Association between Body Mass Index and Risk of Gastric Cancer by Anatomic and Histologic Subtypes in over 500,000 East and Southeast Asian Cohort Participants

Jieun Jang, Sangjun Lee, Kwang Pil Ko, Sarah K. Abe, Md Shafiur Rahman, Eiko Saito, Md Rashedul Islam, Norie Sawada, Xiao Ou Shu, Woon Puay Koh, Atsuko Sadakane, Ichiro Tsuji, Jeongseon Kim, Isao Oze, Chisato Nagata, Shoichiro Tsugane, Hui Cai, Jian Min Yuan, Yu Tang Gao, Kotaro OzasaSanae Matsuyama, Seiki Kanemura, Aesun Shin, Hidemi Ito, Keiko Wada, Yumi Sugawara, Yu Chen, Habibul Ahsan, Paolo Boffetta, Kee Seng Chia, Keitaro Matsuo, You Lin Qiao, Nathaniel Rothman, Wei Zheng, Manami Inoue, Daehee Kang, Sue K. Park

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: This study was performed to investigate the association between body mass index (BMI) and gastric cancer in East and Southeast Asia where most of gastric cancer is non-cardia gastric cancer. Methods:Onthe basis of 8,997 gastric cancer cases among theAsia Cohort Consortium participants from China, Japan, Korea, and Singapore (N = 538,835), we assessed gastric cancer risk according to BMI by calculating hazard ratios (HR) and 95% confidence intervals (CI) using the Cox proportional hazard regression model. Results: A U-shaped associations between BMI and gastric cancer risk were observed. Gastric cancer risks in underweight group (<18.5 kg/m2) and in obesity group (≥27.5 kg/m2) were higher than reference BMI group (23-24.9 kg/m2; HR, 1.15; 95% CI, 1.05-1.25 for underweight; HR, 1.12; 95% CI, 1.03-1.22 for obesity, respectively). The associations of underweight and obesity with gastric cancer risk were consistent in the analyses for non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer. No significant association of underweight and obesity with the risk of cardia gastric cancer, diffuse-type gastric cancer, and early-onset gastric cancer was observed. In addition, we found that the U-shaped association between BMI and gastric cancer risk remained in nonsmokers, while only underweight was related to increased gastric cancer risk in smokers. Conclusions: BMI has a U-shaped association with gastric cancer risk in East and Southeast Asian population, especially for the non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer. Impact: Future studies with consideration of anatomic location and histology of gastric cancer are needed to establish the association of underweight as well as obesity with gastric cancer risk.

Original languageEnglish
Pages (from-to)1727-1734
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Volume31
Issue number9
DOIs
StatePublished - Sep 2022

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