Abstract B85: Childhood obesity and risk of adult squamous-cell carcinoma of the esophagus in a high risk area

Abstract

Abstract Background: Esophageal squamous cell carcinoma (ESCC) is the most common type of esophageal cancer worldwide and the first cause of cancer morbidity and mortality in parts of the world, including northeastern Iran. While obesity has been shown to be a risk factor for esophageal adenocarcinoma, little is known about the association between childhood obesity and ESCC. Methods: As part of the Gastroesophageal Malignancies in Northern Iran (GEMINI) project, a case-control study was conducted between December 2003 and March 2007 in Golestan Province, in northeastern Iran. Newly-diagnosed histologically-proven cases of esophageal squamous cell carcinoma were recruited from the only GI specialty clinic in the region. Two neighborhood controls, matched by age and sex, were recruited for each case. We collected demographic and health-related information from participants using structured questionnaires. In addition, each individual was shown a standard pictogram validated for this population to report the body size at present and at age 15, starting with picture 1 (very slim) to 7 in men and 9 in women (very obese). We used conditional logistic regression (matched on age, sex and current place of residence) to analyze the association between cancer and body size at 15. The model was further adjusted for ethnicity, education, number of siblings, smoking, as well as childhood place of residence, use of piped water, physical activity, therapeutic opium use, early smoking age, and oral health. Results: There were 300 cases and 571 age and sex-matched controls. Twenty-seven percent of cases and 26% of controls were urban residents, and 57% versus 55% were from Turkmen ethnicity, respectively. 10.4% of cases and 4.4% of controls had been very obese at the age of 15 (p<0.001). In the adjusted model, women reporting the highest level of obesity at age 15 had an OR of 2.9 (95%CI: 1.3-6.6) for developing ESCC. In men, this was not significant (OR=1.3, 95% CI: 0.3-5.2) For all participants, body size at 15 showed a positive association with the risk of ESCC (OR=1.1 for each level of increase, 95% CI: 1.05-1.2). In addition, physical activity level during childhood was inversely associated with ESCC risk (OR=0.8, 95%CI: 0.7-0.9). Conclusion: Children, especially girls, with higher weight and low physical activity may be at increased risk of developing squamous cell carcinoma of the esophagus as adults. This underlines the importance of lifestyle modifications much earlier than what is generally considered for ESCC prevention. Citation Information: Cancer Prev Res 2010;3(12 Suppl):B85.