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Abbas D, Ciricillo JA, Elom HA, Moon AM. Extrahepatic Health Effects of Alcohol Use and Alcohol-associated Liver Disease. Clin Ther 2023; 45:1201-1211. [PMID: 37806811 DOI: 10.1016/j.clinthera.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Alcohol use disorder (AUD) is a growing public health concern and an important contributor to global morbidity and mortality. While the hepatotoxic effects of alcohol are well known, the adverse effects of alcohol are manifested in almost every organ system. With the growing public health impact of AUD, the aim of this narrative review is to highlight the epidemiology and burden of AUD and its association with extrahepatic diseases including malignancy and disorders of the gastrointestinal (GI), cardiovascular, immunologic, neurologic, endocrine, and hematologic systems. METHODS A narrative review of the literature was performed to identify studies addressing the epidemiology, pathophysiology, clinical manifestations, and therapy of extrahepatic health manifestations of alcohol use. FINDINGS In the United States, an estimated 14.5 million people have AUD and approximately 88,000 adults die yearly due to alcohol-related causes. The consumption of alcohol and AUD is associated with injuries, violence, cancers, nonmalignant conditions of the GI system, infections, effects on the cardiovascular system, and neurodegenerative diseases. These conditions contribute to the increased mortality associated with AUD and are burdensome to patients and caregivers. IMPLICATIONS Increased awareness of the extrahepatic manifestations of AUD, screening for AUD using validated screening tools, such as the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) score, and offering evidence-based interventions to patients with AUD is imperative to reduce the public health burden of AUD. Although historically controversial, recent evidence suggests that any level of alcohol consumption can have negative health consequences. Further research is warranted to determine if any amount of alcohol is safe for consumption. Public health efforts are warranted to help curtail the growing burden of AUD.
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Affiliation(s)
- Daniyal Abbas
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina
| | - Jacob A Ciricillo
- Department of Internal Medicine, University of Cincinnati Medicine Center, Cincinnati, Ohio
| | - Hilary A Elom
- Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Andrew M Moon
- Department of Gastroenterology and Hepatology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
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2
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Gao X, Wang Z, Liu B, Cheng Y. Causal association of gut microbiota and esophageal cancer: a Mendelian randomization study. Front Microbiol 2023; 14:1286598. [PMID: 38107856 PMCID: PMC10722290 DOI: 10.3389/fmicb.2023.1286598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/07/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Despite the growing body of evidence, the link between the gut microbiota and different types of tumors, such as colorectal, gastric, and liver cancer, is becoming more apparent. The gut microbiota can be used as a reference for evaluating various diseases, including cancer, and can also act as risk factors or preventive factors. However, the specific connection between the gut microbiota and the advancement of esophageal cancer has yet to be investigated. Therefore, the aim of this research is to clarify the possible causal influence of intestinal microorganisms on the vulnerability to esophageal cancer through the utilization of Mendelian randomization (MR) studies. Methods In this study, we employed a two-sample Mendelian randomization approach to evaluate the unbiased causal association between 150 different gut microbiota types and the occurrence of esophageal cancer. Following the selection from the IEU GWAS database and SNP filtration, we utilized various MR statistical techniques on the suitable instrumental variables. These included IVW methods, employing inverse variance weighting. Additionally, we performed a range of sensitivity analyses to confirm the heterogeneity and pleiotropy of the instrumental variables, thus ensuring the reliability of the outcomes. Results The increased likelihood of developing esophageal cancer is linked to the genetically predicted high levels of Gordonibacter, Oxalobacter, Coprobacter, Veillonella, Ruminiclostridium 5, Ruminococcus 1, and Senegalimasilia genera. Conversely, a decreased risk of esophageal cancer is associated with the high abundance of Turicibacter, Eubacterium oxidoreducens group, Romboutsia, and Prevotella 9 genera. No heterogeneity and pleiotropy were detected in the sensitivity analysis. Discussion We found that 11 types of gut microbial communities are associated with esophageal cancer, thereby confirming that the gut microbiota plays a significant role in the path.
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Affiliation(s)
- Xiangyu Gao
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhiguo Wang
- The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bowen Liu
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, China
| | - Yufeng Cheng
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, China
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Zou M, Liang Q, Zhang W, Zhu Y, Xu Y. Causal association between dietary factors and esophageal diseases: A Mendelian randomization study. PLoS One 2023; 18:e0292113. [PMID: 38019753 PMCID: PMC10686502 DOI: 10.1371/journal.pone.0292113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Using Mendelian randomization (MR) approach, our objective was to determine whether there was a causal association between dietary factors and gastroesophageal reflux disease (GERD), Barrett's esophagus (BE), or esophageal cancer (EC). METHODS Genome-wide association study (GWAS) data for eighteen types of dietary intake were obtained from the UK Biobank. GWAS data for GERD, BE, and EC were sourced from the FinnGen consortium. We performed univariable and multivariable MR analysis to assess the cause effect between dietary factors and esophageal diseases. MR results were expressed as odds ratios (OR) with 95% confidence intervals (CI). RESULTS Raw vegetable intake was associated with a lower risk of GERD (OR = 0.478; P = 0.011). On the contrary, cooked vegetable intake increased the risk of GERD (OR = 1.911; P = 0.024). Bread intake was associated with increased odds of BE (OR = 6.754; P = 0.007), while processed meat intake was associated with reduced risk of BE (OR = 0.210; P = 0.035). We also observed evidence that increased consumption of dried fruit (OR = 0.087; P = 0.022) and salt added to food (OR = 0.346; P = 0.045) could prevent EC. The results of multivariable MR showed that the protective effect of consumption of salt added to food on EC was no longer significant after adjusting for the consumption of dried fruit. CONCLUSION Vegetable consumption was associated with GERD, whereas consumption of bread and processed meat was associated with BE. Dried fruit intake was associated with a lower risk of EC, and the protective effect of consumption of salt added food on EC may also be mediated by consumption of dried fruit. Future research should be performed to investigate the mechanisms behind these cause-and-effect relationships to reduce the burden of disease caused by dietary habits.
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Affiliation(s)
- Menglong Zou
- The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
- Graduate School of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Qiaoli Liang
- Zhuhai Second Hospital of Chinese Medicine, Zhuhai, Guangdong, China
| | - Wei Zhang
- The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
- Graduate School of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Ying Zhu
- The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Yin Xu
- The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
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Rizzo G, Baroni L, Bonetto C, Visaggi P, Orazzini M, Solinas I, Guidi G, Pugliese J, Scaramuzza G, Ovidi F, Buselli I, Bellini M, Savarino EV, de Bortoli N. The Role of a Plant-Only (Vegan) Diet in Gastroesophageal Reflux Disease: Online Survey of the Italian General Population. Nutrients 2023; 15:4725. [PMID: 38004119 PMCID: PMC10674515 DOI: 10.3390/nu15224725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The relationship between food and the pathophysiological mechanisms of gastroesophageal reflux disease (GERD) is unclear. There are few data on the impact of dietary habits on GERD symptoms and on the incidence of GERD in subjects undergoing plant-based diets. In this study, we investigated the association between diet and GERD, using data collected through an online survey of the Italian general population. In total, 1077 subjects participated in the study. GERD was defined according to the Montreal Consensus. For all subjects age, gender, body mass index (BMI), marital status, education, occupation, alcohol consumption, and smoking habits were recorded. All participants also completed the SF-36 questionnaire on Quality of Life. A total of 402 subjects (37.3%) were vegans and 675 (62.7%) non-vegans. The prevalence of GERD in the total population was 9%. Subjects with GERD-related symptoms recorded a worse quality of life according to SF-36 analysis (p < 0.05 for all dimensions). In multivariate analysis, after adjusting for confounders, participants undergoing a vegan diet had a significantly lower risk of GERD (OR = 0.47, 95% CI 0.28-0.81, p = 0.006). These findings should be taken into account to inform the lifestyle management of GERD.
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Affiliation(s)
| | - Luciana Baroni
- Scientific Society for Vegetarian Nutrition, 30171 Venice, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Pierfrancesco Visaggi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Mattia Orazzini
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Irene Solinas
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Giada Guidi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Jessica Pugliese
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Giulia Scaramuzza
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Filippo Ovidi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Irene Buselli
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Massimo Bellini
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Edoardo V. Savarino
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35124 Padua, Italy;
| | - Nicola de Bortoli
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
- NUTRAFOOD, Interdepartmental Center for Nutraceutical Research and Nutrition for Health, University of Pisa, 56124 Pisa, Italy
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Beigrezaei S, Sasanfar B, Nafei Z, Behniafard N, Aflatoonian M, Salehi-Abargouei A. Dietary approaches to stop hypertension (DASH)-style diet in association with gastroesophageal reflux disease in adolescents. BMC Public Health 2023; 23:358. [PMID: 36803489 PMCID: PMC9936743 DOI: 10.1186/s12889-023-15225-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Dietary patterns and food items have been associated with gastroesophageal reflux disease (GERD) risk and they have led to conflicting findings. The aim of this study was to determine the association between a dietary approach to stop hypertension (DASH)-style diet with the risk of GERD and its symptoms in adolescents. STUDY DESIGN Cross-sectional. METHODS This study was performed on 5,141 adolescents aged between 13 and 14 years. Dietary intake was evaluated using a food frequency method. The diagnosis of GERD was done by using a six-item GERD questionnaire that asked about GERD symptoms. A binary logistic regression was used to assess the association between the DASH-style diet score and GERD and its symptoms in crude and multivariable-adjusted models. RESULTS Our findings revealed that after adjustment for all confounding variables, the adolescents with the highest adherence to the DASH-style diet had a lower chance of developing GERD [odds ratio (OR) = 0.50; 95%CI 0.33-0.75, Ptrend< 0.001)], reflux (OR = 0.42; 95%CI 0.25-0.71, Ptrend=0.001), nausea (OR = 0.59; 95% CI:0.32-1.08, Ptrend=0.05) and stomach pain (OR = 0.69; 95%CI 0.49-0.98, P trend=0.03) compared to those with the lowest adherence. Similar results were found for odds of GERD among boys, and the total population (OR = 0.37; 95%CI: 0.18-0.73, Ptrend=0.002, OR = 0.51; 95%CI: 0.34-0.77, P trend<0.0, respectively). CONCLUSION The current study revealed that adherence to a DASH-style diet might protect against GERD and its symptoms including, reflux, nausea, and stomach pain in adolescents. Further prospective research is needed to confirm these findings.
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Affiliation(s)
- Sara Beigrezaei
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Bahareh Sasanfar
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Nafei
- grid.412505.70000 0004 0612 5912Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasrin Behniafard
- grid.412505.70000 0004 0612 5912Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Mother and Newborn Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Majid Aflatoonian
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Amin Salehi-Abargouei
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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6
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Zeuge U, Fares AF, Soriano J, Hueniken K, Bajwa J, Wang W, Schmid S, Rudolph-Naiberg S, Brown MC, Yeung J, Chen EX, Jang RW, Xu W, Elimova E, Liu G, Rozenberg D, McInnis MC. Differential prognostic significance of sarcopenia in metastatic esophageal squamous and adenocarcinoma. Esophagus 2023:10.1007/s10388-022-00981-y. [PMID: 36631713 DOI: 10.1007/s10388-022-00981-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 12/16/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Sarcopenia indicates poor prognosis in various malignancies. We evaluated the association of sarcopenia with overall (OS) and progression-free survival (PFS) in metastatic esophageal cancer (MEC) patients, a population often presenting with poor nutritional status. METHODS In newly diagnosed MEC patients managed at the Princess Margaret (PM) Cancer Centre (diagnosed 2006-2015), total muscle area, visceral adiposity (VA), and subcutaneous adiposity (SA) were quantified on abdominal computed tomography at L3. Sarcopenia was determined using published cutoffs, based on sex and height. RESULTS Of 202 MEC patients, most were male (166/82%), < 65 years (116/57%), and had adenocarcinoma histology (141/70%); 110/54% had recurrent MEC after initial curative-intent treatment; 92/46% presented with de novo MEC. At stage IV diagnosis, 20/10% were underweight, 97/48% were normal-weight and 84/42% were overweight/obese; 103/51% were sarcopenic. Sarcopenia was associated with worse median OS (4.6 vs. 7.9 months; log-rank p = 0.03) and 1-year survival, even after adjusting for other body composition variables (e.g., BMI, VA, and SA): adjusted-HR 1.51 [95% CI 1.1-2.2, p = 0.02]. In post hoc analysis, sarcopenia was highly prognostic in adenocarcinomas (p = 0.003), but not squamous cell carcinomas (SCC). In patients receiving palliative systemic treatment (104/51%), sarcopenia was associated with shorter PFS (p = 0.004) in adenocarcinoma patients (75/72%). CONCLUSIONS In metastatic esophageal adenocarcinomas, sarcopenia is associated with worse PFS and OS. In metastatic esophageal SCC, there was a non-significant trend for worse PFS but no association with OS. In order to offset the poor prognosis associated with sarcopenia particularly in metastatic esophageal adenocarcinoma patients, future research should focus on possible countermeasures.
