Abstract
The relationship between excess body weight and gastric cancer risk has not been well
studied to date. We therefore carried out a systematic review and meta-analysis of
published cohort studies to evaluate the association between excess body weight and
gastric cancer risk. An electronic search of the MEDLINE, PubMed, EMBASE and Academic
Search Premier (EBSCO) databases, which contain articles published from 1950 onwards,
was conducted in order to select studies for this meta-analysis. Ten studies with
a total number of 9492 gastric cancer cases and a studied population of 3,097,794
were identified. Overall, excess body weight [body mass index (BMI) ⩾ 25] was associated with an increased risk of gastric cancer [odds ratio (OR) = 1.22; 95% confidence intervals (CIs) = 1.06–1.41]. Specifically, a stratified analysis showed that excess body weight was
associated with an increased risk of cardia gastric cancer [overweight and obese (BMI ⩾ 25), OR = 1.55, 95% CIs = 1.31–1.84] and gastric cancer among non-Asians (overweight and obese, OR = 1.24, 95% CIs = 1.14–1.36); however, the stratified analysis also showed that there was no statistically
significant link between excess body weight and gastric cancer in the following subgroups:
males (overweight and obese, OR = 1.22, 95% CIs = 0.96–1.55), females (overweight and obese, OR = 1.13, 95% CIs = 0.65–1.94), non-cardia gastric cancer (overweight and obese, OR = 1.18, 95% CIs = 0.96–1.45) and Asians (overweight and obese, OR = 1.17, 95% CIs = 0.88–1.56).
The combined results of this meta-analysis, however, do indicate that overweight and
obesity are associated with an increased risk of gastric cancer. The strength of the
association also increases with increasing BMI.
Keywords
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References
- Global cancer statistics, 2002.CA Cancer J Clin. 2005; 55: 74-108
- Epidemiology of stomach cancer.Meth Mol Biol. 2009; 472: 467-477
- Gastric cancer: global pattern of the disease and an overview of environmental risk factors.Best Pract Res Clin Gastroenterol. 2006; 20: 633-649
- Overweight, obesity, and mortality from cancers in a prospectively studied cohort of US adults.N Engl J Med. 2003; 348: 1625-1638
- Body mass index and cancer risk in Korean men and women.Int J Cancer. 2008; 123: 1892-1896
- Body size and composition and the risk of gastric and oesophageal adenocarcinoma.Int J Cancer. 2006; 118: 2628-2631
- Obesity and cancer risk among white and black United States veterans.Cancer Causes Contr. 2004; 15: 35-43
- Prospective study of risk factors for esophageal and gastric cancers in the Linxian genneral population trial cohort in China.Int J Cancer. 2005; 113: 456-463
- Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study.Gut. 2007; 56: 1503-1511
- Dietary patterns and risk of incident gastric adenocarcinoma.Am J Epidemiol. 2008; 167: 295-304
- Adenocarcinoma of the oesophagus and gastric cardia: male preponderance in association with obesity.Eur J Cancer. 2006; 42: 1151-1158
- Body mass, tobacco and alcohol and risk of esophageal, gastric cardia, and gastric non-cardia adenocarcinoma among men and women in a nested case-control study.Cancer Causes Contr. 2005; 16: 285-294
- Socioeconomic factors and risk of esophageal adenocarcinoma: a nationwide Swedish case-control study.Cancer Epidemiol Biomark Prev. 2005; 14: 1754-1761
- Effect of body mass index on adenocarcinoma of gastric cardia.World J Gastroenterol. 2003; 9: 2658-2661
- Population attributable risk of esophageal and gastric cancer.J Natl Cancer Inst. 2003; 95: 1404-1413
- Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma.Cancer. 2003; 98: 940-948
- Height, weight, menstrual and reproductive factors and risk of gastric cancer among Japanese postmenopausal women: analysis by subsite and histologic subtype.Int J Cancer. 2002; 97: 833-838
- A multiethnic population population-based study of smoking, alcohol and body size and risk of adenocarcinomas of stomach and esophagus (United States).Cancer Causes Contr. 2001; 12: 721-732
- Association between obesisty and cancer incidence in the population of the district Sumperk, Czech Republic.Onkologie. 2007; 30: 538-542
- Comparison of self-reported height and weight by cancer type among men from Montreal, Canada.Eur J Cancer Prev. 2005; 14: 431-438
- Abdominal obesity and the risk of esophageal and gastric cardia carcinomas.Cancer Epidemiol Biomark Prev. 2008; 17: 352-358
- Personal history and family history as a predictor of gastric cardiac adenocarcinoma risk: a case-control study in Taiwan.Am J Gastroenterol. 2004; 99: 1250-1257
- A prospective study of weight, body mass index and other anthropometric measurements in relation to site-specific cancers.Int J Cancer. 1994; 57: 313-317
- Impact of body mass index on the risk of total cancer incidence and mortality among middle-aged Japanese: data from a large-scale population-based cohor study – The JPHC Study.Cancer Causes Contr. 2004; 15: 671-680
- A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma.Eur J Cancer. 2008; 44: 465-471
- Occupational exposures and risk of esophageal and gastric cardia cancer among male Swedish Construction workers.Cancer Causes Contr. 2005; 16: 755-764
