Regular Article

British Journal of Cancer (2000) 83, 127–132. doi:10.1054/bjoc.2000.1121 www.bjcancer.com
Published online 6 June 2000

A case-control study of oesophageal adenocarcinoma in women: a preventable disease

K K Cheng1, L Sharp2, P A McKinney3, R F A Logan4, C E D Chilvers4, P Cook-Mozaffari5, A Ahmed6 and N E Day6

  1. 1Department of Public Health and Epidemiology, The University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
  2. 2Department of Medicine & Therapeutics, University of Aberdeen, Aberdeen, UK
  3. 3Information and Statistics Division, NHS in Scotland, UK
  4. 4Division of Public Health Medicine and Epidemiology, The University of Nottingham, Nottingham, UK
  5. 5Division of Public Health and Primary Health Care, University of Oxford, Oxford, UK
  6. 6Department of Community Medicine, University of Cambridge, Cambridge, UK

Received 4 January 2000; Revised 26 January 2000; Accepted 26 January 2000.

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Abstract

The incidence of adenocarcinoma of the oesophagus in British women is among the highest in the world. To investigate its aetiology, we conducted a multi-centre, population based case–control study in four regions in England and Scotland. We included 74 incident cases in women with histologically confirmed diagnoses of adenocarcinoma of the oesophagus, and 74 female controls matched by age and general practice. High body mass index (BMI) around the age of 20 years (highest vs lowest quartile, adjusted odds ratio (OR) = 6.04, 95% confidence interval (CI) 1.28–28.52) and low consumption of fruit (highest vs lowest quartile, adjusted OR = 0.08, 95% Cl 0.01–0.49) were associated with increases in risk. Breastfeeding by women was associated with reduced risk of their subsequently developing this cancer (ever vs never, adjusted OR = 0.41, 95% CI 0.20–0.82) and there was a significant dose–response effect with total duration of breastfeeding. The summary population attributable risk from these three factors was 96% (90% if breastfeeding is excluded). We conclude that high BMI in early adulthood and low consumption of fruit are important risk factors for adenocarcinoma of the oesophagus. Breastfeeding may confer a protective effect but this needs confirmation. This cancer is a largely preventable disease in women. © 2000 Cancer Research Campaign

Keywords:

oesophageal carcinoma, aetiology, obesity, fruit, breastfeeding

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