A history of high body mass index (BMI) is associated strongly with a risk of esophageal adenocarcinoma.
Dr Jesper Lagergren and colleagues from the United Kingdom investigated whether gastroesophageal reflux is involved in this association.
The team analyzed data from a population-based Swedish nationwide study of patients with a new diagnosis of esophageal adenocarcinoma or gastroesophageal junction adenocarcinoma, and matched controls, from 1995 through 1997.
The team's included data on BMI 20 years before study inclusion, involving maximum adult BMI; frequency, severity, and duration of gastroesophageal reflux symptoms; tumor features; and covariates.
The researchers conducted stratified analyses and synergy tests, adjusting for covariates.
|BMI appeared to have the largest effect on gastroesophageal reflux frequency|
|Clinical Gastroenterology & Hepatology|
Odds ratios for esophageal adenocarcinoma among subjects with a BMI of 25 or higher 20 years before inclusion, compared with those with a BMI less than 25, did not differ significantly, without or with adjustment for gastroesophageal reflux frequency, severity, or duration.
However, the team found interactions between BMI and categories of gastroesophageal reflux.
BMI appeared to have the largest effect on gastroesophageal reflux frequency.
Dr Lagergren's team comments, "Based on a population-based study, the association between BMI and esophageal adenocarcinoma does not appear to be affected by symptomatic gastroesophageal reflux, although there appears to be synergy between BMI and reflux."