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Affiliation(s)
- Ulf Zeuge
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
- Zuger Kantonsspital, Baar, Switzerland
| | - Aline F Fares
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
- Hospital de Base and Faculty of Medicine, São Jose Do Rio Preto, Brazil
| | - Joelle Soriano
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
| | - Katrina Hueniken
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada
| | - Jaspreet Bajwa
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Wanning Wang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
| | - Sabine Schmid
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
- Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Sarah Rudolph-Naiberg
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
| | - M Catherine Brown
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
| | - Jonathan Yeung
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
| | - Eric X Chen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
| | - Raymond W Jang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
| | - Wei Xu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada
| | - Elena Elimova
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada
| | - Geoffrey Liu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada.
| | - Dmitry Rozenberg
- Division of Respirology, Temerty Faculty of Medicine, Toronto General Hospital Research Institute, University of Toronto, Toronto, Canada
| | - Micheal C McInnis
- Division of Cardiothoracic Imaging, Joint Department of Medical Imaging, Toronto General Hospital, Toronto, ON, Canada
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Liu C, Ma Y, Qin Q, Wang P, Luo Y, Xu P, Cui Y. Epidemiology of esophageal cancer in 2020 and projections to 2030 and 2040. Thorac Cancer 2022; 14:3-11. [PMID: 36482832 PMCID: PMC9807450 DOI: 10.1111/1759-7714.14745] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 12/14/2022] Open
Abstract
Esophageal cancer is a familiar malignancy with high incidence and mortality, and the overall prognosis is poor. The numbers of cases of and deaths from esophageal cancer have risen rapidly in recent decades. It is one of the most malignant cancers, with more than 0.6 million new cases and 0.54 million deaths worldwide in 2020. Here, we present the global epidemiology of esophageal cancer in 2020 and projections to 2030 and 2040 at different geographical levels of continents, regions and countries, and analyze them by gender, race, geographic region and human development index. We summarize the prospects for the esophageal cancer burden and risk factors in different areas, which will be useful for global esophageal cancer clinical therapy and cancer control planning.
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Affiliation(s)
- Chun‐Quan Liu
- Department of Thoracic SurgeryBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Yun‐Lei Ma
- Department of Thoracic SurgeryBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Qi Qin
- Department of Thoracic SurgeryBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Pei‐Hao Wang
- Department of Thoracic SurgeryBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Yi Luo
- Department of Thoracic SurgeryBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Peng‐Fei Xu
- School of Pharmaceutical SciencesWuhan UniversityWuhanChina,Center for Pharmacogenetics and Department of Pharmaceutical SciencesUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Yong Cui
- Department of Thoracic SurgeryBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
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Ma SZ, Chen HX, Liang ZD, Qi XS. Risk factors for Barrett's esophagus: Recent advances. Shijie Huaren Xiaohua Zazhi 2022; 30:605-613. [DOI: 10.11569/wcjd.v30.i14.605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Esophageal adenocarcinoma (EAC) is the most common malignant tumor of the esophagus in the West. During the past few decades, its morbidity has been increasing in China. Barrett's esophagus (BE) is defined as the replacement of normal squamous epithelium in the lower esophagus by metaplasia of columnar epithelium. BE is closely related to the occurrence of EAC. Knowledge regarding the risk factors for the occurrence and development of BE is of great significance for early screening and diagnosis of BE and prevention of EAC. In this paper, we review the clinical, demographics-related, lifestyle-related, and medications-related risk factors for BE to provide more valuable scientific evidence for the prevention and treatment of BE.
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Affiliation(s)
- Shao-Ze Ma
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China,Graduate School of Dalian Medical University, Dalian 116044, Liaoning Province, China
| | - Hong-Xin Chen
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China,Graduate School of Liaoning University of Traditional Chinese Medicine, Shenyang 110031, Liaoning Province, China
| | - Zhen-Dong Liang
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
| | - Xing-Shun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
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Choueiry F, Barham A, Zhu J. Analyses of lung cancer-derived volatiles in exhaled breath and in vitro models. Exp Biol Med (Maywood) 2022; 247:1179-1190. [PMID: 35410512 PMCID: PMC9335511 DOI: 10.1177/15353702221082634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Lung cancer is one of the leading causes of cancer incidence and cancer-related deaths in the world. Early diagnosis of pulmonary tumors results in improved survival compared to diagnosis with more advanced disease, yet early disease is not reliably indicated by symptoms. Despite of the improved testing and monitoring techniques for lung cancer in the past decades, most diagnostic tests, such as sputum cytology or tissue biopsies, are invasive and risky, rendering them unfeasible for large population screening. The non-invasive analysis of exhaled breath has gained attentions as an innovative screening method to measure chemical alterations within the human volatilome profile as a result of oncogenesis. More importantly, volatile organic compounds (VOCs) have been correlated to the pathophysiology of disease since the source of volatile compounds relies mostly on endogenous metabolic processes that are altered as a result of disease onset. Therefore, studying VOCs emitted from human breath may assist lung cancer diagnosis, treatment monitoring, and other surveillance of this devastating disease. In this mini review, we evaluated recent human studies that have attempted to identify lung cancer-derived volatiles in exhaled breath of patients. We also examined reported volatiles in cell cultures of lung cancer to better understand the origins of cancer-associated VOCs. We highlight the metabolic processes of lung cancer that could be responsible for the endogenous synthesis of these VOCs and pinpoint the protein-encoding genes involved in these pathways. Finally, we highlight the potential value of a breath test in lung cancer and propose prominent areas for future research required for the incorporation of VOCs-based testing into clinical settings.
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Affiliation(s)
- Fouad Choueiry
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210-1132, USA
| | - Addison Barham
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210-1132, USA
| | - Jiangjiang Zhu
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210-1132, USA,James Comprehensive Cancer Center, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA,Jiangjiang Zhu.
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10
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Jia C, Lv X, Liu T, Yang L, Chen H. The Association between Dietary Vitamin C Intake and the Risk of Esophageal Cancer: An Updated Dose-Response Meta-Analysis. Nutr Cancer 2022; 74:3479-3491. [PMID: 35703897 DOI: 10.1080/01635581.2022.2088813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Although some epidemiological studies have reported the associations between vitamin C and risk of esophageal cancer, these results are inconsistent. Therefore, we performed an updated meta-analysis to explore the associations between dietary vitamin C intake and risk of esophageal cancer. We used PubMed, Embase, and the Web of Science to screen all published articles, which yielded 18 papers eligible for data extraction (involving 4,126 cases and 36,902 controls), and then pooled the odds ratios (ORs) and corresponding 95% confidence intervals (CIs) using random-effects model. As we detected the associations in highest category and the lowest type of dietary vitamin C intake, we discovered that dietary vitamin C intake was negatively correlated to the risk of esophageal cancer. The analysis of subgroup showed a significant counter proportion between vitamin C and the risk of ESCC and EAC. Moreover, the dose-analysis indicated that if increasing dietary intake of vitamin C of 50 mg/day, esophageal cancer risk dropped down 10% (OR = 0.81, 95%CI: 0.75-0.87). In summary, our study provides a comprehensive and updated epidemiological evidence to elucidate the relationships between dietary vitamin C and reduction of esophageal cancer risk. Nevertheless, we still need larger case-control and cohort studies to confirm these connections.
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Affiliation(s)
- Chenhao Jia
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaolong Lv
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tianyu Liu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lei Yang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huanwen Chen
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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11
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Lu H, Gomaa A, Wang-Bishop L, Ballout F, Hu T, McDonald O, Washington MK, Livingstone AS, Wang TC, Peng D, El-Rifai W, Chen Z. Unfolded Protein Response Is Activated by Aurora Kinase A in Esophageal Adenocarcinoma. Cancers (Basel) 2022; 14:1401. [PMID: 35326553 PMCID: PMC8946061 DOI: 10.3390/cancers14061401] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/28/2022] [Accepted: 03/04/2022] [Indexed: 12/24/2022] Open
Abstract
Unfolded protein response (UPR) protects malignant cells from endoplasmic reticulum stress-induced apoptosis. We report that Aurora kinase A (AURKA) promotes cancer cell survival by activating UPR in esophageal adenocarcinoma (EAC). A strong positive correlation between AURKA and binding immunoglobulin protein (BIP) mRNA expression levels was found in EACs. The in vitro assays indicated that AURKA promoted IRE1α protein phosphorylation, activating prosurvival UPR in FLO-1 and OE33 cells. The use of acidic bile salts to mimic reflux conditions in patients induced high AURKA and IRE1α levels. This induction was abrogated by AURKA knockdown in EAC cells. AURKA and p-IRE1α protein colocalization was observed in neoplastic gastroesophageal lesions of the L2-IL1b mouse model of Barrett's esophageal neoplasia. The combined treatment using AURKA inhibitor and tunicamycin synergistically induced cancer cell death. The use of alisertib for AURKA inhibition in the EAC xenograft model led to a decrease in IRE1α phosphorylation with a significant reduction in tumor growth. These results indicate that AURKA activates UPR, promoting cancer cell survival during ER stress in EAC. Targeting AURKA can significantly reverse prosurvival UPR signaling mechanisms and decrease cancer cell survival, providing a promising approach for the treatment of EAC patients.
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Affiliation(s)
- Heng Lu
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (H.L.); (A.G.); (F.B.); (T.H.); (A.S.L.); (W.E.-R.)
| | - Ahmed Gomaa
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (H.L.); (A.G.); (F.B.); (T.H.); (A.S.L.); (W.E.-R.)
| | - Lihong Wang-Bishop
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN 37235, USA;
| | - Farah Ballout
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (H.L.); (A.G.); (F.B.); (T.H.); (A.S.L.); (W.E.-R.)
| | - Tianling Hu
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (H.L.); (A.G.); (F.B.); (T.H.); (A.S.L.); (W.E.-R.)
| | - Oliver McDonald
- Department of Pathology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
| | - Mary Kay Washington
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37235, USA;
| | - Alan S. Livingstone
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (H.L.); (A.G.); (F.B.); (T.H.); (A.S.L.); (W.E.-R.)
| | - Timothy C. Wang
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA;
| | - Dunfa Peng
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (H.L.); (A.G.); (F.B.); (T.H.); (A.S.L.); (W.E.-R.)
| | - Wael El-Rifai
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (H.L.); (A.G.); (F.B.); (T.H.); (A.S.L.); (W.E.-R.)
| | - Zheng Chen
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (H.L.); (A.G.); (F.B.); (T.H.); (A.S.L.); (W.E.-R.)
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12
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Shi M, Zhai GQ. Models for Predicting Early Death in Patients With Stage IV Esophageal Cancer: A Surveillance, Epidemiology, and End Results-Based Cohort Study. Cancer Control 2022; 29:10732748211072976. [PMID: 35037487 PMCID: PMC8777366 DOI: 10.1177/10732748211072976] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background Despite enormous progress in the stage IV esophageal cancer (EC) treatment,
some patients experience early death after diagnosis. This study aimed to
identify the early death risk factors and construct models for predicting
early death in stage IV EC patients. Methods Stage IV EC patients diagnosed between 2010 and 2015 in the Surveillance,
Epidemiology, and End Results (SEER) database were selected. Early death was
defined as death within 3 months of diagnosis, with or without therapy.
Early death risk factors were identified using logistic regression analyses
and further used to construct predictive models. The concordance index
(C-index), calibration curves, and decision curve analyses (DCA) were used
to assess model performance. Results Out of 4411 patients enrolled, 1779 died within 3 months. Histologic grade,
therapy, the status of the bone, liver, brain and lung metastasis, marriage,
and insurance were independent factors for early death in stage IV EC
patients. Histologic grade and the status of the bone and liver metastases
were independent factors for early death in both chemoradiotherapy and
untreated groups. Based on these variables, predictive models were
constructed. The C-index was .613 (95% confidence interval (CI),
[.573–.653]) and .635 (95% CI, [.596–.674]) in the chemoradiotherapy and
untreated groups, respectively, while calibration curves and DCA showed
moderate performance. Conclusions More than 40% of stage IV EC patients suffered from an early death. The
models could help clinicians discriminate between low and high risks of
early death and strategize individually-tailed therapeutic interventions in
stage IV EC patients.
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Affiliation(s)
- Min Shi
- Department of Gastroenterology, Changzhou Maternal and Child Health Care Hospital, Changzhou, China
| | - Guo-Qing Zhai
- Department of Gastroenterology, Liyang People's Hospital, Liyang Branch of Jiangsu Province Hospital, Liyang, China
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13
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Nucci D, Marino A, Realdon S, Nardi M, Fatigoni C, Gianfredi V. Lifestyle, WCRF/AICR Recommendations, and Esophageal Adenocarcinoma Risk: A Systematic Review of the Literature. Nutrients 2021; 13:3525. [PMID: 34684526 PMCID: PMC8538904 DOI: 10.3390/nu13103525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
One of the most notable changes in the epidemiology of esophageal cancer (EC) is the rising incidence and prevalence of esophageal adenocarcinoma (EAC) in developed countries. The aim of this systematic review was to collect and summarize all the available evidence regarding lifestyle, diet, and EAC risk. We searched the PubMed and Scopus databases in January 2021 for studies providing information about lifestyle, diet, WCRF/AICR recommendations, and EAC risk; published in English; without a time filter. The Newcastle-Ottawa Scale was used to assess risk of bias. The results are stratified by risk factor. A total of 106 publications were included. Half of the case-control studies were judged as high quality, whilst practically all cohort studies were judged as high quality. Body mass index and waist circumference were associated with increased EAC risk. Physical activity did not appear to have a significant direct role in EAC risk. A diet rich in fruit, vegetables, and whole grains appeared to be more protective than a Western diet. Alcohol does not seem to be related to EAC, whereas smokers, particularly heavy smokers, have an increased risk of EAC. Prevention remains the best option to avert EAC. Comprehensible and easy to follow recommendations should be provided to all subjects. Protocol ID number: CRD-42021228762, no funds received.
