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Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort

Lu Y 1 , Cross AJ 2 , Murphy N 2 , Freisling H 3 , Travis RC 4 , Ferrari P 3 Show all authors , Katzke VA 5 , Kaaks R 5 , Olsson Å 6 , Johansson I 7 , Renström F 8 , Panico S 9 , Pala V 10 , Palli D 11 , Tumino R 12 , Peeters PH 2 , Siersema PD 13 , Bueno-de-Mesquita HB 2 , Trichopoulou A 14 , Klinaki E 14 , Tsironis C 14 , Agudo A 15 , Navarro C 16 , Sánchez MJ 17 , Barricarte A 17 , Boutron-Ruault MC 18 , Fagherazzi G 18 , Racine A 18 , Weiderpass E 19 , Gunter MJ 2 , Riboli E 2

Affiliations 

  • 1 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK. yunxia.lu@imperial.ac.uk
  • 2 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
  • 3 International Agency for Research on Cancer (IARC-WHO), Lyon, France
  • 4 Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
  • 5 Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
  • 6 Department of Surgery, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden
  • 7 Department of Odontology, Umeå University, Umeå, Sweden
  • 8 Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Skåne University Hospital Malmö, Malmö, Sweden
  • 9 Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy
  • 10 Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, 20133, Milan, Italy
  • 11 Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute ISPO, Florence, Italy
  • 12 Cancer Registry and Histopathology Unit, "Civic - M.P. Arezzo" Hospital, ASP Ragusa, Italy
  • 13 Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
  • 14 Hellenic Health Foundation, 23 Alexandroupoleos, 115 27, Athens, Greece
  • 15 Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Av. Gran Via 199-203, 08908, L'Hospitalet de Llobregat, Spain
  • 16 Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
  • 17 Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
  • 18 Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, 94805, Villejuif, France
  • 19 Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, University of Tromsø, Tromsø, Norway
Cancer Causes Control, 2016 07;27(7):919-27.
PMID: 27294726 DOI: 10.1007/s10552-016-0772-z

Abstract

BACKGROUND: The etiology of small intestinal cancer (SIC) is largely unknown, and there are very few epidemiological studies published to date. No studies have investigated abdominal adiposity in relation to SIC.

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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