association mirrored by OSCC mortality. Although the effect of BMI on OSCC and oesophageal adenocarcinoma mortality can be different in Asians, further research based on a large case–control study is recommended.

Funder

Health Effects for Arsenic Longitudinal Study Bangladesh

National Institute of Environmental Health Science

NCI

Shanghai Women's Health Study

National Cancer Center Research and Development of Korea

Singapore Chinese Health Study

Ministry of Health and Welfare and Ministry of Science and Technology

ACC Coordinating Center, National Cancer Center Research and Development Fund

National Research Foundation of Korea

Korean Foundation for Cancer Research

Publisher