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Sex-specific associations between body mass index, waist circumference and the risk of Barrett's oesophagus: a pooled analysis from the international BEACON consortium
  1. Ai Kubo1,
  2. Michael Blaise Cook2,
  3. Nicholas J Shaheen3,
  4. Thomas L Vaughan4,
  5. David C Whiteman5,
  6. Liam Murray6,
  7. Douglas A Corley1
  1. 1Division of Research, Northern California Kaiser Permanente, Oakland, California, USA
  2. 2Division of Cancer Epidemiology and Genetics, National Cancer Institute, Maryland, USA
  3. 3Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
  4. 4Department of Epidemiology, Fred Hutchinson Cancer Center, Seattle, Washington, USA
  5. 5Department of Population and Cancer Studies, Queensland Institute of Medical Research, Brisbane, Queensland, USA
  6. 6School of Medicine, Belfast, Ireland
  1. Correspondence to Dr Ai Kubo, Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA; ai.kubo{at}


Objective Barrett's oesophagus is a precursor lesion of oesophageal adenocarcinoma, a cancer that, in the USA, has increased in incidence over 600% during the past 40 years. Barrett's oesophagus and oesophageal adenocarcinoma are much more common among men than among women; this finding is unexplained and most earlier studies lacked sufficient numbers of women to evaluate sex-specific risk factors. We leveraged the power of an international consortium to assess sex-specific relationships between body mass index (BMI), abdominal circumference and Barrett's oesophagus.

Design Four case–control studies provided a total of 1102 cases (316 women, 786 men) and 1400 population controls (436 women, 964 men) for analysis. Study-specific estimates, generated using individual participant data, were combined using random effects meta-analysis.

Results Waist circumference was significantly associated with Barrett's oesophagus, even after adjustment for BMI; persons in the highest versus the lowest quartiles of waist circumference had approximately 125% and 275% increases in the odds of Barrett's oesophagus among men and women, respectively (OR 2.24, 95% CI 1.08 to 4.65, I2=57; OR 3.75, 95% CI 1.47 to 9.56, I2=0). In contrast, there was no evidence of a significant association between BMI and the risk of Barrett's oesophagus, with or without adjustment for waist circumference.

Conclusions Waist circumference, independent of BMI, was found to be a risk factor for Barrett's oesophagus among both men and women. Future studies examining the biological mechanisms of this association will extend our knowledge regarding the pathogenesis of Barrett's oesophagus.

  • Barrett's Oesophagus
  • Obesity
  • Gastroesophageal Reflux Disease
  • Nutrition

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