Abstract
The relationship between risk of esophageal squamous cell carcinoma (ESCC) and adult height, changes in individual body mass index (BMI) and body shape is not established. We performed a large population‐based case‐control study, which enrolled a total of 1414 ESCC cases and 1989 controls in a high‐incidence area in China. Using face‐to‐face interview with a structured questionnaire, information on participants' heights, weights, and perceived body shapes at 20 years of age was collected. Additionally, data on weight and perceived body shape among the same participants 10 years prior to ascertainment were collected using the same method. Odd ratios (ORs) of ESCC risk in relation to BMI and body shape were estimated using unconditional logistic regression models. The adjusted results indicated that ESCC risk in adults rapidly rose as height increased, plateauing at 170 cm among men and 157 cm among women. Among participants who were underweight, normal weight, or thinner than body shape 4, body weight loss was associated with increased risk of ESCC, and body weight gain was associated with decreased incidence of ESCC (ORs ranging from 0.40 to 0.76). Notably, however, changes in body weight did not significantly affect ESCC risk among participants who were overweight, obese, or larger than body shape 3. Maintaining a fit body shape and a reasonable BMI is advisable and of vital importance to reduce the risk of ESCC, especially in high‐risk areas.
Highlights
According to the International Agency for Research on Cancer (IARC), about 572 000 new esophageal cancer cases (3.2% of all cancers) and 509 000 deaths from esophageal cancer (5.3% of all cancer deaths) were reported worldwide in 2018.1 Around half of all new esophageal cancer cases occurred in China.[2]
Because more than 95% of esophageal cancer cases are esophageal squamous cell carcinoma (ESCC) in China,[22] we focus in this analysis on the effects of adult height, body mass index (BMI), and perceived body shape change on the risk of ESCC in this high‐incidence Chinese population
From this large population‐based case‐control study in a high‐risk Chinese population, we found that the risk of ESCC in adults rose steadily with increasing height up to 170 cm among men and 157 cm among women, after which the risk of ESCC somewhat plateaued
Summary
According to the International Agency for Research on Cancer (IARC), about 572 000 new esophageal cancer cases (3.2% of all cancers) and 509 000 deaths from esophageal cancer (5.3% of all cancer deaths) were reported worldwide in 2018.1 Around half of all new esophageal cancer cases occurred in China.[2]. With the increase of BMI, contrasting risk association patterns for ESCC and EAC are typically observed: elevated BMI has been shown to be associated with increased incidence of EAC,[9,10,11,12,13] and most studies including a meta‐analysis indicate that BMI is inversely associated with ESCC development.[14,15,16,17] weight loss may be a consequence of late‐stage cancer syndromes
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