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Affiliation(s)
- Daniele Nucci
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Alessio Marino
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132 Milan, Italy
| | - Stefano Realdon
- Digestive Endoscopy Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Mariateresa Nardi
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Cristina Fatigoni
- Department of Pharmaceutical Science, University of Perugia, Via del Giochetto 2, 06123 Perugia, Italy
| | - Vincenza Gianfredi
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132 Milan, Italy
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6211 Maastricht, The Netherlands
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14
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Zhao Z, Yin Z, Zhang C. Lifestyle interventions can reduce the risk of Barrett's esophagus: a systematic review and meta-analysis of 62 studies involving 250,157 participants. Cancer Med 2021; 10:5297-5320. [PMID: 34128354 PMCID: PMC8335822 DOI: 10.1002/cam4.4061] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/12/2021] [Accepted: 05/19/2021] [Indexed: 12/12/2022] Open
Abstract
Background Barrett's esophagus (BE) is a well‐established risk factor for esophageal adenocarcinoma. Our objective was to investigate the effectiveness of lifestyle interventions on BE risk. Methods We searched PubMed, Embase, and Web of Science up to 30 September 2020. The summary relative risks (RRs) and 95% confidence intervals (CIs) for the highest versus lowest categories of exposure were assessed. Analyses of subgroup, dose–response, sensitivity, and publication bias were conducted. Results Sixty‐two studies were included that involved more than 250,157 participants and 22,608 cases. Seven lifestyle factors were investigated: smoking, alcohol, body mass index (BMI), physical activity, sleep time, medication, and diet. We observed statistically significant increased BE risks for smoking (RR = 1.35, 95% CI = 1.16–1.57), alcohol intake (RR = 1.23, 95% CI = 1.13–1.34), body fatness (RR = 1.08, 95% CI = 1.03–1.13), less sleep time (RR = 1.76, 95% CI = 1.24–2.49), and proton pump inhibitors use (RR = 1.64, 95% CI = 1.17–2.29). Reduced risks of BE were found for aspirin (RR = 0.70, 95% CI = 0.58–0.84) and the intake of vitamin C (RR = 0.59, 95% CI = 0.44–0.80), folate (RR = 0.47, 95% CI = 0.31–0.71), and fiber (RR = 0.95, 95% CI = 0.93–0.97). The quality of most included studies was high and the subgroup analysis according to the quality score showed significant results (p < 0.05). There was no publication bias for smoking and alcohol. Although the analysis suggested significant evidence of publication bias for BMI, sensitivity analysis showed that the changes in the recalculated RRs were not significant. Conclusions The large meta‐analysis revealed that lifestyle modifications could reduce the risks of BE and, consequently, esophageal adenocarcinoma.
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Affiliation(s)
- Zhanwei Zhao
- Department of General Surgery, the Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Zifang Yin
- Department of Obstetrics, the Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Chaojun Zhang
- Department of General Surgery, the Sixth Medical Center of PLA General Hospital, Beijing, China
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15
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Zhang M, Hou ZK, Huang ZB, Chen XL, Liu FB. Dietary and Lifestyle Factors Related to Gastroesophageal Reflux Disease: A Systematic Review. Ther Clin Risk Manag 2021; 17:305-323. [PMID: 33883899 PMCID: PMC8055252 DOI: 10.2147/tcrm.s296680] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/17/2021] [Indexed: 01/30/2023] Open
Abstract
We performed this review to clarify which dietary and lifestyle factors are related to gastroesophageal reflux disease. Through a systematic search of the PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and Chinese BioMedical Literature (CBM) databases, we identified articles with clear definitions of GERD, including nonerosive gastroesophageal reflux disease (NERD), reflux esophagitis (RE) and Barrett’s esophagus (BE), that included dietary and lifestyle factors as independent factors affecting the onset of GERD (expressed as odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs)). Due to heterogeneity among the studies, we used descriptive statistical analyses to analyze and synthesize each outcome based on the disease type. In total, 72 articles were included, conducted in ten Western countries (26 articles in total) and nine Eastern countries (46 articles in total). We categorized dietary factors into 20 items and lifestyle factors into 11 items. GERD is related to many irregular dietary and lifestyle habits (such as a habit of midnight snacking: OR=5.08, 95% CI 4.03–6.4; skipping breakfast: OR=2.7, 95% CI 2.17–3.35; eating quickly: OR=4.06, 95% CI 3.11–5.29; eating very hot foods: OR=1.81, 95% CI 1.37–2.4; and eating beyond fullness: OR=2.85, 95% CI 2.18–3.73). Vegetarian diets (consumption of nonvegetarian food (no/yes); OR=0.34, 95% CI 0.211–0.545) and no intake of meat (OR=0.841, 95% CI 0.715–0.990) were negatively related to GERD, while meat (daily meat, fish, and egg intake: OR=1.088, 95% CI 1.042-1.135) and fat (high–fat diet: OR=7.568, 95% CI 4.557–8.908) consumption were positively related to GERD. An interval of less than three hours between dinner and bedtime (OR=7.45, 95% CI 3.38–16.4) was positively related to GERD, and proper physical exercise (physical exercise >30 minutes (>3 times/week): OR=0.7, 95% CI 0.6–0.9) was negatively correlated with GERD. Smoking (OR=1.19, 95% CI 1.12–1.264), alcohol consumption (OR=1.278, 95% CI 1.207–1.353) and mental state (poor mental state: OR=1.278, 95% CI 1.207–1.353) were positively correlated with GERD. RE (vitamin C: OR=0.46, 95% CI=0.24–0.90) and BE (vitamin C: OR=0.44,95% CI 0.2-0.98; vitamin E: OR=0.46, 95% CI 0.26–0.83) were generally negatively correlated with antioxidant intake. In conclusion, many dietary and lifestyle factors affect the onset of GERD, and these factors differ among regions and disease types. These findings need to be further confirmed in subsequent studies.
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Affiliation(s)
- Mei Zhang
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zheng-Kun Hou
- Gastroenterology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhi-Bang Huang
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xin-Lin Chen
- Department of Preventive Medicine and Health Statistics, College of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Feng-Bin Liu
- Gastroenterology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Baiyun Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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16
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Wenzl EM, Riedl R, Borenich A, Petritsch W, Wenzl HH. Low prevalence of gastroesophageal reflux symptoms in vegetarians. Indian J Gastroenterol 2021; 40:154-161. [PMID: 33846945 DOI: 10.1007/s12664-021-01156-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/01/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Dietary modification could reduce the risk of gastroesophageal reflux disease. Circumstantial evidence suggests that gastroesophageal reflux is less prevalent in people adhering to a vegetarian diet. We aimed to study the relationship between vegetarianism and the occurrence of gastroesophageal reflux symptoms (GERS). METHODS This study compares the prevalence of GERS in vegetarians with non-vegetarian controls from the general population. Frequency and severity of GERS (heartburn and/or acid regurgitation) were assessed with a self-administrated questionnaire. RESULTS Within 1 year, any GERS were experienced by 19 of 100 (19%) vegetarians and by 98 of 250 (39.2%) non-vegetarian controls (p < 0.001). Frequent GERS, defined as GERS on at least 1 day per week, were noted in 3% of vegetarians and in 12.8% of controls (p = 0.006). Reflux symptoms were significantly less severe in vegetarians than in non-vegetarians (p < 0.001). According to multivariable analysis, independent predictors of GERS included male sex, current smoking, BMI ≥ 25 (odds ratio [OR] = 1.94; 95% confidence interval [CI], 1.14-3.31), and a non-vegetarian diet (OR = 2.19; 95% CI, 1.20-3.97); non-vegetarian diet independently predicted frequent GERS (OR 4.03; 95% CI, 1.17-13.9). An increased risk of GERS (OR = 2.17; 95% CI, 1.09-4.29) and frequent GERS (OR 4.00; 95% CI, 1.13-14.18) in non-vegetarians were also demonstrated by logistic regression of matched data. In non-vegetarians, the risk of reflux symptoms was not significantly related to meat intake. CONCLUSIONS The prevalence and severity of GERS are lower in vegetarians than in non-vegetarians from the general population. The results are in line with a mitigating effect of vegetarianism on GERS. Data must be interpreted with caution given the retrospective study design and the small sample size.
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Affiliation(s)
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Andrea Borenich
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Wolfgang Petritsch
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Heimo H Wenzl
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
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17
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Zhang X, Anandasabapathy S, Abrams J, Othman M, Badr HJ. Lifestyle Risk Factors, Quality of Life, and Intervention Preferences of Barrett's Esophagus Patients: A Prospective Cohort Study. Glob Adv Health Med 2021; 10:21649561211001346. [PMID: 33767920 PMCID: PMC7952842 DOI: 10.1177/21649561211001346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 01/28/2021] [Accepted: 02/19/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND AIMS Lifestyle counseling to achieve a healthy weight, quit smoking, and reduce alcohol is a cornerstone in the management of Barrett's Esophagus (BE). However, little is known about whether patients make these recommended lifestyle changes or the impact of non-adherence on their quality of life (QOL). This study characterized the lifestyle risk factors, QOL, and intervention preferences of BE patients as a first step toward developing lifestyle change interventions for this population. METHODS Patients with a confirmed BE diagnosis (N = 106) completed surveys at a surveillance endoscopy visit (baseline) and at 3- and 6-month follow-ups. Patients reported on lifestyle risk factors, adherence determinants (e.g., perceived benefits/barriers, risk, intentions), QOL, and intervention preferences. RESULTS Most patients (56%) had uncontrolled reflux, were overweight/obese (65.1%), and had low dietary fiber intake (91%). Many (45%) reported poor QOL. Patients' perceived risk of developing esophageal cancer was high, but their behavior change intentions were low. Despite receiving lifestyle counseling from physicians, there were no significant changes in patients' QOL or lifestyle risk factors over time. Nonetheless, patients indicated strong interest in internet (62.6%) and multimedia programs (57.9%) addressing acid reflux and weight control. CONCLUSION BE patients reported uncontrolled reflux, poor QOL, and multiple lifestyle risk factors that did not change over time. Despite low levels of intention for making lifestyle changes, patients were interested receiving more information about controlling acid reflux, suggesting a potential teachable moment and opportunity for web-based and multimedia multiple behavior interventions that seek to control acid reflux symptoms through weight loss and a high fiber diet.
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Affiliation(s)
- Xiaotao Zhang
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, Texas
| | - Sharmila Anandasabapathy
- Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas
| | - Julian Abrams
- Department of Medicine, Columbia University, New York, New York
| | - Mohamed Othman
- Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas
| | - Hoda J Badr
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, Texas
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18
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Wu Z, Pan H, Liu D, Zhou D, Tao L, Zhang J, Wang X, Wang Y, Wang W, Guo X. Association of IgG Glycosylation and Esophageal Precancerosis Beyond Inflammation. Cancer Prev Res (Phila) 2020; 14:347-354. [PMID: 33303693 DOI: 10.1158/1940-6207.capr-20-0489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/26/2020] [Accepted: 12/04/2020] [Indexed: 12/24/2022]
Abstract
This study aimed to investigate the association of IgG glycosylation and esophageal precancerosis for squamous cell carcinoma and determine its role in inflammation. Primary glycans selected by the least absolute shrinkage and selection operator (LASSO) algorithm were validated using univariate and multivariate logistics models plus restricted cubic spline functions. In total, 24 direct glycans and 27 derived traits were detected, among which four glycans and three derived traits were primarily selected. Then, GP5 (adjusted OR: 0.805), GP17 (adjusted OR: 1.305), G12n (adjusted OR: 1.271), Gal_1 (adjusted OR: 0.776) and Fuc (adjusted OR: 0.737) were validated and significantly associated with esophageal precancerosis. In addition, there was a consistent positive association in GP17 and G12n and a negative association in GP5, Gal_1, and Fuc by restricted cubic spline function. Compared with esophageal inflammation, GP17, G12n, and Fuc were still independently associated with precancerosis. In brief, the IgG glycosylation profile was independently associated with esophageal precancerosis beyond inflammation, which could be an early biomarker for esophageal cancer.Prevention Relevance: IgG glycosylation profile is associated with esophageal precancerosis and specific IgG glycans involves in the early stage of esophageal cancer, which is independent of inflammation.
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Affiliation(s)
- Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China
| | - Huiying Pan
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China
| | - Di Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China
| | - Di Zhou
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China
| | - Jie Zhang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China
| | - Xiaonan Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China
| | - Youxin Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China
| | - Wei Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China.,Department of Public Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China.
