Abdominal obesity and gastroesophageal cancer risk: systematic review and meta-analysis of prospective studies

• Published in: Bioscience reports Vol. 37; no. 3
• Main Authors: Du, Xuan, Hidayat, Khemayanto, Shi, Bi-Min
• Format: Journal Article
• Language: English
• Published: England Portland Press Ltd 30.06.2017
• Subjects: Adenocarcinoma - etiology; Adult; Aged; Body Mass Index; Case-Control Studies; Esophageal Neoplasms - etiology; Esophagogastric Junction - physiopathology; Female; Humans; Male; Middle Aged; Obesity, Abdominal - complications; Prospective Studies; Review; Risk Factors; Stomach Neoplasms - etiology; Waist Circumference - physiology; Waist-Hip Ratio - methods; central obesity; esophageal cancer; gastric cancer; abdominal obesity; waist circumference; waist to hip ratio
• ISSN: 0144-8463; 1573-4935
• DOI: 10.1042/BSR20160474

To systematically and quantitatively review the relation of abdominal obesity, as measured by waist circumference (WC) and waist to hip ratio (WHR), to total gastroesophageal cancer, gastric cancer (GC), and esophageal cancer. PubMed and Web of Science databases were searched for studies assessing the association between abdominal obesity and gastroesophageal cancer (GC and/or esophageal cancer) up to August 2016. A random-effect model was used to calculate the summary relative risks (RRs) and 95% confidence intervals (CIs). Seven prospective cohort studies - one publication included two separate cohorts - from six publications were included in the final analysis. A total of 2130 gastroesophageal cancer cases diagnosed amongst 913182 participants. Higher WC and WHR were significantly associated with increased risk of total gastroesophageal cancer (WC: RR 1.68, 95% CI: 1.38, 2.04; WHR: RR 1.49, 95% CI: 1.19, 1.88), GC (WC: RR 1.48, 95% CI: 1.24, 1.78; WHR: 1.33, 95% CI: 1.04, 1.70), and esophageal cancer (WC: RR 2.06, 95% CI: 1.30, 3.24; WHR: RR 1.99, 95% CI: 1.05, 3.75).Findings from our subgroup analyses showed non-significant positive associations between gastric non-cardia adenocarcinoma (GNCA) and both measures of abdominal adiposity, while gastric cardia adenocarcinoma (GCA) was positively associated with WC but not with WHR. On analysis restricted to studies that adjusted for body mass index (BMI), WC was positively associated with GC and esophageal cancer, whereas WHR was positively associated with risk of GC only. Although limited, the findings from our meta-analysis suggest the potential role of abdominal obesity in the etiology of gastric and esophageal cancers.