Association between diabetes and esophageal cancer, independent of obesity, in the United States Veterans Affairs population
Summary In the past 30 years, the incidence of esophageal adenocarcinoma (EAC) has increased more rapidly than any other cancer in the United States. The prevalence of obesity and diabetes mellitus has drastically increased as well. We explored the potential association between obesity, diabetes mel...
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Veröffentlicht in: | Diseases of the esophagus 2016-10, Vol.29 (7), p.747-751 |
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container_title | Diseases of the esophagus |
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creator | Dixon, J. L. Copeland, L. A. Zeber, J. E. MacCarthy, A. A. Reznik, S. I. Smythe, W. R. Rascoe, P. A. |
description | Summary
In the past 30 years, the incidence of esophageal adenocarcinoma (EAC) has increased more rapidly than any other cancer in the United States. The prevalence of obesity and diabetes mellitus has drastically increased as well. We explored the potential association between obesity, diabetes mellitus, and EAC. By means of retrospective interrogation of an administrative database from fiscal year 2005–2009, we identified two cohorts. The cancer cohort was defined as patients with adenocarcinoma of the distal esophagus or gastric cardia. The comparison cohort contained patients with gastroesophageal reflux disorder (GERD; diagnosis coupled with a procedure code for fundoplication). Patient data, including demographic measures, diagnoses of obesity, diabetes mellitus, dyslipidemia, alcohol abuse, and nicotine dependence were examined. A logistic regression model identified risk factors for development of EAC. The sample included 2,836 patients identified as having either EAC (1,704) or fundoplication with GERD (1,132). Although slightly higher percentages of the benign cohort were obese, the cancer cohort had more diabetics (30.8% vs. 14.8%; chi‐square = 94.5; P < 0.0001). In a logistic regression analysis adjusting for comorbidity and lifestyle factors, diagnosis of diabetes mellitus was significantly associated with esophageal cancer as opposed to GERD without cancer (OR = 2.2; 95% confidence interval [CI] 1.7–2.8). Nicotine dependence was also identified as a risk factor (OR = 1.7; 95% CI 1.4–2.0). We identified a potential association between diabetes mellitus and adenocarcinoma of the esophagus or gastric cardia. This association appears to be independent of obesity. Additionally, nicotine dependence was identified as a risk factor for EAC. |
doi_str_mv | 10.1111/dote.12402 |
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In the past 30 years, the incidence of esophageal adenocarcinoma (EAC) has increased more rapidly than any other cancer in the United States. The prevalence of obesity and diabetes mellitus has drastically increased as well. We explored the potential association between obesity, diabetes mellitus, and EAC. By means of retrospective interrogation of an administrative database from fiscal year 2005–2009, we identified two cohorts. The cancer cohort was defined as patients with adenocarcinoma of the distal esophagus or gastric cardia. The comparison cohort contained patients with gastroesophageal reflux disorder (GERD; diagnosis coupled with a procedure code for fundoplication). Patient data, including demographic measures, diagnoses of obesity, diabetes mellitus, dyslipidemia, alcohol abuse, and nicotine dependence were examined. A logistic regression model identified risk factors for development of EAC. The sample included 2,836 patients identified as having either EAC (1,704) or fundoplication with GERD (1,132). Although slightly higher percentages of the benign cohort were obese, the cancer cohort had more diabetics (30.8% vs. 14.8%; chi‐square = 94.5; P < 0.0001). In a logistic regression analysis adjusting for comorbidity and lifestyle factors, diagnosis of diabetes mellitus was significantly associated with esophageal cancer as opposed to GERD without cancer (OR = 2.2; 95% confidence interval [CI] 1.7–2.8). Nicotine dependence was also identified as a risk factor (OR = 1.7; 95% CI 1.4–2.0). We identified a potential association between diabetes mellitus and adenocarcinoma of the esophagus or gastric cardia. This association appears to be independent of obesity. Additionally, nicotine dependence was identified as a risk factor for EAC.</description><identifier>ISSN: 1120-8694</identifier><identifier>EISSN: 1442-2050</identifier><identifier>DOI: 10.1111/dote.12402</identifier><identifier>PMID: 26455587</identifier><language>eng</language><publisher>United States</publisher><subject>adenocarcinoma ; Adenocarcinoma - epidemiology ; Adenocarcinoma - etiology ; Aged ; Cardia ; Chi-Square Distribution ; Databases, Factual ; diabetes ; Diabetes Mellitus, Type 2 - complications ; epidemiology ; esophageal cancer ; Esophageal Neoplasms - epidemiology ; Esophageal Neoplasms - etiology ; Esophagus ; Female ; Fundoplication ; Gastroesophageal Reflux - complications ; Gastroesophageal Reflux - therapy ; Humans ; Logistic Models ; Male ; Middle Aged ; Obesity - complications ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms - epidemiology ; Stomach Neoplasms - etiology ; Tobacco Use Disorder - complications ; United States - epidemiology ; United States Department of Veterans Affairs - statistics & numerical data</subject><ispartof>Diseases of the esophagus, 2016-10, Vol.29 (7), p.747-751</ispartof><rights>2015 International Society for Diseases of the Esophagus</rights><rights>2015 International Society for Diseases of the Esophagus.