Assessment of familiality, obesity, and other risk factors for early age of cancer diagnosis in adenocarcinomas of the esophagus and gastroesophageal junction.
Assessment of familiality, obesity, and other risk factors for early age of cancer diagnosis in adenocarcinomas of the esophagus and gastroesophageal junction.
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DOI：
10.1038/ajg.2009.241
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发表时间：
2009-08
影响因子：
9.8
通讯作者：
Barnholtz-Sloan, Jill
中科院分区：
文献类型：
--
作者：
Chak, Amitabh;Falk, Gary;Grady, William M.;Kinnard, Margaret;Elston, Robert;Mittal, Sumeet;King, James F.;Willis, Joseph E.;Kondru, Anokh;Brock, Wendy;Barnholtz-Sloan, Jill
食管腺癌和胃食管交界处腺癌被认为是复杂的遗传性疾病。环境因素和遗传易感性的综合影响可能会影响这些癌症发生的年龄。这项研究的目的是确定熟悉度和其他公认的危险因素是否与早期癌症的发展有关。在五所三级专科医院，采用结构化的有效问卷收集胃食管反流症状、巴雷特食管（BE）危险因素和家族史的自我报告数据，包括先证者患BE、食管腺癌或胃食管交界腺癌的受影响亲属的癌症诊断年龄。向提供这种癌症治疗的医院索取了报告受影响的所有亲属的医疗记录，以确认家族史。对BE/癌症的熟悉程度、肥胖（定义为体重指数bbb30）、胃食管反流症状和其他危险因素与年轻癌症诊断的相关性进行了评估。共有356,216例非家族性癌症和140例家族性癌症被研究。研究人群包括292名（82%）男性和64名（18%）女性。家族性癌症和非家族性癌症的平均诊断年龄没有差异，分别为62.6岁和61.9岁，p = 0.70。家族性和非家族性癌症患者在胃食管反流症状、体重指数、种族、性别和吸烟史方面也无显著差异。癌症诊断的平均年龄明显低于诊断前一年的肥胖者和非肥胖者，平均年龄分别为58.99岁和63.6岁，p = 0.008。癌症诊断年龄的多变量模型显示，在调整胃灼热和反流持续时间后，诊断前1年的肥胖与较年轻的癌症诊断年龄相关（p=0.005）。肥胖与早期食管癌和胃食管交界腺癌的发生有关。家族性癌症与非家族性癌症的发病年龄相同，具有相似的风险因素。
Adenocarcinomas of the esophagus and adenocarcinomas of the gastroesophageal junction are postulated to be complex genetic diseases. Combined influences of environmental factors and genetic susceptibility likely influence the age at which these cancers develop. The aim of this study was to determine whether familiality and other recognized risk factors are associated with the development of these cancers at an earlier age. A structured validated questionnaire was utilized to collect self reported data on gastro-esophageal reflux symptoms, risk factors for Barrett’s esophagus (BE) and family history, including age of cancer diagnosis in affected relatives from probands with BE, adenocarcinoma of the esophagus, or adenocarcinoma of the gastro-esophageal junction, at five tertiary care academic hospitals. Medical records of all relatives reported to be affected were requested from hospitals providing this cancer care to confirm family histories. Familiality of BE/cancer, obesity (defined as body mass index > 30), gastro-esophageal reflux symptoms, and other risk factors were assessed for association with a young age of cancer diagnosis. A total of 356, 216 non-familial and 140 familial, cancers were studied. The study population consisted of 292 (82%) men and 64 (18%) women. Mean age of cancer diagnosis was no different comparing familial and non-familial cancers, 62.6 yrs vs. 61.9 yrs, p = 0.70. There were also no significant differences in symptoms of gastroesophageal reflux, body mass index, race, gender, and smoking history between familial and non-familial cancers. Mean age of cancer diagnosis was significantly younger comparing those who were obese one year prior to diagnosis with those who were non-obese, mean age 58.99 yrs vs. 63.6 yrs, p = 0.008. Multivariable modeling of age at cancer diagnosis showed that obesity 1 year before diagnosis was associated with a younger age of cancer diagnosis (p=0.005) after adjustment for heartburn and regurgitation duration. Obesity is associated with the development of esophageal and gastro-esophageal junctional adenocarcinomas at an earlier age. Familial cancers arise at the same age as non-familial cancers and have a similar risk factor profile.
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影响因子：
3.8
作者：
Chak, Amitabh;Ochs-Balcom, Heather;Eng, Charis
通讯作者：
Eng, Charis
影响因子：
9.8
作者：
El-Serag, HB;Kvapil, P;Kramer, JR
通讯作者：
Kramer, JR
影响因子：
7.1
作者：
ROWLAND, ML
通讯作者：
ROWLAND, ML
影响因子：
10.3
作者：
Gammon, MD;Schoenberg, JB;Fraumeni, JF
通讯作者：
Fraumeni, JF
影响因子：
2.3
作者：
KABAT, GC;NG, SKC;WYNDER, EL
通讯作者：
WYNDER, EL