446 Background: The relationship between overall obesity, as measured by body mass index (BMI), and risk of esophageal squamous cell carcinoma (ESCC) has been reported, and it has a negative correlation. However, the relationship with abdominal obesity, as measured by waist circumference, may be different. We investigated the association between abdominal obesity and ESCC. Methods: Retrospective cohort study with 22,809,722 individuals who had undergone regular health check-ups provided by the National Health Insurance Corporation between 2009 and 2012 (median follow-up period was 6.4 years) in South Korea. Abdominal obesity was defined as a waist circumference over 90 cm for men and 85 cm for women. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Chi-squared test and Cox proportional hazard model adjusted for confounding factors. Primary outcome was newly developed esophageal cancer. Results: After adjusting for BMI, abdominal obesity increased the risk of ESCC (HR 1.29, 95% CI 1.23–1.36). Waist circumference is associated with increased risk of ESCC in a dose-dependent manner ( P for trend < 0.0001). We analyzed individuals divided into five categories of BMI. Among individuals with overweight (BMI 23–24.9 kg/m2) and obese I (BMI 25–29.9 kg/m2), abdominal obesity was a risk factor associated with developing ESCC (HR 1.22, 95% CI 1.11–1.34; HR 1.28, 95% CI 1.18–1.39, respectively). Conclusions: Abdominal obesity, not BMI itself, is associated with an increased risk for ESCC. Therefore, reducing abdominal obesity may affect decreasing the development of ESCC.
The Willingness to Change Risky Health Behaviors among Chinese Rural Residents: What We Learned from a Population-Based Esophageal Cancer Cohort Study