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4332-fd72d27321ed935e2d82afb652658d2500ad83d6b680020ee7a55ab764cd03603</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdote.12402$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdote.12402$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26455587$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dixon, J. L.</creatorcontrib><creatorcontrib>Copeland, L. A.</creatorcontrib><creatorcontrib>Zeber, J. E.</creatorcontrib><creatorcontrib>MacCarthy, A. A.</creatorcontrib><creatorcontrib>Reznik, S. I.</creatorcontrib><creatorcontrib>Smythe, W. R.</creatorcontrib><creatorcontrib>Rascoe, P. A.</creatorcontrib><title>Association between diabetes and esophageal cancer, independent of obesity, in the United States Veterans Affairs population</title><title>Diseases of the esophagus</title><addtitle>Dis Esophagus</addtitle><description>Summary
In the past 30 years, the incidence of esophageal adenocarcinoma (EAC) has increased more rapidly than any other cancer in the United States. The prevalence of obesity and diabetes mellitus has drastically increased as well. We explored the potential association between obesity, diabetes mellitus, and EAC. By means of retrospective interrogation of an administrative database from fiscal year 2005–2009, we identified two cohorts. The cancer cohort was defined as patients with adenocarcinoma of the distal esophagus or gastric cardia. The comparison cohort contained patients with gastroesophageal reflux disorder (GERD; diagnosis coupled with a procedure code for fundoplication). Patient data, including demographic measures, diagnoses of obesity, diabetes mellitus, dyslipidemia, alcohol abuse, and nicotine dependence were examined. A logistic regression model identified risk factors for development of EAC. The sample included 2,836 patients identified as having either EAC (1,704) or fundoplication with GERD (1,132). Although slightly higher percentages of the benign cohort were obese, the cancer cohort had more diabetics (30.8% vs. 14.8%; chi‐square = 94.5; P < 0.0001). In a logistic regression analysis adjusting for comorbidity and lifestyle factors, diagnosis of diabetes mellitus was significantly associated with esophageal cancer as opposed to GERD without cancer (OR = 2.2; 95% confidence interval [CI] 1.7–2.8). Nicotine dependence was also identified as a risk factor (OR = 1.7; 95% CI 1.4–2.0). We identified a potential association between diabetes mellitus and adenocarcinoma of the esophagus or gastric cardia. This association appears to be independent of obesity. Additionally, nicotine dependence was identified as a risk factor for EAC.</description><subject>adenocarcinoma</subject><subject>Adenocarcinoma - epidemiology</subject><subject>Adenocarcinoma - etiology</subject><subject>Aged</subject><subject>Cardia</subject><subject>Chi-Square Distribution</subject><subject>Databases, Factual</subject><subject>diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>epidemiology</subject><subject>esophageal cancer</subject><subject>Esophageal Neoplasms - epidemiology</subject><subject>Esophageal Neoplasms - etiology</subject><subject>Esophagus</subject><subject>Female</subject><subject>Fundoplication</subject><subject>Gastroesophageal Reflux - complications</subject><subject>Gastroesophageal Reflux - therapy</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Obesity - complications</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stomach Neoplasms - epidemiology</subject><subject>Stomach Neoplasms - etiology</subject><subject>Tobacco Use Disorder - complications</subject><subject>United States - epidemiology</subject><subject>United States Department of Veterans Affairs - statistics & numerical data</subject><issn>1120-8694</issn><issn>1442-2050</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1LxDAQhoMofl_8AZKjB6vJpEnT4-I3CHtw9VrSZqqRblKbLMuCP97u-nE2h8nLzMM7MC8hJ5xd8PFd2pDwgkPOYIvs8zyHDJhk26PmwDKtynyPHMT4zhgvhNK7ZA9ULqXUxT75nMQYGmeSC57WmJaInlpnRomRGm8pxtC_mVc0HW2Mb3A4p85b7HEsPtHQ0lBjdGm17tP0hvTZu4SWPiWz9ngZnQbjI520rXFDpH3oF91m4RHZaU0X8fjnPyTPtzezq_vscXr3cDV5zJpcCMhaW4CFQgBHWwqJYDWYtlYSlNQWJGPGamFVrTRjwBALI6WpC5U3lgnFxCE5-_bth_CxwJiquYsNdp3xGBax4roshBaF_A8KSkFZSjGipz_oop6jrfrBzc2wqn6POwL8G1i6Dld_c86qdWzVOrZqE1t1PZ3dbJT4At2-ixE</recordid><startdate>201610</startdate><enddate>201610</enddate><creator>Dixon, J. L.</creator><creator>Copeland, L. A.</creator><creator>Zeber, J. E.</creator><creator>MacCarthy, A. A.</creator><creator>Reznik, S. I.</creator><creator>Smythe, W. R.</creator><creator>Rascoe, P. A.