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
Jie Tian
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Search for more papers by this authorChunjian Zuo
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Search for more papers by this authorGuanchu Liu
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Search for more papers by this authorPengyu Che
Department of Cardiothoracic Surgery, The People's Hospital of Chongqing Hechuan, Chongqing, China
Search for more papers by this authorGang Li
Department of Cardiothoracic Surgery, Chonggang General Hospital, Chongqing, China
Search for more papers by this authorXiang Li
Department of Cardiothoracic Surgery, The People's Hospital of Chongqing Tongnan, Chongqing, China
Search for more papers by this authorCorresponding Author
Huanwen Chen
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Correspondence
Huanwen Chen, Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuzhong District, Chongqing 400010, China.
Email: [email protected]
Search for more papers by this authorJie Tian
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Search for more papers by this authorChunjian Zuo
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Search for more papers by this authorGuanchu Liu
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Search for more papers by this authorPengyu Che
Department of Cardiothoracic Surgery, The People's Hospital of Chongqing Hechuan, Chongqing, China
Search for more papers by this authorGang Li
Department of Cardiothoracic Surgery, Chonggang General Hospital, Chongqing, China
Search for more papers by this authorXiang Li
Department of Cardiothoracic Surgery, The People's Hospital of Chongqing Tongnan, Chongqing, China
Search for more papers by this authorCorresponding Author
Huanwen Chen
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Correspondence
Huanwen Chen, Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuzhong District, Chongqing 400010, China.
Email: [email protected]
Search for more papers by this authorAbstract
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).
Supporting Information
| Filename | Description |
|---|---|
| jgh14917-sup-0001-Supplementary Table S1.docxWord 2007 document , 28 KB |
Table S1. PRISMA checklist items of our meta-analysis. |
| jgh14917-sup-0002-Supplementary Table S2.docxWord 2007 document , 40.1 KB |
Table S2. Characteristics of the included studies and BMI cut-off points, ORs (95% CIs) of meta-analysis of the association between BMI and the risk of esophageal cancer and its sub-type and Newcastle Ottawa Scale (NOS) for each included case-control or cohort study. Table S2.1. Characteristics of the included studies and BMI cut-off points, ORs (95% CIs) of meta-analysis of the association between BMI and the risk of esophageal cancer and its sub-type. Table S2.2. Newcastle Ottawa Scale (NOS) of cohort studies was used to evaluate the quality for each eligible study. Table S2.3. Newcastle Ottawa Scale (NOS) of case-control studies was used to evaluate the quality for each eligible study. |
| jgh14917-sup-0003-Supplementary Figure S1.pdfPDF document, 137.7 KB |
Figure S1. presented forest plot of association between underweight subjects and EC and its sub-type, and relevant information of subgroup. |
| jgh14917-sup-0004-Supplementary Figure S2.pdfPDF document, 154 KB |
Figure S2. presented forest plot of association between overweight subjects and EC and its sub-type, and relevant information of subgroup. |
| jgh14917-sup-0005-Supplementary Figure S3.pdfPDF document, 152.4 KB |
Figure S3. presented forest plot of association between obese subjects and EC and its sub-type, and relevant information of subgroup. |
| jgh14917-sup-0006-Supplementary Figure S4.pdfPDF document, 95.2 KB |
Figure S4. present funnel plot of studies evaluating the associations. |
| jgh14917-sup-0007-Supplementary Figure S5.pdfPDF document, 211.2 KB |
Figure S5. present sensitive analysis for associations. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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