TY - JOUR
T1 - Association between Body Mass Index and Risk of Gastric Cancer by Anatomic and Histologic Subtypes in over 500,000 East and Southeast Asian Cohort Participants
AU - Jang, Jieun
AU - Lee, Sangjun
AU - Ko, Kwang Pil
AU - Abe, Sarah K.
AU - Rahman, Md Shafiur
AU - Saito, Eiko
AU - Islam, Md Rashedul
AU - Sawada, Norie
AU - Shu, Xiao Ou
AU - Koh, Woon Puay
AU - Sadakane, Atsuko
AU - Tsuji, Ichiro
AU - Kim, Jeongseon
AU - Oze, Isao
AU - Nagata, Chisato
AU - Tsugane, Shoichiro
AU - Cai, Hui
AU - Yuan, Jian Min
AU - Gao, Yu Tang
AU - Ozasa, Kotaro
AU - Matsuyama, Sanae
AU - Kanemura, Seiki
AU - Shin, Aesun
AU - Ito, Hidemi
AU - Wada, Keiko
AU - Sugawara, Yumi
AU - Chen, Yu
AU - Ahsan, Habibul
AU - Boffetta, Paolo
AU - Chia, Kee Seng
AU - Matsuo, Keitaro
AU - Qiao, You Lin
AU - Rothman, Nathaniel
AU - Zheng, Wei
AU - Inoue, Manami
AU - Kang, Daehee
AU - Park, Sue K.
N1 - Funding Information:
This work was supported by the following grants: Korean Multicenter Cancer Cohort (KMCC), the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP; No. NRF-2016R1A2B4014552; Principal investigator: S.K. Park); Shanghai Men’s Health Study (SMHS), the US NCI (grant number UM1 CA173640; Principal investigator: X.O. Shu); Shanghai Women’s Health Study (SWHS), the US NCI (grant numbers R37 CA070867 and UM1 CA182910; Principal investigator: W. Zheng); Japan Public Health Center-based prospective Study (JPHC Study) 1 and 2, National Cancer Center Research and Development Fund [23-A-31 (toku) and 26-A-2; since 2011] and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010; Principal investigator: S. Tsugane); Miyagi Cohort Study, National Cancer Center Research and Development Fund (Principal investigator: I. Tsuji); Ohsaki Cohort Study, National Cancer Center Research and Development Fund (Principal investigator: I. Tsuji); Radiation Effects Research Foundation, The Japanese Ministry of Health, Labour, and Welfare and the U.S. Department of Energy (Principal investigator: A. Sadakane); Takayama Study, National Cancer Center Research and Development Fund (Principal investigator: C. Nagata); 3 Prefecture Miyagi Study, National Cancer Center Research and Development Fund (Principal investigator: I. Tsuji); 3 Prefecture Aichi Study, The Japanese Ministry of the Environment (formerly, Environment Agency; Principal investigator: K. Matsuo); Korean National Cancer Screenee Cohort Study, National Cancer Center Research and Development of Korea (grant number 1910330; Principal investigator: J. Kim); Singapore Chinese Health Study, the US NCI (grant numbers R01CA144034 and UM1CA182876; Principal investigator: J.M. Yuan); ACC Coordinating Center, National Cancer Center Research and Development Fund (30-A-15; Principal investigator: M. Inoue). The authors thank all of the participants of the ACC.
Funding Information:
This work was supported by the following grants: Korean Multicenter Cancer Cohort (KMCC), the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP; No. NRF-2016R1A2B4014552; Principal investigator: S.K. Park); Shanghai Men's Health Study (SMHS), the US NCI (grant number UM1 CA173640; Principal investigator: X.O. Shu); Shanghai Women's Health Study (SWHS), the US NCI (grant numbers R37 CA070867 and UM1 CA182910; Principal investigator: W. Zheng); Japan Public Health Center-based prospective Study (JPHC Study) 1 and 2, National Cancer Center Research and Development Fund [23-A-31 (toku) and 26-A-2; since 2011] and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010; Principal investigator: S. Tsugane);Miyagi Cohort Study, National Cancer Center Research and Development Fund (Principal investigator: I. Tsuji); Ohsaki Cohort Study, National Cancer Center Research and Development Fund (Principal investigator: I. Tsuji); Radiation Effects Research Foundation, The Japanese Ministry of Health, Labour, and Welfare and the U.S. Department of Energy (Principal investigator: A. Sadakane); Takayama Study, National Cancer Center Research and Development Fund (Principal investigator: C. Nagata); 3 Prefecture Miyagi Study, National Cancer Center Research and Development Fund (Principal investigator: I. Tsuji); 3 Prefecture Aichi Study, The Japanese Ministry of the Environment (formerly, Environment Agency; Principal investigator: K. Matsuo); Korean National Cancer Screenee Cohort Study, National Cancer Center Research andDevelopment of Korea (grant number 1910330; Principal investigator: J. Kim); Singapore Chinese Health Study, the US NCI (grant numbers R01CA144034 and UM1CA182876; Principal investigator: J.M. Yuan); ACC Coordinating Center, National Cancer Center Research and Development Fund (30-A-15; Principal investigator: M. Inoue).