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19
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Risk Prediction Models for Barrett's Esophagus Discriminate Well and Are Generalizable in an External Validation Study. Dig Dis Sci 2020; 65:2992-2999. [PMID: 31897894 DOI: 10.1007/s10620-019-06018-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Barrett's esophagus is the precursor to the highly lethal esophageal adenocarcinoma. Risk prediction models have been developed to assist in its detection, potentially improving early identification and treatment of esophageal adenocarcinoma. Six models have been developed. AIMS To externally validate three models (Rubenstein, Thrift, and Baldwin-Hunter models) and compare them to a fourth risk prediction model (Ireland model) for Barrett's esophagus. METHODS Data from 120 Barrett's cases and 235 population controls were available to externally validate the three models. Discriminatory ability of these models was assessed by the area under the receiver operating characteristic curve. Calibration was assessed with the calibration slope, Hosmer-Lemeshow test, and Lowess smoother calibration plot. Following external validation, diagnostic accuracy of the three models was compared to that of the Ireland model. RESULTS On external validation, the Rubenstein model had an area under the receiver operating characteristic curve of 0.71 and was well calibrated (Hosmer-Lemeshow test, p = 0.67). Likewise, the Thrift and Baldwin-Hunter models had similar discrimination (0.71 and 0.70, respectively) and were also well calibrated (p = 0.69 and p = 0.28). Our previous external validation of the Ireland model provided an area under the receiver operating characteristic curve of 0.83 and was well calibrated (p = 0.14). The Ireland model demonstrated a statistically significantly greater area under the receiver operating characteristic curve than the Rubenstein (p = 0.02), Thrift (p = 0.001), and Baldwin-Hunter (p = 0.002) models. CONCLUSION We externally validated the Rubenstein, Thrift, and Baldwin-Hunter risk prediction models and compared them to the Ireland model. The Ireland model demonstrated improved accuracy, albeit with slightly poorer calibration.
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20
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Yu X, Chen J, Jiang W, Zhang D. Alcohol, Alcoholic Beverages and Risk of Esophageal Cancer by Histological Type: A Dose–Response Meta-Analysis of Observational Studies. Alcohol Alcohol 2020; 55:457-467. [DOI: 10.1093/alcalc/agaa047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Abstract
Aims
We conducted a dose–response meta-analysis to explore the association between alcohol and particular alcoholic beverages with risk of esophageal cancer (EC) by histological type [esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC)] and whether the association differs according to gender.
Methods
PubMed and Web of Science databases were searched for relevant articles published between January 1960 and December 2019. The pooled relative ratios (RRs) and 95% confidence interval (CI) were calculated with the fixed or random effect model. The dose–response relationship was assessed by restricted cubic spline.
Results
A total of 74 published articles involving 31,105 cases among 3,369,024 participants were included in this meta-analysis. The pooled RRs of the highest versus lowest alcohol intake were 3.67 (95% CI, 2.89,4.67) for EC, 5.11 (95% CI, 3.60,7.25) for ESCC and 0.96 (95% CI, 0.79,1.16) for EAC. The above-mentioned associations were observed in cohort design, for different alcoholic beverages (beer, wine and liquor/spirits) and gender. Evidence of a nonlinear dose–response relationship for EC risk with alcohol intake was found (Pnon-linearity < 0.001), and a linear relationship (Pnon-linearity = 0.216) suggested that the risk of ESCC increased by 33% for every 12.5 g/day increment of alcohol intake.
Conclusions
This meta-analysis suggests that alcohol intake might significantly increase the incidence of EC, especially for ESCC.
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Affiliation(s)
- Xiaohui Yu
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao, Shandong 266071, People’s Republic of China
| | - Jiahao Chen
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao, Shandong 266071, People’s Republic of China
| | - Wenjie Jiang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao, Shandong 266071, People’s Republic of China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, 308 Ningxia Road, Qingdao, Shandong 266071, People’s Republic of China
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21
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Fan J, Liu Z, Mao X, Tong X, Zhang T, Suo C, Chen X. Global trends in the incidence and mortality of esophageal cancer from 1990 to 2017. Cancer Med 2020; 9:6875-6887. [PMID: 32750217 PMCID: PMC7520289 DOI: 10.1002/cam4.3338] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/28/2020] [Accepted: 07/08/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The incidence and mortality of esophageal cancer are high, with 5.90 new cases and 5.48 deaths per 100 000 people worldwide in 2017. The prognosis of esophageal cancer is poor, with an overall 5-year survival rate of less than 20%. Esophageal cancer in different geographical locations has different etiologies, and the incidence and mortality of esophageal cancer continue to rise in some regions. METHODS We collected incidence and mortality data by age and gender for 195 countries and territories from 1990 to 2017 in the Global Burden of Disease (GBD) database. And we used these data to calculate the estimated annual percentage change (EAPC) to quantify trends in morbidity and mortality. Then we analyzed the gender- and age-specific incidence and mortality in esophageal cancer to targeted high-risk populations. Finally, we analyzed the correlation between the age-standardized mortality rate (ASMR) and both the EAPC and social-demographic index (SDI), and we calculated the Pearson correlation coefficient. RESULTS We found that Malawi, East Asia, and high-middle SDI regions had the highest age-standardized incidence rate (ASIR) and ASMR, and the ASIR and ASMR in western Sub-Saharan Africa showed an upward trend. Our study also showed that the incidence and mortality in esophageal cancer were highest in men and in the 70+ years age group, and they presented a decreasing trend in most regions, but the 15-49 years age groups in Australasia, Caribbean, and Oceania and the 70+ years age group in High-Income North America, Oceania and high-SDI regions presented an increasing trend. There were significant negative associations between ASMR at baseline and EAPC and between ASMR and SDI in 2017. CONCLUSION By analyzing the global distribution of incidence and mortality in esophageal cancer, trends over time, and gender and age specificity, we can understand the heterogeneity of its global trends. This heterogeneity can help us to identify high-risk groupsand to provide clues for the exploration of the etiology and early prevention of the disease.
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Affiliation(s)
- Jiahui Fan
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Zhenqiu Liu
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Xianhua Mao
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Xin Tong
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Chen Suo
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, China
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22
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Davoodvandi A, Shabani Varkani M, Clark CCT, Jafarnejad S. Quercetin as an anticancer agent: Focus on esophageal cancer. J Food Biochem 2020; 44:e13374. [PMID: 32686158 DOI: 10.1111/jfbc.13374] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 05/09/2020] [Accepted: 06/01/2020] [Indexed: 12/11/2022]
Abstract
Esophageal cancer (EC) is regarded as the sixth highest contributor to all cancer-related mortality, worldwide. In spite of advances in the treatment of EC, currently used methods remain ineffective. Quercetin, as a dietary antioxidant, is a plant flavonol from the flavonoid group of polyphenols, and can be found in numerous vegetables, fruits, and herbs. Quercetin can affect the processes of cancer-related diseases via cell proliferation inhibitory effects, potential apoptosis effects, and antioxidant properties. Of the various types of cancer, the use of quercetin has now become prominent in the treatment of EC. In this review, we discuss how quercetin may be an important supplement for the prevention, treatment, and management of EC, owing to its natural origin, and low-cost relative to synthetic cancer drugs. However, most findings cited in the current study are based on in vitro and in vivo studies, and thus, further human-based research is necessitated. PRACTICAL APPLICATIONS: In spite of advances in the treatment of esophageal cancer, currently used methods remain ineffective, therefore, an alternative or complementary therapy is required. Quercetin, as a dietary antioxidant, can affect the processes of cancer-related diseases via cell proliferation inhibitory effects, potential proapoptotic functions, and antioxidant properties. Quercetin may be an important supplement for the prevention, treatment, and management of EC, owing to its natural origin. The low cost of quercetin as supplement or dietary intake, relative to synthetic cancer drugs, is an advantage of the compound which should be considered.
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Affiliation(s)
- Amirhossein Davoodvandi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran.,Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Cain C T Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Sadegh Jafarnejad
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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23
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Shao JM, Elhage SA, Prasad T, Gersin K, Augenstein VA, Colavita PD, Heniford BT. Best reoperative strategy for failed fundoplication: redo fundoplication or conversion to Roux-en-Y gastric diversion? Surg Endosc 2020; 35:3865-3873. [PMID: 32676728 DOI: 10.1007/s00464-020-07800-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/07/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Failed fundoplication is a difficult reoperative challenge, with limited evidence differentiating outcomes of a redo fundoplication versus conversion to Roux-en-Y anatomy with a gastric diversion (RYGD). The aim of this study was to determine the impact of these reoperative strategies on symptom resolution. METHODS A retrospective single institution study of patients with failed fundoplications undergoing conversion to RYGD or redo fundoplication between 2006 and 2019 was conducted. Patient characteristics, preoperative evaluation, operative findings, and postoperative outcomes were recorded and analyzed. RESULTS 180 patients with symptomatic, failed fundoplications were identified: 101 patients (56.1%) underwent conversion to RYGD, and 79 patients (43.9%) underwent redo fundoplication. Body mass index (BMI) was significantly higher for the patients undergoing RYGD with mean BMI of 34.3 ± 6.9 vs 27.7 ± 3.9 kg/m2 (p < 0.001). Patients undergoing conversion to RYGD were also more comorbid than their counterparts, with higher rates of obstructive sleep apnea (17.8% vs 5.1%, p = 0.01), but similar rates of hypertension (54.5% vs 44.3%, p = 0.18, asthma/COPD (25.7% vs 16.5%, p = 0.13), diabetes (10.9% vs 10.1%, p = 0.87), and hyperlipidemia (29.7% vs 36.7%, p = 0.32). Mean operative times were significantly higher for the RYGD (359.6 ± 90.4 vs 238.8 ± 75.6 min, p < 0.0001), as was mean estimated blood loss (168.8 ± 207.5 vs 81.0 ± 145.4, p < 0.0001). Conversion rates from minimally invasive to open were similar (10.9% vs 11.4%, p = 0.92). The incidence of recurrent reflux symptoms was not significantly different (p = 0.46) between RYGD (16.8%) and redo fundoplication (12.8%), at an average follow-up of 50.6 ± 140.7 vs 34.7 ± 39.2 months, (p = 0.03). For the RYGD cohort, patients also had resolution of other comorbidities including obesity 35.6%, OSA 16.7%, hyperlipidemia 10.0%, hypertension 9.1%, and diabetes 9.1%. On average, patients decreased their BMI by 6.8 ± 5.5 kg/m2 and lost 69.6% of their excess body weight. Mean length of stay was higher in patients undergoing RYGD (5.3 ± 7.3 vs 3.0 ± 1.9 days, p = 0.01). Thirty-day readmission rates were similar (9.9% vs 3.8%, p = 0.12). The reoperation rate was higher in the RYGD cohort (17.8% vs 2.5%, p = 0.001). CONCLUSIONS RYBG and redo fundoplication are equivalent in terms of resolution of reflux. RYGD resulted in significant loss of excess body weight.
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Affiliation(s)
- Jenny M Shao
- Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive Suite 300, Charlotte, NC, 28204, USA
| | - Sharbel A Elhage
- Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive Suite 300, Charlotte, NC, 28204, USA
| | - Tanu Prasad
- Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive Suite 300, Charlotte, NC, 28204, USA
| | - Keith Gersin
- Atrium Health Weight Management, Department of Surgery, Carolinas Medical Center, Charlotte, NC, 28204, USA
| | - Vedra A Augenstein
- Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive Suite 300, Charlotte, NC, 28204, USA
| | - Paul D Colavita
- Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive Suite 300, Charlotte, NC, 28204, USA
| | - B Todd Heniford
- Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive Suite 300, Charlotte, NC, 28204, USA.
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24
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Alkhayyat M, Sanghi V, Qapaja T, Butler R, Rouphael C, McMichael J, Goldblum J, Sanaka MR, Thota PN. Pyloroplasty and the risk of Barrett's esophagus in patients with gastroparesis. Dis Esophagus 2020; 33:5859591. [PMID: 32556104 PMCID: PMC7672201 DOI: 10.1093/dote/doaa049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/05/2020] [Accepted: 05/09/2020] [Indexed: 02/07/2023]
Abstract
Barrett's esophagus (BE), a consequence of gastroesophageal reflux disease (GERD), is a premalignant condition for esophageal adenocarcinoma. Impaired gastric emptying leads to increased gastric volume and therefore more severe reflux. We seek to investigate the association between gastroparesis and BE and the predictors of BE among patients with gastroparesis. This is a retrospective review of patients seen at Cleveland Clinic between 2011 and 2016 who had an upper endoscopy and a gastric emptying study. Demographics, symptoms, medications, endoscopic and histological findings, and therapeutic interventions were abstracted. Risk of BE among gastroparesis group and control group was assessed, and logistic regression analysis was performed to identify predictors of BE among gastroparesis patients. Of the 4,154 patients, 864 (20.8%) had gastroparesis and 3, 290 (79.2%) had normal gastric emptying. The mean age was 51.4 ± 16.4 years, 72% were women and 80% were Caucasians. Among the gastroparesis group, 18 (2.1%) patients had BE compared to 71 (2.2%) cases of BE in the control group, P = 0.89. There were no differences in gender, race, reflux symptoms, or esophageal findings between the two groups. Among gastroparesis group, predictors of developing BE were a history of alcohol use (odds ratio [OR] 6.76; 95% confidence intervals [CI]: 1.65-27.67, P = 0.008), history of pyloroplasty (OR: 8.228; CI: 2.114-32.016, P = 0.002), and hiatal hernia (OR: 8.014; CI: 2.053-31.277, P = 0.003). Though gastroparesis is a known contributing factor for GERD, there was no increased prevalence of BE in gastroparesis. Among patients with gastroparesis, predictors of BE are history of alcohol use, hiatal hernia, and pyloroplasty.
