Abdominal obesity increases risk for esophageal cancer: a nationwide population-based cohort study of South Korea

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Abstract

Background: The relationship between overall obesity, as measured by body mass index (BMI) and risk of esophageal squamous cell carcinoma (ESCC) has been reported to show a negative correlation. However, the relationship of ESCC, which accounts for around 90% of esophageal cancers in South Korea, with abdominal obesity, as measured by waist circumference (WC), may be different. Thus, we investigated the association between abdominal obesity and esophageal cancer in a nationwide population-based cohort. Methods: A retrospective cohort study of 22,809,722 individuals who had undergone regular health check-ups provided by the National Health Insurance Corporation between 2009 and 2012 (median follow-up period, 6.4 years) in South Korea was conducted. Abdominal obesity was defined as a WC > 90 cm for men and > 85 cm for women. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using χ2 test and Cox proportional hazards model adjusted for confounding factors. The primary outcome was newly developed esophageal cancer. Results: After adjusting for BMI, abdominal obesity increased the risk of esophageal cancer (HR 1.29, 95% CI 1.23–1.36). WC increased the risk for esophageal cancer in a dose-dependent manner (p values for trend < 0.0001). Among overweight (BMI 23–24.9 kg/m2) and obese I (BMI 25–29.9 kg/m2) individuals, abdominal obesity was a risk factor for esophageal cancer (HR 1.22, 95% CI 1.11–1.34; HR 1.28, 95% CI 1.18–1.39, respectively). Conclusion: Increasing abdominal obesity may be associated with an increased risk for esophageal cancer. Further studies are warranted to confirm the relationship.

Original languageEnglish
JournalJournal of Gastroenterology
DOIs
StateAccepted/In press - 1 Jan 2019

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Republic of Korea
Abdominal Obesity
Esophageal Neoplasms
Cohort Studies
Waist Circumference
Body Mass Index
Population
Confidence Intervals
National Health Programs
Proportional Hazards Models
Retrospective Studies
Obesity
Health

Keywords

  • Abdominal obesity
  • Esophageal cancer
  • Esophageal squamous cell carcinoma
  • Waist circumference

Cite this

@article{8b5b46f6401d41ffa3aa57e255de1612,
title = "Abdominal obesity increases risk for esophageal cancer: a nationwide population-based cohort study of South Korea",
abstract = "Background: The relationship between overall obesity, as measured by body mass index (BMI) and risk of esophageal squamous cell carcinoma (ESCC) has been reported to show a negative correlation. However, the relationship of ESCC, which accounts for around 90{\%} of esophageal cancers in South Korea, with abdominal obesity, as measured by waist circumference (WC), may be different. Thus, we investigated the association between abdominal obesity and esophageal cancer in a nationwide population-based cohort. Methods: A retrospective cohort study of 22,809,722 individuals who had undergone regular health check-ups provided by the National Health Insurance Corporation between 2009 and 2012 (median follow-up period, 6.4 years) in South Korea was conducted. Abdominal obesity was defined as a WC > 90 cm for men and > 85 cm for women. We estimated hazard ratios (HRs) and 95{\%} confidence intervals (CIs) using χ2 test and Cox proportional hazards model adjusted for confounding factors. The primary outcome was newly developed esophageal cancer. Results: After adjusting for BMI, abdominal obesity increased the risk of esophageal cancer (HR 1.29, 95{\%} CI 1.23–1.36). WC increased the risk for esophageal cancer in a dose-dependent manner (p values for trend < 0.0001). Among overweight (BMI 23–24.9 kg/m2) and obese I (BMI 25–29.9 kg/m2) individuals, abdominal obesity was a risk factor for esophageal cancer (HR 1.22, 95{\%} CI 1.11–1.34; HR 1.28, 95{\%} CI 1.18–1.39, respectively). Conclusion: Increasing abdominal obesity may be associated with an increased risk for esophageal cancer. Further studies are warranted to confirm the relationship.",
keywords = "Abdominal obesity, Esophageal cancer, Esophageal squamous cell carcinoma, Waist circumference",
author = "Cho, {Jae Ho} and Shin, {Cheol Min} and Han, {Kyung Do} and Hyuk Yoon and Park, {Young Soo} and Nayoung Kim and Lee, {Dong Ho}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00535-019-01648-9",
language = "English",
journal = "Journal of Gastroenterology",
issn = "0944-1174",
publisher = "Springer Japan",

