A prospective cohort study on overweight, smoking, alcohol consumption, and risk of Barrett’s esophagus
BACKGROUND: Barrett's esophagus (BE) is a precursor lesion of esophageal adenocarcinoma. Besides gastroesophageal reflux, possible risk factors for BE include overweight, cigarette smoking, and alcohol consumption. Our objective was to study these associations using prospective data.
METHODS: The prospective Netherlands Cohort Study, initiated in 1986, consists of 120,852 men and women, aged 55-69 years at baseline. At baseline, all subjects completed a questionnaire on dietary habits and lifestyle. After 16.3 years of follow-up, 370 BE cases with specialized intestinal metaplasia and 3866 subcohort members were available for case-cohort analysis. Cox proportional hazards models were used to calculate incidence rate ratios (RR) and 95% confidence intervals (CI).
RESULTS: Body mass index at baseline was associated with risk of BE in women [multivariable adjusted RR per 1 kg/m2, 1.07 (1.03-1.11)] but not in men [RR per 1 kg/m2, 0.99 (0.93-1.05)]. The association in women was not specifically due to abdominal overweight. Former cigarette smokers were at increased risk of BE (RR=1.33, 95% CI 1.00-1.77), but current smokers were not. Smoking duration showed a positive association with BE risk (p trend=0.03). For alcohol consumption, the RR per 10 grams ethanol/day was 0.95 (0.87-1.03).
CONCLUSIONS: Increased body mass index was a risk factor for BE in women, but not in men. Several aspects of cigarette smoking were positively associated with BE risk. Alcohol consumption was not associated with an increased risk of BE.Impact: Future research should focus on risk factors for development as well as for progression of BE to esophageal adenocarcinoma.
Additional Info
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Authors
Goldbohm R.A.; van den Brandt P.A.; Schouten L.J.; Steevens J.; Driessen A.L.; Huysentruyt C.J.; Keulemans Y.C. -
Issue
Cancer Epidemiol.Biomarkers Prev. -
Published Date
20 december 2010
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