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Affiliation(s)
- Motasem Alkhayyat
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Vedha Sanghi
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Thabet Qapaja
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Robert Butler
- Department of Biostatistics, Cleveland Clinic, Cleveland, OH, USA
| | - Carol Rouphael
- Center of Excellence for Barrett’s Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA
| | - John McMichael
- Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - John Goldblum
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Madhusudhan R Sanaka
- Center of Excellence for Barrett’s Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA
| | - Prashanthi N Thota
- Center of Excellence for Barrett’s Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA,Address correspondence to: Prashanthi N. Thota MD, Center of Excellence for Barrett’s Esophagus, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio 44195, USA.
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25
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Tian J, Zuo C, Liu G, Che P, Li G, Li X, Chen H. Cumulative evidence for the relationship between body mass index and the risk of esophageal cancer: An updated meta-analysis with evidence from 25 observational studies. J Gastroenterol Hepatol 2020; 35:730-743. [PMID: 31733067 DOI: 10.1111/jgh.14917] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 10/10/2019] [Accepted: 10/20/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIM A large number of papers reporting the relationships between body mass index (BMI) and esophageal cancer (EC) risk have been published in the past few decades; however, these results are inconsistent. Therefore, we carried out meta-analyses to explore the relationships between BMI and the risk of EC (including esophageal squamous cell carcinoma [ESCC] and esophageal adenocarcinoma [EADC]). METHODS We used the Web of Science, PubMed, and Embase to identify all published/online articles before December 30, 2018, which yielded 25 articles eligible for data extraction (including 16,561 cases and 11,954,161 controls), and then pooled the relative risks (RRs) and corresponding 95% confidence intervals (CIs) using random-effects model. RESULTS Our study presented that underweight had statistically significant association with the risk of EC (RR = 1.78, 95% CI = 1.48, 2.14, P < 0.001) and ESCC (RR = 1.57, 95% CI = 1.20, 2.06, P = 0.001) when compared with normal weight. Interestingly, both overweight and obesity could increase the risk of EADC (RR = 1.56, 95% CI = 1.42, 1.71, P < 0.001; RR = 2.34, 95% CI = 2.02, 2.70, P < 0.001) while decrease the risk of ESCC (RR = 0.71, 95% CI = 0.60, 0.84, P < 0.001; RR = 0.63, 95% CI = 0.60, 0.84, P = 0.002). Additionally, obesity could increase the risk of EC (RR = 1.51, 95% CI = 1.21, 1.89, P < 0.001). CONCLUSION These meta-analyses provide a comprehensive and updated epidemiological evidence to confirm the associations between BMI and EC risk. These findings have public health implications with respect to better control bodyweight and then reduce the occurrence of EC (including ESCC and EADC).
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Affiliation(s)
- Jie Tian
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chunjian Zuo
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guanchu Liu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Pengyu Che
- Department of Cardiothoracic Surgery, The People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Gang Li
- Department of Cardiothoracic Surgery, Chonggang General Hospital, Chongqing, China
| | - Xiang Li
- Department of Cardiothoracic Surgery, The People's Hospital of Chongqing Tongnan, Chongqing, China
| | - Huanwen Chen
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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26
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Schmidt M, Ankerst DP, Chen Y, Wiethaler M, Slotta-Huspenina J, Becker KF, Horstmann J, Kohlmayer F, Lehmann A, Linkohr B, Strauch K, Schmid RM, Quante AS, Quante M. Epidemiologic Risk Factors in a Comparison of a Barrett Esophagus Registry (BarrettNET) and a Case-Control Population in Germany. Cancer Prev Res (Phila) 2020; 13:377-384. [PMID: 32066580 DOI: 10.1158/1940-6207.capr-19-0474] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/15/2020] [Accepted: 02/11/2020] [Indexed: 11/16/2022]
Abstract
Endoscopic screening for Barrett's esophagus as the major precursor lesion for esophageal adenocarcinoma is mostly offered to patients with symptoms of gastroesophageal reflux disease (GERD). However, other epidemiologic risk factors might affect the development of Barrett's esophagus and esophageal adenocarcinoma. Therefore, efforts to improve the efficiency of screening to find the Barrett's esophagus population "at risk" compared with the normal population are needed. In a cross-sectional analysis, we compared 587 patients with Barrett's esophagus from the multicenter German BarrettNET registry to 1976 healthy subjects from the population-based German KORA cohort, with and without GERD symptoms. Data on demographic and lifestyle factors, including age, gender, smoking, alcohol consumption, body mass index, physical activity, and symptoms were collected in a standardized epidemiologic survey. Increased age, male gender, smoking, heavy alcohol consumption, low physical activity, low health status, and GERD symptoms were significantly associated with Barrett's esophagus. Surprisingly, among patients stratified for GERD symptoms, these associations did not change. Demographic, lifestyle, and clinical factors as well as GERD symptoms were associated with Barrett's esophagus development in Germany, suggesting that a combination of risk factors could be useful in developing individualized screening efforts for patients with Barrett's esophagus and GERD in Germany.
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Affiliation(s)
- Melissa Schmidt
- Department of Medicine II, Klinikum rechts der Isar, Technical University Munich (TUM), München, Germany
| | - Donna P Ankerst
- Department of Mathematics and Life Sciences, TUM, Boltzmannstr, Garching, Germany
| | - Yiyao Chen
- Department of Mathematics and Life Sciences, TUM, Boltzmannstr, Garching, Germany
| | - Maria Wiethaler
- Department of Medicine II, Klinikum rechts der Isar, Technical University Munich (TUM), München, Germany
| | - Julia Slotta-Huspenina
- Institute of Pathology, TUM, München, Germany.,Tissue Bank of the Klinikum rechts der Isar Munich and TUM, Munich, Germany
| | - Karl-Friedrich Becker
- Institute of Pathology, TUM, München, Germany.,Tissue Bank of the Klinikum rechts der Isar Munich and TUM, Munich, Germany
| | - Julia Horstmann
- Department of Medicine II, Klinikum rechts der Isar, Technical University Munich (TUM), München, Germany
| | - Florian Kohlmayer
- Institute of Medical Informatics, Statistics and Epidemiology, University Hospital rechts der Isar, TUM, Munich, Germany
| | - Andreas Lehmann
- Institute of Medical Informatics, Statistics and Epidemiology, University Hospital rechts der Isar, TUM, Munich, Germany
| | - Birgit Linkohr
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, Germany
| | - Roland M Schmid
- Department of Medicine II, Klinikum rechts der Isar, Technical University Munich (TUM), München, Germany
| | - Anne S Quante
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, Germany.,Department of Gynecology and Obstetrics, Klinikum rechts der Isar, TUM, Munich, Germany
| | - Michael Quante
- Department of Medicine II, Klinikum rechts der Isar, Technical University Munich (TUM), München, Germany.
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27
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Kumble LD, Silver E, Oh A, Abrams JA, Sonett JR, Hur C. Treatment of early stage (T1) esophageal adenocarcinoma: Personalizing the best therapy choice. World J Meta-Anal 2019; 7:406-417. [DOI: 10.13105/wjma.v7.i9.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/03/2019] [Accepted: 10/19/2019] [Indexed: 02/06/2023] Open
Abstract
Esophagectomy is considered the primary form of management for esophageal adenocarcinoma (EAC); however, the surgery is associated with high rates of morbidity and mortality. For patients with early-stage EAC, endoscopic resection (ER) presents a potential curative treatment option that is less invasive and carries fewer risks procedure related risks, but it is associated with higher rates of cancer recurrence following the procedure. For some patients, age and comorbidities may prevent them from having esophagectomy as a treatment option, while other patients may be operative candidates but do not wish to undergo esophagectomy for a variety of reasons related to their values and preferences. Furthermore, while anxiety of cancer recurrence following ER may significantly diminish a patient’s quality of life (QOL), so might the morbidity surrounding esophagectomy. In addition to considering health status, patient preferences, and impacts on QOL, physicians and patients must also consider what treatments would be both beneficial and available to the patient, considering esophagectomy methods-minimally invasive vs open-or the use of chemoradiotherapy in addition to ER. Our article reviews and summarizes available treatment options for patients with early EAC and their potential effects on the health and wellbeing of patients based on the current data. We conclude with a request for more research of available options for early EAC patients, the conditions that determine when each option should be employed, and their effects not only on patient health but also QOL.
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Affiliation(s)
| | - Elisabeth Silver
- General Medicine, Columbia University Medical Center, New York, NY 10032, United States
| | - Aaron Oh
- General Medicine, Columbia University Medical Center, New York, NY 10032, United States
| | - Julian A Abrams
- Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States
| | - Joshua R Sonett
- Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States
| | - Chin Hur
- Department of Medicine, Columbia University Medical Center, New York, NY 10032, United States
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28
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Tang W, Wang Y, Pan H, Qiu H, Chen S. Association of miRNA-499 rs3746444 A>G variants with adenocarcinoma of esophagogastric junction (AEG) risk and lymph node status. Onco Targets Ther 2019; 12:6245-6252. [PMID: 31496728 PMCID: PMC6690596 DOI: 10.2147/ott.s209013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 07/11/2019] [Indexed: 12/24/2022] Open
Abstract
Background MicroRNAs (miRNAs) miRNA-499 rs3746444 A>G polymorphism may be complicated in the susceptibility to cancer. However, the correlation of this polymorphism with adenocarcinoma of esophagogastric junction (AEG) was unknown. Patients and methods A total of 1063 AEG patients and 1677 controls were included in this study to assess the association of miR-499 rs3746444 A>G with AEG risk. SNPscanTM genotyping assay was harnessed to obtain the genotypes of miRNA-499 rs3746444 A>G polymorphism. Results We identified that SNP miR-499 rs3746444 A>G increased the susceptibility of AEG (AG vs AA: adjusted OR=1.25, 95% CI=1.05–1.49, P=0.012 and AG/GG vs AA: adjusted OR=1.30, 95% CI=1.10–1.54, P=0.002). In a stratified analysis, we found that miR-499 rs3746444 A>G polymorphism had an increased susceptibility of AEG in several subgroups (male subgroup: AG vs AA: adjusted P=0.004 and AG/GG vs AA: adjusted P=0.002; female subgroup: GG vs AG/AA: adjusted P=0.046; <64 years subgroup: AG vs AA: adjusted P=0.006 and AG/GG vs AA: adjusted P=0.003; never smoking subgroup: AG vs AA: adjusted P=0.003 and AG/GG vs AA: adjusted P=0.001; and never drinking subgroup: AG vs AA: adjusted P=0.008 and AG/GG vs AA: adjusted P=0.002). The results of power calculation indicated that miR-499 rs3746444 A>G polymorphism increased the risk of AEG in overall comparison, male, <64 years, never smoking, and never drinking subgroups. Among the AEG cases, 625 patients accompanied by positive lymph node. However, the distribution of miRNA-499 rs3746444 A>G variants was no significant difference between different lymph node status. Conclusion Our findings indicate that miR-499 rs3746444 A>G polymorphism is significantly associated with AEG susceptibility. In the future, further exploration of this genetic factor in relation to AEG susceptibility with an adequate methodological quality is needed.
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Affiliation(s)
- Weifeng Tang
- Department of Cardiothoracic Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, People's Republic of China
| | - Yafeng Wang
- Department of Cardiology, The People's Hospital of Xishuangbanna dai Autonomous Prefecture, Jinghong, Yunnan Province, People's Republic of China
| | - Huiwen Pan
- Department of Cardiothoracic Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, People's Republic of China
| | - Hao Qiu
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu Province, People's Republic of China
| | - Shuchen Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, People's Republic of China
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Lu T, Chen D, Wang Y, Sun X, Li S, Miao S, Wo Y, Dong Y, Leng X, Du W, Jiao W. Identification of DNA methylation-driven genes in esophageal squamous cell carcinoma: a study based on The Cancer Genome Atlas. Cancer Cell Int 2019; 19:52. [PMID: 30886542 PMCID: PMC6404309 DOI: 10.1186/s12935-019-0770-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 02/28/2019] [Indexed: 02/06/2023] Open
Abstract
Background Aberrant DNA methylations are significantly associated with esophageal squamous cell carcinoma (ESCC). In this study, we aimed to investigate the DNA methylation-driven genes in ESCC by integrative bioinformatics analysis. Methods Data of DNA methylation and transcriptome profiling were downloaded from TCGA database. DNA methylation-driven genes were obtained by methylmix R package. David database and ConsensusPathDB were used to perform gene ontology (GO) analysis and pathway analysis, respectively. Survival R package was used to analyze overall survival analysis of methylation-driven genes. Results Totally 26 DNA methylation-driven genes were identified by the methylmix, which were enriched in molecular function of DNA binding and transcription factor activity. Then, ABCD1, SLC5A10, SPIN3, ZNF69, and ZNF608 were recognized as significant independent prognostic biomarkers from 26 methylation-driven genes. Additionally, a further integrative survival analysis, which combined methylation and gene expression data, was identified that ABCD1, CCDC8, FBXO17 were significantly associated with patients’ survival. Also, multiple aberrant methylation sites were found to be correlated with gene expression. Conclusion In summary, we studied the DNA methylation-driven genes in ESCC by bioinformatics analysis, offering better understand of molecular mechanisms of ESCC and providing potential biomarkers precision treatment and prognosis detection. Electronic supplementary material The online version of this article (10.1186/s12935-019-0770-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tong Lu
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Di Chen
- 2Department of Gastroenterology, Affiliated Hospital of Qingdao University, No 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Yuanyong Wang
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Xiao Sun
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Shicheng Li
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Shuncheng Miao
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Yang Wo
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Yanting Dong
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Xiaoliang Leng
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Wenxing Du
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
| | - Wenjie Jiao
- 1Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266003 China
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Effect of increased body mass index on risk of diagnosis or death from cancer. Br J Cancer 2019; 120:565-570. [PMID: 30733581 PMCID: PMC6462026 DOI: 10.1038/s41416-019-0386-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/03/2019] [Accepted: 01/10/2019] [Indexed: 12/22/2022] Open
Abstract
Background Whether body mass index (BMI) is causally associated with the risk of being diagnosed with or dying from any cancer remains unclear. Weight reduction has clinical importance for cancer control only if weight gain causes cancer development or death. We aimed to answer the question 'does genetically predicted BMI influence my risk of being diagnosed with or dying from any cancer'. Methods We used a Mendelian randomisation (MR) approach to estimate causal effect of BMI in 46,155 white-British participants aged between 40 and 69 years at recruitment (median age at follow-up 61 years) from the UK Biobank, who developed any type of cancer, among whom 6998 died from cancer. To derive MR instruments for BMI, we selected up to 390,628 cancer-free participants. Results For each standard deviation (4.78 units) increase in genetically predicted BMI, we estimated a causal odds ratio (COR) of 1.07 (1.02–1.12) and 1.28 (1.16–1.41) for overall cancer risk and mortality, respectively. The corresponding estimates were similar for males and females, and smokers and non-smokers. Conclusions Higher genetically predicted BMI increases the risk of being diagnosed with or dying from any cancer. These data suggest that increased overall weight may causally increase overall cancer incidence and mortality among Europeans.
