Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort
AuthorLu, Yunxia; 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; Tumino, Rosario; Peeters, Petra H; Siersema, Peter D; Bueno-De-Mesquita, HB; Trichopoulou, Antonia; Klinaki, Eleni; Tsironis, Christos; Agudo, Antonio; Navarro, Camen; Sanchez, Maria-Jose; Barricarte, Aurelio; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Racine, Antoine; Weiderpass, Elisabete; Gunter, Marc J; Riboli, Eilo
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.