Abdominal fat and male excess of esophageal adenocarcinoma

• The 7-to-1 male-to-female ratio in esophageal and gastroesophageal junctional adenocarcinoma (EAC) might be explained by abdominal adiposity, typical for males. If true, a stronger male predominance in higher BMI categories is expected. We conducted a nationwide Swedish population-based case-control study in 1995-1997 and collected data on BMI and other variables at face-to-face interviews. Age-adjusted relative risk (RR) and 95% confidence intervals (CI) levels were calculated using Poisson regression. Among 451 EAC cases and 820 controls, RR of EAC in males compared to females did not increase with higher BMI as assessed 20 years before interview, at 20 years of age, or at maximum or minimum adult BMI. For BMI 20 years before interview, RR in males compared to females were 7.4 (95%CI:3.9-14.1), 5.3 (95%CI:3.5-8.1), and 5.8 (95%CI:3.9-8.8) in the BMI categories <22, 22-<25, and ≥25, respectively. Conclusions: Abdominal adiposity might not explain the male predominance in esophageal adenocarcinoma.

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