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Tang W, Chen S, Liu J, Liu C, Wang Y, Kang M. Investigation of IGF1, IGF2BP2, and IGFBP3 variants with lymph node status and esophagogastric junction adenocarcinoma risk. J Cell Biochem 2018; 120:5510-5518. [PMID: 30335898 PMCID: PMC6587846 DOI: 10.1002/jcb.27834] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 09/14/2018] [Indexed: 12/12/2022]
Abstract
Esophagogastric junction adenocarcinoma (EGJA) may be associated with obesity and overweight. Thus, any variant in energy metabolism–related gene may influence the development of EGJA. In this study, we recruited 720 EGJA cases and 1541 noncancer controls. We selected IGF2BP2 rs4402960 G > T, rs1470579 A > C,
IGF1 rs5742612 A > G and
IGFBP3 rs3110697 G > A, rs2270628 C > T and rs6953668 G > A loci and assessed the relationship of these polymorphisms with lymph node status and susceptibility of EGJA. We found that
IGF2BP2 rs1470579 A > C and
IGFBP3 rs6953668 G > A polymorphisms were associated with the decreased risk of EGJA (
IGF2BP2 rs1470579: CC vs AA: adjusted odds ratio [OR] = 0.65, 95% confidence interval [CI] = 0.43‐0.98,
P = 0.041 and CC vs AA/AC: adjusted OR = 0.62, 95% CI = 0.41‐0.93,
P = 0.021 and
IGFBP3 rs6953668: GA vs GG: adjusted OR = 0.66, 95% CI = 0.47‐0.93,
P = 0.019 and GA/AA vs GG: adjusted OR = 0.68, 95% CI = 0.48‐0.95,
P = 0.026). However, we also found that
IGF1 rs5742612 A > G polymorphism increased the risk of LNM among patients with EGJA (GG vs AA: adjusted OR = 1.88, 95% CI = 1.02‐3.46,
P = 0.042 and GG vs AA/AG: adjusted OR = 1.92, 95% CI = 1.06‐3.47,
P = 0.032). This study suggests that
IGF2BP2 rs1470579 A > C and
IGFBP3 rs6953668 G > A polymorphisms may decrease genetic susceptibility to EGJA in eastern Chinese Han population. In addition, our findings also indicate that
IGF1 rs5742612 A > G polymorphism may increase the susceptibility of LNM among patients with EGJA.
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Affiliation(s)
- Weifeng Tang
- Department of Cardiothoracic Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Shuchen Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian, China.,Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, Fujian, China
| | - Jun Liu
- Central Lab, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Chao Liu
- Department of Cardiothoracic Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Yafeng Wang
- Department of Cardiology, The People's Hospital of Xishuangbanna Dai Autonomous Prefecture, Jinghong, Yunnan, China
| | - Mingqiang Kang
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian, China.,Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, Fujian, China
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Kyriakou K, Petinou K, Phinikettos I. Risk Factors for Voice Disorders in University Professors in Cyprus. J Voice 2018; 32:643.e1-643.e9. [DOI: 10.1016/j.jvoice.2017.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/24/2017] [Accepted: 07/07/2017] [Indexed: 11/29/2022]
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Stephens JA, Fisher JL, Krok-Schoen JL, Baltic RD, Sobotka HL, Paskett ED. Esophageal Adenocarcinoma: Opportunities for Targeted Prevention in Ohio. CLINICAL MEDICINE INSIGHTS. GASTROENTEROLOGY 2018; 11:1179552218791170. [PMID: 30083064 PMCID: PMC6066804 DOI: 10.1177/1179552218791170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/06/2018] [Indexed: 12/25/2022]
Abstract
Objective: The incidence of esophageal adenocarcinoma, one of the most lethal
gastroenterological diseases, has been increasing since the 1960s.
Prevention of esophageal adenocarcinoma is important because no early
detection screening programs have been shown to reduce mortality. Obesity,
gastroesophageal reflux disease, and tobacco smoking are risk factors for
esophageal adenocarcinoma. Due to the high prevalence in Ohio of obesity
(32.6%) and cigarette smoking (21.0%), this study sought to identify trends
and patterns of these risk factors and esophageal adenocarcinoma in Ohio as
compared with the United States. Methods: Data from the Ohio Cancer Incidence Surveillance System, Surveillance
Epidemiology and End Results Program (SEER), and Behavioral Risk Factor
Surveillance System were used. Incidence rates overall, by demographics and
by county, as well as trends in incidence of esophageal adenocarcinoma and
the percent of esophageal adenocarcinoma among esophageal cancers were
examined. Trends in obesity and cigarette smoking in Ohio, and the
prevalence of each by county, were reported. Results: There was an increasing trend in esophageal adenocarcinoma incidence in Ohio.
Ohio’s average annual esophageal adenocarcinoma incidence rate was higher
than the SEER rate overall and for each sex, race, and age group in 2009 to
2013. There was also an increasing prevalence of obesity in Ohio. Although
the prevalence of cigarette smoking has been stable, it was high in Ohio
compared with the United States. Conclusions: Health care providers and researchers should be aware of the esophageal
adenocarcinoma incidence rates and risk factor patterns and tailor
interventions for areas and populations at higher risk.
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Affiliation(s)
- Julie A Stephens
- Center for Biostatistics, Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - James L Fisher
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Ryan D Baltic
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Holly L Sobotka
- Chronic Disease Epidemiology and Evaluation, Bureau of Health Promotion, Office of the Medical Director, Ohio Department of Health, Columbus, OH, USA
| | - Electra D Paskett
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
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Kang JHE, Luben R, Alexandre L, Hart AR. Dietary antioxidant intake and the risk of developing Barrett's oesophagus and oesophageal adenocarcinoma. Br J Cancer 2018; 118:1658-1661. [PMID: 29780162 PMCID: PMC6008398 DOI: 10.1038/s41416-018-0113-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/22/2018] [Accepted: 04/17/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND We investigated in a cohort study, for the first time using 7-day food diaries (7-DFDs), for age-dependent inverse associations with antioxidants, which have anti-carcinogenic properties, and development of Barrett's oesophagus (BO) and oesophageal adenocarcinoma (OAC). METHODS A total of 24,068 well individuals completed 7-DFDs and donated blood. Vitamins C and E, carotenes, zinc and selenium intakes, and plasma vitamin C were measured. Participants were monitored for 15 years for BO and OAC. Hazard ratios (HRs) were estimated for: quintiles of intake and in participants younger and >=65 years at recruitment, the midpoint of BO peak prevalence. RESULTS A total of 197 participants developed BO and 74 OAC. There were no significant associations between antioxidants and BO or OAC in the whole cohort or if >65 years at recruitment. In participants <65 years, for BO, there was an inverse trend across plasma vitamin C quintiles (trend HR = 0.82; 95% CI = 0.71-0.96, P = 0.01), OAC for plasma vitamin C (trend HR = 0.58; 95% CI = 0.37-0.92, P = 0.02) and for dietary vitamins C and E (trend HR = 0.71 95% CI = 0.51-0.99, P = 0.04 and trend HR = 0.70; 95% CI = 0.51-0.96; P = 0.03). CONCLUSIONS Data supports a role for dietary antioxidants prevent BO and OAC, perhaps at the earlier stages of carcinogenesis.
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Affiliation(s)
- James H-E Kang
- Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, NR4 7UY, UK. .,Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK.
| | - Robert Luben
- Strangeways Research Laboratories, Wort's Causeway, Cambridge, CB1 8RN, UK
| | - Leo Alexandre
- Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, NR4 7UY, UK.,Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK
| | - Andrew R Hart
- Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, NR4 7UY, UK.,Norwich Medical School, University of East Anglia, Norwich, NR4 7UQ, UK
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Min YW, Kim Y, Gwak GY, Gu S, Kang D, Cho SJ, Guallar E, Cho J, Sinn DH. Non-alcoholic fatty liver disease and the development of reflux esophagitis: A cohort study. J Gastroenterol Hepatol 2018; 33:1053-1058. [PMID: 29131401 DOI: 10.1111/jgh.14042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/25/2017] [Accepted: 11/01/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, is associated with gastroesophageal reflux disease in cross-sectional studies, but a prospective association has not been evaluated. The current study aimed to determine whether NAFLD increases the risk of incident reflux esophagitis in a large cohort study. METHODS We conducted a cohort study of 34 063 men and women without reflux esophagitis or other upper gastrointestinal disease at baseline who underwent health checkup examinations between January 2003 and December 2013. Fatty liver was diagnosed by ultrasound based on standard criteria. Reflux esophagitis was defined by the presence of at least grade A mucosal break on esophagogastroduodenoscopy. RESULTS The prevalence of NAFLD at baseline was 33.2%. During 153 520.2 person-years of follow-up, the cumulative incidences of reflux esophagitis for participants without and with NAFLD were 9.6% and 13.8%, respectively (P < 0.001). The age-adjusted and sex-adjusted hazard ratio for the risk of reflux esophagitis development in participants with NAFLD compared with those without NAFLD was 1.15 (95% confidence interval 1.07-1.23; P < 0.001). However, this association disappeared after adjusting for body mass index and other metabolic factors (hazard ratio 1.01, 95% confidence interval 0.94-1.09; P = 0.79). Similarly, in multivariable-adjusted models, there was no significant association between NAFLD severity and the risk of developing reflux esophagitis. CONCLUSIONS Non-alcoholic fatty liver disease is not independently associated with the risk of the development of reflux esophagitis, but rather, reflux esophagitis is primarily the consequence of increased body mass index commonly associated with NAFLD.
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Affiliation(s)
- Yang Won Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Youngha Kim
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Geum-Youn Gwak
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seonhye Gu
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Danbee Kang
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Jin Cho
- Center for Health Promotion, Samsung Medical Center, Seoul, Korea
| | - Eliseo Guallar
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Juhee Cho
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea.,Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Can We Use Diet to Effectively Treat Esophageal Disease? A Review of the Current Literature. Curr Gastroenterol Rep 2017; 19:38. [PMID: 28730507 DOI: 10.1007/s11894-017-0578-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Esophageal diseases represent a wide variety of conditions affecting esophageal anatomy, physiology, and motility. Therapy focuses on pharmacotherapy and endoscopic or surgical management. Dietary therapy can be considered in management algorithms for specific esophageal diseases. This review focuses on outlining the literature related to dietary therapy in gastroesophageal reflux disease, eosinophilic esophagitis, Barrett's esophagus, and esophageal adenocarcinoma. RECENT FINDINGS Currently, data are strongest for dietary manipulation in eosinophilic esophagitis, specifically the six-food elimination diet. Dietary effects on gastroesophageal reflux disease are less clear, though newer research indicates that increased fiber with reduction in simple sugar intake may improve symptoms. In terms of Barrett's esophagus and esophageal adenocarcinoma, antioxidant intake may affect carcinogenesis, though to an unknown degree. Outcomes data regarding dietary manipulation for the management of esophageal diseases is heterogeneous. Given the rising interest in non-pharmacological treatment options for these patients, continued research is warranted.