- Body mass index and cancer: results from the Northern Sweden health and disease cohort.Int J Cancer. 2006; 118: 458-466
- Effects of excess weight on cancer incidences depending on cancer sites and histologic findings among men: Korea national health insurance corporation study.J Clin Oncol. 2005; 23: 4742-4754
- Impact of prediagnosis smoking, alcohol, obesity, and insulin resistance on survival in male cancer patients: national health insurance corporation study.J Clin Oncol. 2006; 24: 5107-5124
- Female reproductive factors and the risk of gastric cancer in a large-scale population-based cohort study in Japan (JPHC study).Eur J Cancer Prev. 2008; 17: 345-353
- Cancer incidence and mortality in relation to body mass index in the million women study: cohort study.BMJ. 2007; 335: 1134-1144
- Body mass and physical activity and risk of gastric cancer in a population-based cohort study in Norway.Cancer Epidemiol Biomark Prev. 2008; 17: 135-140
- Prospective cohort study of body mass index in adolescence and death from stomach cancer in Japan.Cancer Sci. 2007; 98: 1785-1789
- Anthropometric factors and risk of endometrial cancer: the European prospective investigation into cancer and nutrition.Cancer Causes Contr. 2007; 18: 399-413
- Diabetes and endometrial cancer: an evaluation of the modifying effects of other known risk factors.Am J Epidemiol. 2008; 167: 607-614
- Endometrial adenocarcinoma in young Thai women.Asian Pac J Cancer Prev. 2008; 9: 283-286
- Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies.Lancet. 2008; 371: 569-578
- Adult weight change and risk of postmenopausal breast cancer.JAMA. 2006; 296: 193-201
- Body mass index in relation to ovarian cancer survival.Cancer Epidemiol Biomark Prev. 2005; 14: 1307-1310
- Body mass index and risk of ovarian cancer.Cancer. 2009; 115: 812-822
- A prospective study of anthropometric and clinical measurements associated with insulin resistance syndrome and colorectal cancer in male smokers.Am J Epidemiol. 2006; 164: 652-664
- Body size and composition and risk of rectal cancer (Australia).Cancer Causes Contr. 2006; 17: 1291-1297
- Prospective weight Chang and Colo cancer risk in male US health professionals.Int J Cancer. 2008; 123: 1160-1165
- Body mass index and risk of cancers of the gastric carsia and distal stomach in Shanghai, China.Cancer Epidemiol Biomark Prev. 1997; 6: 481-485
- Adenocarcinoma of the gastric cardia.Dig Dis. 1997; 15: 346-356
- Clincopathologic features of adenocarcinoma at the gastric cardia: is it different from distal cancer of the stomach?.J Am Coll Surg. 2008; 206: 306-310
- Increased incidence of adenocarcinomas at the gastro-oesophageal junction in Dutch males since 1990s.Eur J Gastroenterol Hepatol. 2002; 14: 115-122
- Influence of site classification on cancer incidence rates: an analysis of gastric cardia carcinomas.J Natl Cancer Inst. 2004; 96: 1383-1387
- Trends in the incidence of adenocarcinoma of the oesophagus and cardia in the Netherlands 1989–2003.Br J Cancer. 2007; 96: 1767-1771
- Long-term and recent time trends in the prevalence of obesity among Dutch men and women.Int J Obes Relat Metab Disord. 2002; 26: 1218-1224
- Obesity and cancer.Oncogene. 2004; 23: 6365-6378
- Changes of waist circumference distribution and the prevalence of abdominal adiposity among Chinese adults from 1993 to 2006.Zhonghua Liu Xing Bing Xue Za Zhi. 2008; 29: 953-958
- Body mass index and percent body fat: a meta-analysis among different ethnic groups.Int J Obes Relat Metab Disord. 1998; 22: 1164-1171
- Adenocarcinomas of distal oesophagus and gastric cardia are one clinical entity. Rotterdam Oesophageal Tumour Study Group.Br J Surg. 1999; 86: 529-535
- Comparison of comorbidity prevalence in oesophageal and gastric carcinoma patients: a population-based study.Eur J Gastroenterol Hepatol. 2004; 16: 681-688
- Obesity and estrogen as risk factors for gastroesophageal reflux symptoms.JAMA. 2003; 290: 66-72
- Relationship between body mass and gastro-oesophageal reflux symptoms: The Bristol Helicobacter Project.Int J Epidemiol. 2003; 32: 645-650
- Gastrointestinal disorders and symptoms: does body mass index matter?.Neth J Med. 2006; 64: 45-49
- Overweight, obesity, and cancer risk.Lancet Oncol. 2002; 3: 565-574
- Adiponectin inhibits the growth and peritoneal metastasis of gastric cancer through its specific membrane receptors AdipoR1 and AdipoR2.Cancer Sci. 2007; 98: 1120-1127
- Differential effects of leptin on caner in vitro.J Surg Res. 2003; 113: 50-55
- Insulin-like growth factors and breast cancer.Onkologie. 2003; 26: 290-294
- Adipose tissue as an endocrine organ.J Clin Endocrinol Metab. 2004; 89: 2548-2556
- Leisure-time physical activity and reduced plasma levels of obesity-related inflammatory markers.Obes Res. 2003; 11: 1055-1064
- AP1- and NF-kappaB-binding sites conserved among mammalian WNT10B orthologs elucidate the TNFalpha-WNT10B signaling loop implicated in carcinogenesis and adipogenesis.Int J Mol Med. 2007; 19: 699-703
- Study of quantification of oxidative stresses caused by lifestyle habits.Rinsho Byori. 2007; 55: 35-40
Article Info
Publication History
Published online: May 08, 2009
Accepted:
April 14,
2009
Received in revised form:
March 31,
2009
Received:
March 25,
2009
Identification
Copyright
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
