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Jang J, Lee S, Ko KP, Abe SK, Rahman MS, Saito E, Islam MR, Sawada N, Shu XO, Koh WP, Sadakane A, Tsuji I, Kim J, Oze I, Nagata C, Tsugane S, Cai H, Yuan JM, Gao YT, Ozasa K, Matsuyama S, Kanemura S, Shin A, Ito H, Wada K, Sugawara Y, Chen Y, Ahsan H, Boffetta P, Chia KS, Matsuo K, Qiao YL, Rothman N, Zheng W, Inoue M, Kang D, Park SK. Association between Body Mass Index and Risk of Gastric Cancer by Anatomic and Histologic Subtypes in Over 500,000 East and Southeast Asian Cohort Participants. Cancer Epidemiol Biomarkers Prev 2022; 31:1727-1734. [PMID: 35793701 PMCID: PMC9489277 DOI: 10.1158/1055-9965.epi-22-0051] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/13/2022] [Accepted: 06/24/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study was performed to investigate the association between body mass index (BMI) and gastric cancer in East and Southeast Asia where most of gastric cancer is non-cardia gastric cancer. METHODS On the basis of 8,997 gastric cancer cases among the Asia Cohort Consortium participants from China, Japan, Korea, and Singapore (N = 538,835), we assessed gastric cancer risk according to BMI by calculating hazard ratios (HR) and 95% confidence intervals (CI) using the Cox proportional hazard regression model. RESULTS A U-shaped associations between BMI and gastric cancer risk were observed. Gastric cancer risks in underweight group (<18.5 kg/m2) and in obesity group (≥27.5 kg/m2) were higher than reference BMI group (23-24.9 kg/m2; HR, 1.15; 95% CI, 1.05-1.25 for underweight; HR, 1.12; 95% CI, 1.03-1.22 for obesity, respectively). The associations of underweight and obesity with gastric cancer risk were consistent in the analyses for non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer. No significant association of underweight and obesity with the risk of cardia gastric cancer, diffuse-type gastric cancer, and early-onset gastric cancer was observed. In addition, we found that the U-shaped association between BMI and gastric cancer risk remained in nonsmokers, while only underweight was related to increased gastric cancer risk in smokers. CONCLUSIONS BMI has a U-shaped association with gastric cancer risk in East and Southeast Asian population, especially for the non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer. IMPACT Future studies with consideration of anatomic location and histology of gastric cancer are needed to establish the association of underweight as well as obesity with gastric cancer risk.
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Affiliation(s)
- Jieun Jang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Sangjun Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Kwang-Pil Ko
- Clinical Preventive Medicine Center, Seoul National University Bundang HospitaI, Seongnam-si, Gyeonggi-do, Korea
| | - Sarah K Abe
- Division of Prevention, National Cancer Center Institute for Cancer Control, Japan
| | - Md. Shafiur Rahman
- Division of Prevention, National Cancer Center Institute for Cancer Control, Japan,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Japan
| | - Md. Rashedul Islam
- Division of Prevention, National Cancer Center Institute for Cancer Control, Japan,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, National Cancer Center Institute for Cancer Control, Japan
| | - Xiao-Ou Shu
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, USA
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore Singapore
| | | | - Ichiro Tsuji
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Jeongseon Kim
- Graduate School of Science and Policy, National Cancer Center, Korea
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, National Cancer Center Institute for Cancer Control, Japan
| | - Hui Cai
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, USA
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute/Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Kotaro Ozasa
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - Sanae Matsuyama
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Seiki Kanemura
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea,Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan,Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yumi Sugawara
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago IL, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya Japan,Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - You-Lin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nathaniel Rothman
- Division of Cancer Epidemiology & Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, USA
| | - Manami Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, Japan
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea,Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea,Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
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