Physical activity, obesity and risk for esophageal adenocarcinoma


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Lloyd Balbuena, Alan Casson

University of Saskatchewan, Saskatoon SK, Canada

Abstract

Aim

To explore associations between physical activity, obesity and risk of esophageal adenocarcinoma (EADC), we conducted a 2-year prospective case-control study.

Method

Cases included patients with esophageal premalignancy (gastroesophageal reflux disease [GERD] n=142; Barrett esophagus [BE] n=130), and EADC (n=57) defined according to strict clinicopathologic criteria. Controls comprised 102 healthy, asymptomatic individuals. For each participant, a 102-point structured questionnaire was administered, including sociodemographic information, lifestyle risk factors, diet, body mass index (BMI), and physical activity at work and leisure. Using logistic regression methods, we compared physical activity and obesity rates between cases and controls adjusting for differences in age, gender, sociodemographic and lifestyle risk factors.

Results

Relative to normal weight, obese individuals (BMI > 30) were at increased risk for BE (Odds Ratio [OR] 3.29, 95% Confidence Interval [CI] 1.29 – 8.4) and EADC (OR 3.92, 95% CI 1.04-14.8). Although dietary caloric intake was not a significant independent risk factor for EADC, energy consumption correlated with BMI (r=0.12; P<0.05) and work-related metabolic activity (r=0.15; p<0.01). Increased physical activity (combined work and leisure) between the ages of 20 and 29 years was associated with reduced risk for EADC (high compared to low quartiles: OR 0.58; 95% CI 0.39-0.87).

Conclusions

Whereas obesity is associated with an increased risk for EADC, physical activity during the 20s appears to have a protective effect. However, the underlying mechanisms to explain the inverse association between exercise and cancer risk remain unclear. Successful promotion of healthy body weight and exercise may substantially reduce the incidence of this disease.

Aim

To explore associations between physical activity, obesity and risk of esophageal adenocarcinoma (EADC), we conducted a 2-year prospective case-control study.

Method

Cases included patients with esophageal premalignancy (gastroesophageal reflux disease [GERD] n=142; Barrett esophagus [BE] n=130), and EADC (n=57) defined according to strict clinicopathologic criteria. Controls comprised 102 healthy, asymptomatic individuals. For each participant, a 102-point structured questionnaire was administered, including sociodemographic information, lifestyle risk factors, diet, body mass index (BMI), and physical activity at work and leisure. Using logistic regression methods, we compared physical activity and obesity rates between cases and controls adjusting for differences in age, gender, sociodemographic and lifestyle risk factors.

Results

Relative to normal weight, obese individuals (BMI > 30) were at increased risk for BE (Odds Ratio [OR] 3.29, 95% Confidence Interval [CI] 1.29 – 8.4) and EADC (OR 3.92, 95% CI 1.04-14.8). Although dietary caloric intake was not a significant independent risk factor for EADC, energy consumption correlated with BMI (r=0.12; P<0.05) and work-related metabolic activity (r=0.15; p<0.01). Increased physical activity (combined work and leisure) between the ages of 20 and 29 years was associated with reduced risk for EADC (high compared to low quartiles: OR 0.58; 95% CI 0.39-0.87).

Conclusions

Whereas obesity is associated with an increased risk for EADC, physical activity during the 20s appears to have a protective effect. However, the underlying mechanisms to explain the inverse association between exercise and cancer risk remain unclear. Successful promotion of healthy body weight and exercise may substantially reduce the incidence of this disease.