Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Obesity (Silver Spring). 2019 Sep;27(9):1520-1526. doi: 10.1002/oby.22570. Epub 2019 Aug 5.
Esophageal adenocarcinoma (EA) and gastric cardia adenocarcinoma (GCA) are among the most rapidly increasing cancers in Western countries. Elevated BMI in adulthood is a known risk factor, but associations in early life are unclear.
This study assessed weight change between childhood and early adulthood in relation to EA/GCA. Measured weights and heights during childhood (7-13 years) and early adulthood (17-26 years) were available for 64,695 young men from the Copenhagen School Health Records Register and the Danish Conscription Database. Individuals were categorized as having normal weight or overweight. Linkage with the Danish Cancer Registry identified 275 EA/GCA cases. Hazard ratios (HR) and 95% CI were estimated using Cox proportional hazards regression.
The risk of EA/GCA was 2.5 times higher in men who were first classified as having overweight at age 7 (HR = 2.49; 95% CI: 1.50-4.14) compared with men who were never classified as having overweight. Men who had persistent overweight at ages 7 and 13 and in early adulthood had an EA/GCA risk that was 3.2 times higher (HR = 3.18; 95% CI: 1.57-6.44). However, there was little evidence of increased EA/GCA risk for men with overweight during childhood and subsequent remittance by early adulthood.
Persistent overweight in early life is associated with increased EA/GCA risk, which declines if body weight is reduced.
食管腺癌（EA）和胃贲门腺癌（GCA）是西方国家发病率增长最快的癌症之一。成年后 BMI 升高是已知的危险因素，但在生命早期的相关性尚不清楚。
本研究评估了儿童期和成年早期体重变化与 EA/GCA 的关系。来自哥本哈根学校健康记录登记处和丹麦征兵数据库的 64695 名年轻男性提供了儿童期（7-13 岁）和成年早期（17-26 岁）的体重和身高测量值。个体被分为正常体重或超重。与丹麦癌症登记处的链接确定了 275 例 EA/GCA 病例。使用 Cox 比例风险回归估计危险比（HR）和 95%CI。
与从未被归类为超重的男性相比，在 7 岁时首次被归类为超重的男性患 EA/GCA 的风险高 2.5 倍（HR=2.49；95%CI：1.50-4.14）。在 7 岁和 13 岁以及成年早期一直超重的男性患 EA/GCA 的风险高 3.2 倍（HR=3.18；95%CI：1.57-6.44）。然而，对于儿童期超重且成年早期体重减轻的男性，EA/GCA 风险增加的证据很少。
生命早期持续超重与 EA/GCA 风险增加相关，如果体重减轻，风险会降低。
