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. 2011 Nov;20(11):2450-6.
doi: 10.1158/1055-9965.EPI-11-0547. Epub 2011 Sep 19.

The impact of obesity on the rise in esophageal adenocarcinoma incidence: estimates from a disease simulation model

Chung Yin Kong  1 , Kevin J Nattinger, Tristan J Hayeck, Zehra B Omer, Y Claire Wang, Stuart J Spechler, Pamela M McMahon, G Scott Gazelle, Chin Hur
Affiliations

The impact of obesity on the rise in esophageal adenocarcinoma incidence: estimates from a disease simulation model

Chung Yin Kong et al. Cancer Epidemiol Biomarkers Prev. 2011 Nov.

Abstract

Background: The United States has experienced an alarming and unexplained increase in the incidence of esophageal adenocarcinoma (EAC) since the 1970s. A concurrent increase in obesity has led some to suggest a relationship between the two trends. We explore the extent of this relationship.

Methods: Using a previously validated disease simulation model of white males in the United States, we estimated EAC incidence 1973 to 2005 given constant obesity prevalence and low population progression rates consistent with the early 1970s. Introducing only the observed, rising obesity prevalence, we calculated the incremental incidence caused by obesity. We compared these with EAC incidence data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registry to determine obesity's contribution to the rise therein. Incidences were converted to absolute numbers of cases using U.S. population data.

Results: Using constant obesity prevalence, we projected a total of 30,555 EAC cases cumulatively over 1973 to 2005 and 1,151 in 2005 alone. Incorporating the observed obesity trend resulted in 35,767 cumulative EACs and 1,608 in 2005. Estimates derived from SEER data showed 111,223 cumulative and 7,173 cases in 2005. We conclude that the rise in obesity accounted for 6.5% of the increase in EAC cases that occurred from 1973 to 2005 and 7.6% in the year 2005.

Conclusion: Using published OR for EAC among obese individuals, we found that only a small percentage of the rise in EAC incidence is attributable to secular trends in obesity.

Impact: Other factors, alone and in combination, should be explored as causes of the EAC epidemic.

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the form for Disclosure of Potential Conflicts of Interest and the following were reported:

Stuart Spechler:

AstraZeneca Pharmaceuticals: Grant/Research Support

Ironwood Pharmaceuticals Inc.: Consulting fee

Takeda Pharmaceutical Company Ltd: Grant/Research Support

XenoPort, Inc.: Consulting fee

Torax Medical: Consulting fee

BARRX Medical, Inc.: Grant/Research Support

G Scott Gazelle:

GE Healthcare: Consulting fee

The remaining authors disclosed no potential conflicts of interest.

Figures

Figure 1
Figure 1. Obesity Prevalences from 1973–2005 for US White Males
Obesity prevalences used for Scenario 2, which incorporates the rising prevalences over the study period (1973–2005) are plotted. The prevalence of obesity, defined as body mass index (BMI) >30kg/m2, rises from 11% of the population in 1973 to 32% in 2005.
Figure 2
Figure 2. EAC Incidence by Year: Simulation Results Compared to SEER Data
In this figure, EAC incidences over the study period (1973–2005) are plotted for Scenarios 1 and 2 next to SEER data for direct visual comparison.
See this image and copyright information in PMC

References

    1. Bollschweiler E, Wolfgarten E, Gutschow C, Holscher AH. Demographic variations in the rising incidence of esophageal adenocarcinoma in white males. Cancer. 2001;92:549–555. - PubMed
    1. Islami F, Kamangar F. Helicobacter pylori and esophageal cancer risk: a meta-analysis. Cancer Prev Res (Phila) 2008;1:329–338. - PMC - PubMed
    1. Vaughan TL, Kristal AR, Blount PL, Levine DS, Galipeau PC, Prevo LJ, et al. Nonsteroidal anti-inflammatory drug use, body mass index, and anthropometry in relation to genetic and flow cytometric abnormalities in Barrett's esophagus. Cancer Epidemiol Biomarkers Prev. 2002;11:745–752. - PubMed
    1. Whiteman DC, Sadeghi S, Pandeya N, Smithers BM, Gotley DC, Bain CJ, et al. Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus. Gut. 2008;57:173–180. - PubMed
    1. Devesa SS, Blot WJ, Fraumeni JF., Jr Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer. 1998;83:2049–2053. - PubMed

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