The risk of Barrett's Esophagus associated with abdominal obesity in males and females

Bradley J Kendall, Graeme Macdonald, Nicholas Hayward, Johannes Prins, Suzanne O'Brien, David Whiteman, Adele Green, Peter Parsons, Sandra Pavey, David Purdie, Penelope Webb, David Gotley, Mark Smithers, Glyn Jamieson, Paul Drew, David Watson, Andrew Clouston, Derek Nancarrow, Christine Hill, Jeanette MayhewA McMurtrie, Barbara Ranieri

    Research output: Contribution to journalArticlepeer-review

    37 Citations (Scopus)


    Esophageal adenocarcinoma arises from Barrett's esophagus (BE). Both occur predominantly in males. The role of abdominal obesity in this sex distribution is uncertain. Our study aimed to determine whether there is an association between abdominal obesity and risk of BE and if present was it modified by sex. A structured interview and anthropometric measures were conducted within a population-based case-control study. We recruited 237 BE cases (70% male) and 247 population controls, frequency matched by age and sex. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression analysis. In the overall group and males, all measures of abdominal obesity [waist circumference (WC), waist-hip ratio (WHR), sagittal abdominal diameter (SAD) and waist-height ratio (WHtR)] were strongly associated with risk of BE (Overall: WC OR 2.2 95% CI 1.4-3.5, WHR 1.8 95% CI 1.2-2.9, SAD 2.3 95% CI 1.4-3.7, WHtR 1.9 95% CI 1.2-3.0, males WC 2.5 95% CI 1.4-4.3, WHR 2.4 95% CI 1.3-4.2, SAD 2.5 95% CI 1.4-4.3, WHtR 1.9 95% CI 1.1-3.4). These associations were minimally attenuated by adjusting for ever-symptoms of gastroesophageal reflux (GER). These findings suggest in males, non-GER factors related to abdominal obesity may be important in the development of BE. In females, there was modest association between measures of abdominal obesity and risk of BE but these were all abolished after adjusting for ever-symptoms of GER. The power to detect differences between sexes in the risk of BE associated with abdominal obesity was limited by the number of females in the study. What's new? Barrett's esophagus (BE), a condition in which the lining of the esophagus is damaged by stomach acid, leads to esophageal cancer. It's suspected that obesity leads to BE, which occurs more often in males than females. This paper reports the results of a case-control study, which show that abdominal obesity does strongly associate with BE in males, but not females, independent of gastroesophageal reflux.

    Original languageEnglish
    Pages (from-to)2192-2199
    Number of pages8
    JournalInternational Journal of Cancer
    Issue number9
    Publication statusPublished - 1 May 2013


    • Barrett's esophagus
    • case-control
    • obesity
    • risk factors


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