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>7TS</scope></search><sort><creationdate>201610</creationdate><title>Association between diabetes and esophageal cancer, independent of obesity, in the United States Veterans Affairs population</title><author>Dixon, J. L. ; Copeland, L. A. ; Zeber, J. E. ; MacCarthy, A. A. ; Reznik, S. I. ; Smythe, W. R. ; Rascoe, P. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4332-fd72d27321ed935e2d82afb652658d2500ad83d6b680020ee7a55ab764cd03603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>adenocarcinoma</topic><topic>Adenocarcinoma - epidemiology</topic><topic>Adenocarcinoma - etiology</topic><topic>Aged</topic><topic>Cardia</topic><topic>Chi-Square Distribution</topic><topic>Databases, Factual</topic><topic>diabetes</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>epidemiology</topic><topic>esophageal cancer</topic><topic>Esophageal Neoplasms - epidemiology</topic><topic>Esophageal Neoplasms - etiology</topic><topic>Esophagus</topic><topic>Female</topic><topic>Fundoplication</topic><topic>Gastroesophageal Reflux - complications</topic><topic>Gastroesophageal Reflux - therapy</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Obesity - complications</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stomach Neoplasms - epidemiology</topic><topic>Stomach Neoplasms - etiology</topic><topic>Tobacco Use Disorder - complications</topic><topic>United States - epidemiology</topic><topic>United States Department of Veterans Affairs - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dixon, J. L.</creatorcontrib><creatorcontrib>Copeland, L. A.</creatorcontrib><creatorcontrib>Zeber, J. E.</creatorcontrib><creatorcontrib>MacCarthy, A. A.</creatorcontrib><creatorcontrib>Reznik, S. I.</creatorcontrib><creatorcontrib>Smythe, W. R.</creatorcontrib><creatorcontrib>Rascoe, P. A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>Physical Education Index</collection><jtitle>Diseases of the esophagus</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dixon, J. L.</au><au>Copeland, L. A.</au><au>Zeber, J. E.</au><au>MacCarthy, A. A.</au><au>Reznik, S. I.</au><au>Smythe, W. R.</au><au>Rascoe, P. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between diabetes and esophageal cancer, independent of obesity, in the United States Veterans Affairs population</atitle><jtitle>Diseases of the esophagus</jtitle><addtitle>Dis Esophagus</addtitle><date>2016-10</date><risdate>2016</risdate><volume>29</volume><issue>7</issue><spage>747</spage><epage>751</epage><pages>747-751</pages><issn>1120-8694</issn><eissn>1442-2050</eissn><abstract>Summary
In the past 30 years, the incidence of esophageal adenocarcinoma (EAC) has increased more rapidly than any other cancer in the United States. The prevalence of obesity and diabetes mellitus has drastically increased as well. We explored the potential association between obesity, diabetes mellitus, and EAC. By means of retrospective interrogation of an administrative database from fiscal year 2005–2009, we identified two cohorts. The cancer cohort was defined as patients with adenocarcinoma of the distal esophagus or gastric cardia. The comparison cohort contained patients with gastroesophageal reflux disorder (GERD; diagnosis coupled with a procedure code for fundoplication). Patient data, including demographic measures, diagnoses of obesity, diabetes mellitus, dyslipidemia, alcohol abuse, and nicotine dependence were examined. A logistic regression model identified risk factors for development of EAC. The sample included 2,836 patients identified as having either EAC (1,704) or fundoplication with GERD (1,132). Although slightly higher percentages of the benign cohort were obese, the cancer cohort had more diabetics (30.8% vs. 14.8%; chi‐square = 94.5; P < 0.0001). In a logistic regression analysis adjusting for comorbidity and lifestyle factors, diagnosis of diabetes mellitus was significantly associated with esophageal cancer as opposed to GERD without cancer (OR = 2.2; 95% confidence interval [CI] 1.7–2.8). Nicotine dependence was also identified as a risk factor (OR = 1.7; 95% CI 1.4–2.0). We identified a potential association between diabetes mellitus and adenocarcinoma of the esophagus or gastric cardia. This association appears to be independent of obesity. Additionally, nicotine dependence was identified as a risk factor for EAC.</abstract><cop>United States</cop><pmid>26455587</pmid><doi>10.1111/dote.12402</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | adenocarcinoma Adenocarcinoma - epidemiology Adenocarcinoma - etiology Aged Cardia Chi-Square Distribution Databases, Factual diabetes Diabetes Mellitus, Type 2 - complications epidemiology esophageal cancer Esophageal Neoplasms - epidemiology Esophageal Neoplasms - etiology Esophagus Female Fundoplication Gastroesophageal Reflux - complications Gastroesophageal Reflux - therapy Humans Logistic Models Male Middle Aged Obesity - complications Retrospective Studies Risk Factors Stomach Neoplasms - epidemiology Stomach Neoplasms - etiology Tobacco Use Disorder - complications United States - epidemiology United States Department of Veterans Affairs - statistics & numerical data |
title | Association between diabetes and esophageal cancer, independent of obesity, in the United States Veterans Affairs population |
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