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Moon RC, Teixeira AF, Jawad MA. Safety and effectiveness of anterior fundoplication sleeve gastrectomy in patients with severe reflux. Surg Obes Relat Dis 2017; 13:547-552. [DOI: 10.1016/j.soard.2016.10.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/16/2016] [Accepted: 10/11/2016] [Indexed: 12/12/2022]
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Filiberti RA, Fontana V, De Ceglie A, Blanchi S, Grossi E, Della Casa D, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Rosa A, Foti M, Laterza F, D'Onofrio V, Iaquinto G, Conio M. Alcohol consumption pattern and risk of Barrett's oesophagus and erosive oesophagitis: an Italian case-control study. Br J Nutr 2017; 117:1151-1161. [PMID: 28478792 DOI: 10.1017/s0007114517000940] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Knowledge about the association between alcohol and Barrett's oesophagus and reflux oesophagitis is conflicting. In this case-control study we evaluated the role of specific alcoholic beverages (red and white wine, beer and liquors) in 339 Barrett's oesophagus and 462 oesophagitis patients compared with 619 endoscopic controls with other disorders, recruited in twelve Italian endoscopic units. Data on alcohol and other individual characteristics were obtained from structured questionnaires. No clear, monotonic significant dose-response relationship was pointed out for red wine. However, a generalised U-shaped trend of Barrett's oesophagus/oesophagitis risk due to red wine consumption particularly among current drinkers was found. Similar results were also found for white wine. Liquor/spirit consumption seemed to bring about a 1·14-2·30 risk excess, although statistically non-significant, for current Barrett's oesophagus/oesophagitis drinkers. Statistically significant decreasing dose-response relationships were found in Barrett's oesophagus for frequency and duration of beer consumption. Similar, but less clear downward tendencies were also found for oesophagitis patients. In conclusion, although often not statistically significant, our data suggested a reduced risk of Barrett's oesophagus and oesophagitis with a low/moderate intake of wine and beer consumption. A non-significant increased risk of Barrett's oesophagus/oesophagitis was observed with a higher intake of any type of heavy alcohol consumption, but no conclusion can be drawn owing to the high number of non-spirit drinkers and to the small number of drinkers at higher alcohol intake levels.
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Affiliation(s)
- Rosa A Filiberti
- 1Clinical Epidemiology,IRCCS AOU San Martino-IST,Largo R Benzi 10,16132 Genova,Italy
| | - Vincenzo Fontana
- 1Clinical Epidemiology,IRCCS AOU San Martino-IST,Largo R Benzi 10,16132 Genova,Italy
| | - Antonella De Ceglie
- 2Gastroenterology,General Hospital,Via G Borea 56,18038 Sanremo,Imperia,Italy
| | - Sabrina Blanchi
- 2Gastroenterology,General Hospital,Via G Borea 56,18038 Sanremo,Imperia,Italy
| | - Enzo Grossi
- 3Medical Department,Bracco Spa,Via E Folli 50,20134 Milan,Italy
| | - Domenico Della Casa
- 4Digestive Endoscopic Surgery,Spedali Civili di Brescia,Piazzale Spedali Civili 1,25123 Brescia,Italy
| | - Teresa Lacchin
- 5Endoscopy,Policlinico San Giorgio,Via Gemelli 10,33170 Pordenone,Italy
| | - Marina De Matthaeis
- 6Gastroenterology and Digestive Endoscopy,Ospedale di Lavagna,ASL 4 Chiavarese,Via Don Bobbio 25,16033 Lavagna,Italy
| | - Orazio Ignomirelli
- 7Endoscopy,IIRCCS,Centro di Riferimento Oncologico di Basilicata,Via Padre Pio 1,85028 Rionero in Vulture,Potenza,Italy
| | - Roberta Cappiello
- 8Gastroenterology,S. Maria degli Angeli Hospital,Via Piave 54,33170 Pordenone,Italy
| | - Alessandra Rosa
- 1Clinical Epidemiology,IRCCS AOU San Martino-IST,Largo R Benzi 10,16132 Genova,Italy
| | - Monica Foti
- 9Gastroenterology,LARC Private Clinic,Cso Venezia 10,10155 Torino,Italy
| | - Francesco Laterza
- 10Department of Internal Medicine,Unit of Endoscopy and Gastroenterology,University Hospital SS.Annunziata, G.D'Annunzio University,Via dei Vestini,66100 Chieti,Italy
| | - Vittorio D'Onofrio
- 11Gastroenterology and Digestive Endoscopy,S. G. Moscati Hospital,Via San Giuseppe Moscati,83100 Avellino,Italy
| | - Gaetano Iaquinto
- 11Gastroenterology and Digestive Endoscopy,S. G. Moscati Hospital,Via San Giuseppe Moscati,83100 Avellino,Italy
| | - Massimo Conio
- 2Gastroenterology,General Hospital,Via G Borea 56,18038 Sanremo,Imperia,Italy
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Tumour biology of obesity-related cancers: understanding the molecular concept for better diagnosis and treatment. Tumour Biol 2016; 37:14363-14380. [PMID: 27623943 DOI: 10.1007/s13277-016-5357-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 09/07/2016] [Indexed: 12/18/2022] Open
Abstract
Obesity continues to be a major global problem. Various cancers are related to obesity and proper understanding of their aetiology, especially their molecular tumour biology is important for early diagnosis and better treatment. Genes play an important role in the development of obesity. Few genes such as leptin, leptin receptor encoded by the db (diabetes), pro-opiomelanocortin, AgRP and NPY and melanocortin-4 receptors and insulin-induced gene 2 were linked to obesity. MicroRNAs control gene expression via mRNA degradation and protein translation inhibition and influence cell differentiation, cell growth and cell death. Overexpression of miR-143 inhibits tumour growth by suppressing B cell lymphoma 2, extracellular signal-regulated kinase-5 activities and KRAS oncogene. Cancers of the breast, uterus, renal, thyroid and liver are also related to obesity. Any disturbance in the production of sex hormones and insulin, leads to distortion in the balance between cell proliferation, differentiation and apoptosis. The possible mechanism linking obesity to cancer involves alteration in the level of adipokines and sex hormones. These mediators act as biomarkers for cancer progression and act as targets for cancer therapy and prevention. Interestingly, many anti-cancerous drugs are also beneficial in treating obesity and vice versa. We also reviewed the possible link in the mechanism of few drugs which act both on cancer and obesity. The present review may be important for molecular biologists, oncologists and clinicians treating cancers and also pave the way for better therapeutic options.
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Arroyo-Martínez Q, Rodríguez-Téllez M, García-Escudero A, Brugal-Medina J, González-Cámpora R, Caunedo Álvarez Á. Epidemiology of Barrett's esophagus and esophageal adenocarcinoma in Spain. A unicentric study. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2016; 108:609-617. [PMID: 27616661 DOI: 10.17235/reed.2016.4229/2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Barrett's esophagus (BE) is an acquired disease defined by the presence of intestinal metaplasia with goblet cells in the distal esophagus. The prevalence of BE has increased dramatically over the last years. AIMS The primary aims of the study were to analyze the characteristics of BE and esophageal adenocarcinoma (EAC) in a Spanish health district during a follow-up period. METHODOLOGY Sociodemographic factors, alcohol consumption and cigarette smoking were analyzed. We also studied the histological behavior and cause of death in each group. RESULTS In the present study 430 patients were included, 338 with BE and 92 with EAC. Incidence rates have risen from 2.25 and 1.25 per 100,000 inhabitants in 1996 to 6.5 and 4.75 per 100,000 in 2011, respectively. In the EAC group, male gender, age and alcohol consumption were higher in comparison to the BE group, and the overall survival was 23 months. In the BE group, the main causes of death were non-esophageal cancer and cardiovascular disease. CONCLUSIONS The incidence and prevalence rates of AEC and BE have risen over the past years. Risk factors for these conditions were male gender, age and alcohol consumption. Long BE (> 3 cm) is involved in dysplasia progression. AEC diagnosis mainly occurs after neoplasia is detected and, in a few cases, due to a previous BE. Cardiovascular diseases and non-esophageal cancers have been found to be the main cause of death in BE patients.
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He Q, Li JD, Huang W, Zhu WC, Yang JQ. Metabolic syndrome is associated with increased risk of Barrett esophagus: A meta-analysis. Medicine (Baltimore) 2016; 95:e4338. [PMID: 27495039 PMCID: PMC4979793 DOI: 10.1097/md.0000000000004338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Barrett esophagus (BE) is considered precursor condition of esophageal adenocarcinoma. Its incidence and prevalence are increasing in general population. Studies reported that metabolic syndrome (MS) or diabetes mellitus (DM) is related to increased risk of BE. Current study was to assess and better understand the relationship between MS /DM and BE. METHODS Electronic search was conducted in the database Pubmed/Medline (-December, 2015), Embase (-December, 2015), Cochrane Library (-December, 2015), and Web of Knowledge (-December, 2015). Studies included were assessed with summary odds ratios (ORs) with 95% confidence intervals (CIs) and compared exposure group with control group. The heterogeneity was examined by the funnel plot and the Egger's test. Subgroup analyses and sensitive analyses were performed for the detection of possible heterogeneity and impact on stability of analysis results. RESULTS Twelve publications met the criteria and included 355,311 subjects were analyzed. The pooled results showed MS was closely associated with increased risk of BE (OR = 1.23; 95%CI 1.03-1.47; P = 0.024), and yet DM did not significantly increase the risk of BE (OR = 1.07; 95%CI 0.82-1.38; P = 0.627). Substantial heterogeneities were detected. No significant publication bias was detected by Egger's test (P = 0.23). CONCLUSIONS Based on the results of current meta-analysis, MS is associated with increased risk of BE. Further long-term follow-up prospective study needs to verify the current results, and definite pathophysiological mechanism needs to be further investigated and clearly elucidated.
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Affiliation(s)
- Qiong He
- Department of Gastroenterology, The First Affiliated Hospital of Jinan University
- Correspondence: Qiong He, Department of Gastroenterology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China (e-mail: )
| | - Jian-dong Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China
| | - Wei Huang
- Department of Gastroenterology, The First Affiliated Hospital of Jinan University
| | - Wen-chang Zhu
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China
| | - Jian-quan Yang
- Department of Gastroenterology, The First Affiliated Hospital of Jinan University
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Ma K, Cao B, Guo M. The detective, prognostic, and predictive value of DNA methylation in human esophageal squamous cell carcinoma. Clin Epigenetics 2016; 8:43. [PMID: 27110300 PMCID: PMC4840959 DOI: 10.1186/s13148-016-0210-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 04/14/2016] [Indexed: 12/17/2022] Open
Abstract
Esophageal cancer is one of the most common malignancies in the world. Squamous cell carcinoma accounts for approximately 90 % of esophageal cancer cases. Genetic and epigenetic changes have been found to accumulate during the development of various cancers, including esophageal squamous carcinoma (ESCC). Tobacco smoking and alcohol consumption are two major risk factors for ESCC, and both tobacco and alcohol were found to induce methylation changes in ESCC. Growing evidence demonstrates that aberrant epigenetic changes play important roles in the multiple-step processes of carcinogenesis and tumor progression. DNA methylation may occur in the key components of cancer-related signaling pathways. Aberrant DNA methylation affects genes involved in cell cycle, DNA damage repair, Wnt, TGF-β, and NF-κB signaling pathways, including P16, MGMT, SFRP2, DACH1, and ZNF382. Certain genes methylated in precursor lesions of the esophagus demonstrate that DNA methylation may serve as esophageal cancer early detection marker, such as methylation of HIN1, TFPI-2, DACH1, and SOX17. CHFR methylation is a late stage event in ESCC and is a sensitive marker for taxanes in human ESCC. FHIT methylation is associated with poor prognosis in ESCC. Aberrant DNA methylation changes may serve as diagnostic, prognostic, and chemo-sensitive markers. Characterization of the DNA methylome in ESCC will help to better understand its mechanisms and develop improved therapies.
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Affiliation(s)
- Kai Ma
- />Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Baoping Cao
- />Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853 China
| | - Mingzhou Guo
- />Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, #28 Fuxing Road, Beijing, 100853 China
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Smoking Exposure and Survival of Patients with Esophagus Cancer: A Systematic Review and Meta-Analysis. Gastroenterol Res Pract 2016; 2016:7682387. [PMID: 27073394 PMCID: PMC4814674 DOI: 10.1155/2016/7682387] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/28/2016] [Accepted: 02/29/2016] [Indexed: 12/21/2022] Open
Abstract
Smoking is a well-known major risk factor in development of esophageal cancer, but few studies have reported the association between smoking status and prognosis of these patients. We conduct the present study to summarize current evidence. A computerized search of the PubMed and EMBASE was performed up to April 30, 2015. Eight studies, containing 4,286 patients, were analyzed. In the grouping analysis, among esophageal squamous-cell carcinoma patients, current and former smokers, compared to those who have never smoked, seemed to have a poorer prognosis (HR = 1.41, 95% CI 1.22-1.64, and HR = 1.35, 95% CI 0.92-1.97, resp.). In the subgroup analysis, adverse effects on current smoker compared with never smoker were also observed in China and the other countries (HR = 1.5, 95% CI 1.18-1.92, and HR = 1.36, 95% CI 1.12-1.65, resp.). In the group that ever smoked, we could not get a similar result. No significantly increased risk was found in esophageal adenocarcinoma patients compared to the squamous-cell histology ones. In the smoking intensity analysis, heavy smoking was associated with poor survival in esophageal squamous-cell carcinoma. Our pooled results supported the existence of harmful effects of smoking on survival after esophagus cancer diagnosis.
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Kolkman P, Stack A, McCarthy M, Kolkman M, Rao TS, Mukta S, Rajaram S, Thompson J, Are C. Variations in the Histopathologic Type of Esophageal Carcinoma Between the United States of America and India. Indian J Surg Oncol 2016; 7:52-5. [PMID: 27065682 PMCID: PMC4811830 DOI: 10.1007/s13193-015-0468-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 09/01/2015] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to compare the incidence of the different histopathologic types of esophageal carcinoma between the United States of American (US) and India. The Surveillance Epidemiology and End Result (SEER) database was analyzed to determine the incidence of different types of esophageal carcinoma in US. A retrospective review was conducted of all the patients that underwent resection for esophageal carcinoma at a regional oncology center in India from 2001 to 2007. Data relating to histopathologic variables was collected and compared to the patients in the SEER database for the same time period. Esophageal adenocarcinoma accounts for the majority of newly diagnosed cases in the US. Although squamous cell carcinoma is the dominant type of esophageal carcinoma in India, we noted a small but gradual increase (0 % in 2001 to 28 % in 2007) in the incidence of esophageal adenocarcinoma. The results of our study demonstrate a geographic variation in the histopathologic type of esophageal carcinoma. A recent increase in the incidence of esophageal adenocarcinoma in India was also demonstrated. Analysis of risk factors known to be associated with esophageal adenocarcinoma, in the context of India, can provide targets for implementing public health measures.