}

TY - JOUR

T1 - Abdominal obesity increases risk for esophageal cancer

T2 - a nationwide population-based cohort study of South Korea

AU - Cho, Jae Ho

AU - Shin, Cheol Min

AU - Han, Kyung Do

AU - Yoon, Hyuk

AU - Park, Young Soo

AU - Kim, Nayoung

AU - Lee, Dong Ho

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The relationship between overall obesity, as measured by body mass index (BMI) and risk of esophageal squamous cell carcinoma (ESCC) has been reported to show a negative correlation. However, the relationship of ESCC, which accounts for around 90% of esophageal cancers in South Korea, with abdominal obesity, as measured by waist circumference (WC), may be different. Thus, we investigated the association between abdominal obesity and esophageal cancer in a nationwide population-based cohort. Methods: A retrospective cohort study of 22,809,722 individuals who had undergone regular health check-ups provided by the National Health Insurance Corporation between 2009 and 2012 (median follow-up period, 6.4 years) in South Korea was conducted. Abdominal obesity was defined as a WC > 90 cm for men and > 85 cm for women. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using χ2 test and Cox proportional hazards model adjusted for confounding factors. The primary outcome was newly developed esophageal cancer. Results: After adjusting for BMI, abdominal obesity increased the risk of esophageal cancer (HR 1.29, 95% CI 1.23–1.36). WC increased the risk for esophageal cancer in a dose-dependent manner (p values for trend < 0.0001). Among overweight (BMI 23–24.9 kg/m2) and obese I (BMI 25–29.9 kg/m2) individuals, abdominal obesity was a risk factor for esophageal cancer (HR 1.22, 95% CI 1.11–1.34; HR 1.28, 95% CI 1.18–1.39, respectively). Conclusion: Increasing abdominal obesity may be associated with an increased risk for esophageal cancer. Further studies are warranted to confirm the relationship.

AB - Background: The relationship between overall obesity, as measured by body mass index (BMI) and risk of esophageal squamous cell carcinoma (ESCC) has been reported to show a negative correlation. However, the relationship of ESCC, which accounts for around 90% of esophageal cancers in South Korea, with abdominal obesity, as measured by waist circumference (WC), may be different. Thus, we investigated the association between abdominal obesity and esophageal cancer in a nationwide population-based cohort. Methods: A retrospective cohort study of 22,809,722 individuals who had undergone regular health check-ups provided by the National Health Insurance Corporation between 2009 and 2012 (median follow-up period, 6.4 years) in South Korea was conducted. Abdominal obesity was defined as a WC > 90 cm for men and > 85 cm for women. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using χ2 test and Cox proportional hazards model adjusted for confounding factors. The primary outcome was newly developed esophageal cancer. Results: After adjusting for BMI, abdominal obesity increased the risk of esophageal cancer (HR 1.29, 95% CI 1.23–1.36). WC increased the risk for esophageal cancer in a dose-dependent manner (p values for trend < 0.0001). Among overweight (BMI 23–24.9 kg/m2) and obese I (BMI 25–29.9 kg/m2) individuals, abdominal obesity was a risk factor for esophageal cancer (HR 1.22, 95% CI 1.11–1.34; HR 1.28, 95% CI 1.18–1.39, respectively). Conclusion: Increasing abdominal obesity may be associated with an increased risk for esophageal cancer. Further studies are warranted to confirm the relationship.

KW - Abdominal obesity

KW - Esophageal cancer

KW - Esophageal squamous cell carcinoma

KW - Waist circumference

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U2 - 10.1007/s00535-019-01648-9

DO - 10.1007/s00535-019-01648-9

M3 - Article

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AN - SCOPUS:85076103583

JO - Journal of Gastroenterology

JF - Journal of Gastroenterology

SN - 0944-1174

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