Annals of Oncology 12:975-979, 2001
© 2001 European Society for Medical Oncology
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Leanness and squamous cell oesophageal cancer
1Istituto, di Ricercize Farmacologiche Mario Negri
2present address. Department of Oncologiy, Uni Ziekenhuis Antwerpen, Istituto di Statistica Medica e Biometria, Unversita degli Studt di Milano Edegem. Belgium Milan, Italy
3Registre raudois des tumeurs, Institut universitaire de mèdecine, sociale et prèventive Lausanne, Switzerland
4Servizio di Epidemiologia dei Tumori Registro de Tumori de Veneto, Padua
5Centro di Riferimento Oncologico Aviano Pordenone, Italy
6International Agency for Research on Cancer Lyon, France
Dr S. Gallus Istituto di Ricerche Farmacologiche Mario Negri Via Eritrea, 62 20157 Milano Italy gallus{at}marionegri.it
Background: Squamous cell oesophageal cancer is one of the few neoplasms inversely related to body mass index (BMI). However, it is not clear whether this is due to cancer-related weight loss or to other correlates of leanness.
Patients and methods: 395 incident, histologically confirmed cases of squamous cell oesophageal cancer and 1,066 controls, admitted for acute, non-neoplastic diseases, in Italy and Switzerland. Odds ratios (ORs) were derived from multiple logistic regression, including terms for education, tobacco, alcohol, non-alcohol energy, fruit and vegetable intake
Results: The ORs for the lowest vs. the highest quartile of BMI in the year before diagnosis were 2.0 in men, 1.6 in women, and 1.9 (95% confidence interval: 1.3–2.9) in both sexes combined. The association with leanness was stronger in heavy smokers, but was not accounted for by smoking and drinking, nor by differences in diet. Weight change in the decade prior to diagnosis showed no linear association with risk. However, cases were not leaner than controls at age 30 (OR = 0.6 for the lowest BMI quartile) and 50 (OR = 1.1).
Conclusions: Leanness appears to be an indicator of squamous cell oesophageal carcinogenesis. However, low BMI in the distant past was unrelated to oesophageal cancer risk.
body mass index, drinking, oral cancer, oesophageal cancer, smoking
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