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Affiliation(s)
- Paul Kolkman
- />Methodist Hospital, General Surgery, Omaha, Nebraska
| | - Apollo Stack
- />College of Medicine, University of Nebraska Medical Center, Omaha, NE USA
| | - Molly McCarthy
- />Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE USA
| | - Marcy Kolkman
- />College of Nursing, University of Nebraska Medical Center, Omaha, NE USA
| | - T. Subramanyeshwar Rao
- />Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana India
| | - Srinivasulu Mukta
- />Mehdi Nawaz Jung Institute of Oncology, Hyderabad, Andhra Pradesh India
| | - Shireen Rajaram
- />Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE USA
| | - Jon Thompson
- />Department of Surgery, University of Nebraska Medical Center, Omaha, NE USA
| | - Chandrakanth Are
- />Department of Surgery, University of Nebraska Medical Center, Omaha, NE USA
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Ireland CJ, Thompson SK, Laws TA, Esterman A. Risk factors for Barrett’s esophagus: a scoping review. Cancer Causes Control 2016; 27:301-23. [DOI: 10.1007/s10552-015-0710-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 12/22/2015] [Indexed: 02/08/2023]
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Koca T, Arslan D, Basaran H, Cerkesli AK, Tastekin D, Sezen D, Koca O, Binici DN, Bassorgun CI, Ozdogan M. Dietary and demographical risk factors for oesophageal squamous cell carcinoma in the Eastern Anatolian region of Turkey where upper gastrointestinal cancers are endemic. Asian Pac J Cancer Prev 2016; 16:1913-7. [PMID: 25773844 DOI: 10.7314/apjcp.2015.16.5.1913] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oesophageal squamous cell carcinoma (ESCC) is endemic in the Eastern Anatolian region of Turkey. The present study was performed to identify risk factors for ESCC that specifically reflect the demography and nutritional habits of individuals living in this region. MATERIALS AND METHODS The following parameters were compared in 208 ESCC patients and 200 control individuals in the Eastern Anatolian region: age, sex, place of living, socioeconomic level, education level, smoking, alcohol intake, nutritional habits, and food preservation methods. RESULTS The mean age of ESCC patients was 56.2 years, and 87 (41.8%) were 65 years-old or older. The ratio of women to men in the patient group was 1.39/1. ESCC patients consumed significantly less fruit and yellow or green vegetables and more hot black tea, 'boiled yellow butter', and mouldy cheese than did control individuals. Residence in rural areas, smoking, and cooking food by burning animal manure were also significantly associated with ESCC. CONCLUSIONS The consumption of boiled yellow butter and mouldy cheese, which are specific to the Eastern Anatolian region, and the use of animal manure for food preparation were identified as risk factors in this region. Further studies are required to potentially identify the carcinogenic substances that promote the development of ESCC in this region.
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Affiliation(s)
- Timur Koca
- Department of Radiation Oncology, Regional Training and Research Hospital, Erzurum, Turkey E-mail :
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Khodarahmi M, Azadbakht L, Daghaghzadeh H, Feinle-Bisset C, Keshteli AH, Afshar H, Feizi A, Esmaillzadeh A, Adibi P. Evaluation of the relationship between major dietary patterns and uninvestigated reflux among Iranian adults. Nutrition 2015; 32:573-83. [PMID: 26830010 DOI: 10.1016/j.nut.2015.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 11/23/2015] [Accepted: 11/25/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The etiology of uninvestigated reflux is largely unknown. Although diet has been associated with uninvestigated reflux, the role of dietary patterns is not clear yet. The aim of this study was to investigate dietary patterns in relation to uninvestigated reflux among Iranian adults. METHODS This cross-sectional study was carried out within the framework of SEPAHAN (Study on the Epidemiology of Psychological, Alimentary Health and Nutrition) among Iranian adults. Dietary data were collected using a self-administered, 106-item, dish-based, semiquantitative food frequency questionnaire. Uninvestigated reflux was considered to be present when an individual reported to be suffering from heartburn sometimes or frequently in the preceding 3 mo. Specific dietary patterns were identified using factor analysis. RESULTS Complete information from 3846 individuals was available for statistical analysis. We identified four major dietary patterns: fast food, traditional, vegetarian, and Western. After controlling for potential confounders, no overall significant associations were found between these dietary patterns and uninvestigated reflux. However, participants in the third quintile of the traditional dietary pattern had greater odds of uninvestigated reflux, either in the crude (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.09-1.74) or the adjusted (OR, 1.52; 95% CI, 1.16-2.00) model taking into account different confounders. After controlling for age, men in the second (OR, 1.64; 95% CI, 1.10-2.45) and women in the fourth (OR, 1.47; 95% CI, 1.02-2.11) quintiles of the fast food dietary pattern were more likely to have uninvestigated reflux. Moreover, in the age-adjusted model, men in the second (OR, 1.72; 95% CI, 1.14-2.59) and fourth (OR, 1.56; 95% CI, 1.03-2.35) quintiles, and women in the second (OR, 1.48; 95% CI, 1.08-2.04) quintile of the traditional dietary pattern were at higher risk for being diagnosed with uninvestigated reflux. CONCLUSION Although the present study showed no statistically significant associations between major dietary patterns and the risk for uninvestigated reflux, relative positive associations were found between uninvestigated reflux and adherence to either fast food or traditional dietary patterns, suggesting that these contribute to the risk for developing reflux.
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Affiliation(s)
- Mahdieh Khodarahmi
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Azadbakht
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hamed Daghaghzadeh
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Christine Feinle-Bisset
- University of Adelaide Discipline of Medicine and NHMRC Centre of Research Excellence of Translating Nutritional Science to Good Health, Adelaide, Australia
| | - Ammar Hassanzadeh Keshteli
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Medicine, University of Alberta, Edmonton, Canada
| | - Hamid Afshar
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Ren LL, Yan TT, Wang ZH, Bian ZL, Yang F, Hong J, Chen HY, Fang JY. Alcohol consumption and the risk of Barrett's esophagus: a comprehensive meta-analysis. Sci Rep 2015; 5:16048. [PMID: 26542211 PMCID: PMC4635354 DOI: 10.1038/srep16048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 09/24/2015] [Indexed: 02/08/2023] Open
Abstract
Several studies have been proposed to investigate the association between alcohol consumption and risk of Barrett’s esophagus (BE), but as of yet, no quantitative summary of the literature to clarify the relationship between them. In our study, twenty eligible cohort studies involving 42925 participants were identified. Combined relative risk (RR) ratios for the highest versus lowest alcohol consumption levels were calculated. The alcohol dose-response analysis was performed to investigate the association between the increment consumption of 10 g/d alcohol and the risk of developing BE. Subgroup analyses were used to examine heterogeneity across the studies. A combined RR of 0.98 (0.62–1.34) was found when comparing highest vs. lowest alcohol consumption levels for BE. An inverse association between alcohol and incidence of BE (RR 0.51; 95% CI: 0.055–0.96) was demonstrated in women. Moreover, Asian drinkers had a relative higher risk of BE (RR 1.34; 95% CI: 1.11–1.56) compared with Western drinkers. In conclusion, our results showed that overall alcohol consumption was not associated with increased BE incidence. The limited data available on alcohol consumption supports a tentative inversion of alcohol consumption with BE risk in women, while Asian drinkers tend to have a higher risk of BE.
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Affiliation(s)
- Lin-Lin Ren
- State Key Laboratory of Oncogenes and Related Genes, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease. 145 Middle Shandong Rd, Shanghai, 200001, China
| | - Ting-Ting Yan
- State Key Laboratory of Oncogenes and Related Genes, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease. 145 Middle Shandong Rd, Shanghai, 200001, China
| | - Zhen-Hua Wang
- State Key Laboratory of Oncogenes and Related Genes, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease. 145 Middle Shandong Rd, Shanghai, 200001, China
| | - Zhao-Lian Bian
- State Key Laboratory of Oncogenes and Related Genes, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease. 145 Middle Shandong Rd, Shanghai, 200001, China
| | - Fan Yang
- State Key Laboratory of Oncogenes and Related Genes, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease. 145 Middle Shandong Rd, Shanghai, 200001, China
| | - Jie Hong
- State Key Laboratory of Oncogenes and Related Genes, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease. 145 Middle Shandong Rd, Shanghai, 200001, China
| | - Hao-Yan Chen
- State Key Laboratory of Oncogenes and Related Genes, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease. 145 Middle Shandong Rd, Shanghai, 200001, China
| | - Jing-Yuan Fang
- State Key Laboratory of Oncogenes and Related Genes, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease. 145 Middle Shandong Rd, Shanghai, 200001, China
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Bo Y, Lu Y, Zhao Y, Zhao E, Yuan L, Lu W, Cui L, Lu Q. Association between dietary vitamin C intake and risk of esophageal cancer: A dose-response meta-analysis. Int J Cancer 2015; 138:1843-50. [PMID: 26355388 DOI: 10.1002/ijc.29838] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 09/01/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Yacong Bo
- Department of Nutrition and Food Hygiene; College of Public Health, Zhengzhou University; Zhengzhou Henan 450001 China
| | - Yan Lu
- The North Hospital of the Ninth People's Hospital of Shanghai City; Shanghai 201999 China
| | - Yan Zhao
- Henan Tumor Hospital; Affiliated Tumor Hospital of Zhengzhou University; Zhengzhou Henan 450003 China
| | - Erjiang Zhao
- Henan Tumor Hospital; Affiliated Tumor Hospital of Zhengzhou University; Zhengzhou Henan 450003 China
| | - Ling Yuan
- Henan Tumor Hospital; Affiliated Tumor Hospital of Zhengzhou University; Zhengzhou Henan 450003 China
| | - Weiquan Lu
- Henan Tumor Hospital; Affiliated Tumor Hospital of Zhengzhou University; Zhengzhou Henan 450003 China
| | - Lingling Cui
- Department of Nutrition and Food Hygiene; College of Public Health, Zhengzhou University; Zhengzhou Henan 450001 China
| | - Quanjun Lu
- Department of Nutrition and Food Hygiene; College of Public Health, Zhengzhou University; Zhengzhou Henan 450001 China
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Drahos J, Xiao Q, Risch HA, Freedman ND, Abnet CC, Anderson LA, Bernstein L, Brown L, Chow WH, Gammon MD, Kamangar F, Liao LM, Murray LJ, Ward MH, Ye W, Wu AH, Vaughan TL, Whiteman DC, Cook MB. Age-specific risk factor profiles of adenocarcinomas of the esophagus: A pooled analysis from the international BEACON consortium. Int J Cancer 2015; 138:55-64. [PMID: 26175109 DOI: 10.1002/ijc.29688] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 06/19/2015] [Indexed: 12/13/2022]
Abstract
Esophageal (EA) and esophagogastric junction (EGJA) adenocarcinoma have been steadily increasing in frequency in younger people; however, the etiology of these cancers is poorly understood. We therefore investigated associations of body mass index (BMI), cigarette smoking, alcohol consumption, gastroesophageal reflux and use of nonsteroidal anti-inflammatory drugs (NSAIDs) in relation to age-specific risks of EA and EGJA. We pooled individual participant data from eight population-based, case-control studies within the international Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). The analysis included 1,363 EA patients, 1,472 EGJA patients and 5,728 control participants. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for age-specific (<50, 50-59, 60-69, ≥70 years) cancer outcomes, as well as interactions by age. BMI, smoking status and pack-years, recurrent gastroesophageal reflux and frequency of gastroesophageal reflux were positively associated with EA and EGJA in each age group. Early-onset EA (<50 years) had stronger associations with recurrent gastroesophageal reflux (OR = 8.06, 95% CI: 4.52, 14.37; peffect modification = 0.01) and BMI (ORBMI ≥ 30 vs . <25 = 4.19, 95% CI: 2.23, 7.87; peffect modification = 0.04), relative to older age groups. In contrast, inverse associations of NSAID use were strongest in the oldest age group (≥70 years), although this apparent difference was not statistically significant. Age-specific associations with EGJA showed similar, but slightly weaker patterns and no statistically significant differences by age were observed. Our study provides evidence that associations between obesity and gastroesophageal reflux are stronger among earlier onset EA cancers.
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Affiliation(s)
- Jennifer Drahos
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Qian Xiao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Lesley A Anderson
- Centre for Public Health, Queen's University, Belfast, Northern Ireland
| | - Leslie Bernstein
- Department of Population Sciences, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | - Wong-Ho Chow
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Marilie D Gammon
- Department of Epidemiology, University of North Carolina School, Chapel Hill, NC
| | - Farin Kamangar
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Liam J Murray
- Centre for Public Health, Queen's University, Belfast, Northern Ireland
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Thomas L Vaughan
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - David C Whiteman
- Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
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