Funding Information:
Abbreviations: IQR, Interquartile range; SD, Standard deviation; N, Number; RERF, Radiation Effects Research Foundation; 3pref. Miyagi, Three-Prefecture Cohort Study, Miyagi; 3pref. Aichi, Three-Prefecture Cohort Study, Aichi; JPHC1, Japan Public Health Center-based prospective Study1; JPHC2, Japan Public Health Center-based prospective Study2; KMCC, Korean Multi-center Cancer Cohort; KNCC, Korean National Cancer Screenee Cohort; SCHS, Singapore Chinese Health Study; SMHS, Shanghai Men’s Health Study; SWHS, Shanghai Women’s Health Study. aMean of BMI = 23.3 kg/m2 (SD, 3.2 kg/m2).
Funding Information:
X.O. Shu reports grants from NCI outside the submitted work. S.K. Park reports grants from National Research Foundation of Korea; US NCI; National Cancer Center Research and Development Fund; Grant-in-Aid for Cancer Research from the Ministry of Health, Labour, and Welfare of Japan; National Cancer Center Research and Development Fund; The Japanese Ministry of Health, Labour and Welfare; the U. S. Department of Energy; National Cancer Center Research and Development Fund; The Japanese Ministry of the Environment; National Cancer Center Research and Development of Korea; and grants from National Cancer Center Research and Development Fund during the conduct of the study. No disclosures were reported by the other authors.
Publisher Copyright:
© 2022 American Association for Cancer Research.
PY - 2022/9
Y1 - 2022/9
N2 - Background: This study was performed to investigate the association between body mass index (BMI) and gastric cancer in East and Southeast Asia where most of gastric cancer is non-cardia gastric cancer. Methods:Onthe basis of 8,997 gastric cancer cases among theAsia Cohort Consortium participants from China, Japan, Korea, and Singapore (N = 538,835), we assessed gastric cancer risk according to BMI by calculating hazard ratios (HR) and 95% confidence intervals (CI) using the Cox proportional hazard regression model. Results: A U-shaped associations between BMI and gastric cancer risk were observed. Gastric cancer risks in underweight group (<18.5 kg/m2) and in obesity group (≥27.5 kg/m2) were higher than reference BMI group (23-24.9 kg/m2; HR, 1.15; 95% CI, 1.05-1.25 for underweight; HR, 1.12; 95% CI, 1.03-1.22 for obesity, respectively). The associations of underweight and obesity with gastric cancer risk were consistent in the analyses for non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer. No significant association of underweight and obesity with the risk of cardia gastric cancer, diffuse-type gastric cancer, and early-onset gastric cancer was observed. In addition, we found that the U-shaped association between BMI and gastric cancer risk remained in nonsmokers, while only underweight was related to increased gastric cancer risk in smokers. Conclusions: BMI has a U-shaped association with gastric cancer risk in East and Southeast Asian population, especially for the non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer. Impact: Future studies with consideration of anatomic location and histology of gastric cancer are needed to establish the association of underweight as well as obesity with gastric cancer risk.
AB - Background: This study was performed to investigate the association between body mass index (BMI) and gastric cancer in East and Southeast Asia where most of gastric cancer is non-cardia gastric cancer. Methods:Onthe basis of 8,997 gastric cancer cases among theAsia Cohort Consortium participants from China, Japan, Korea, and Singapore (N = 538,835), we assessed gastric cancer risk according to BMI by calculating hazard ratios (HR) and 95% confidence intervals (CI) using the Cox proportional hazard regression model. Results: A U-shaped associations between BMI and gastric cancer risk were observed. Gastric cancer risks in underweight group (<18.5 kg/m2) and in obesity group (≥27.5 kg/m2) were higher than reference BMI group (23-24.9 kg/m2; HR, 1.15; 95% CI, 1.05-1.25 for underweight; HR, 1.12; 95% CI, 1.03-1.22 for obesity, respectively). The associations of underweight and obesity with gastric cancer risk were consistent in the analyses for non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer. No significant association of underweight and obesity with the risk of cardia gastric cancer, diffuse-type gastric cancer, and early-onset gastric cancer was observed. In addition, we found that the U-shaped association between BMI and gastric cancer risk remained in nonsmokers, while only underweight was related to increased gastric cancer risk in smokers. Conclusions: BMI has a U-shaped association with gastric cancer risk in East and Southeast Asian population, especially for the non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer. Impact: Future studies with consideration of anatomic location and histology of gastric cancer are needed to establish the association of underweight as well as obesity with gastric cancer risk.
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U2 - 10.1158/1055-9965.EPI-22-0051
DO - 10.1158/1055-9965.EPI-22-0051
M3 - Article
C2 - 35793701
AN - SCOPUS:85137135467
SN - 1055-9965
VL - 31
SP - 1727
EP - 1734
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 9
ER -