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
Hauptverfasser: Dixon, J. L., Copeland, L. A., Zeber, J. E., MacCarthy, A. A., Reznik, S. I., Smythe, W. R., Rascoe, P. A.
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container_end_page 751
container_issue 7
container_start_page 747
container_title Diseases of the esophagus
container_volume 29
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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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 &lt; 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. 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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 &lt; 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. 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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 &lt; 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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