This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Akre, O. Articles by Ekbom, A. Search for Related Content PubMed PubMed Citation Articles by Akre, O. Articles by Ekbom, A.

Perinatal Risk Factors for Cancer of the Esophagus and Gastric Cardia: A Nested Case-Control Study

¹ Clinical Epidemiology Unit, Department of Medicine Solna; ² Department of Surgical Sciences, Karolinska Institutet, Karolinska University Hospital; and ³ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Requests for reprints: Olof Akre, Clinical Epidemiology Unit, Karolinska University Hospital, Solna, M9:01, SE-171 76 Stockholm, Sweden. Phone: 46-8-5177-9324; Fax: 46-8-5177-9304. E-mail: olof.akre{at}medks.ki.se

Background: We have previously hypothesized that preterm birth or impaired fetal growth may cause esophageal adenocarcinomas through gastroesophageal reflux early in life. In this study, we aimed to test if there is an association between gestational duration and birth weight on the one hand, and risk of esophageal and cardia adenocarcinoma on the other.

Methods: We conducted a nested case-control study of 67 cases of esophageal adenocarcinoma and 93 cases of cardia adenocarcinoma, whereas 50 cases of squamous cell carcinoma were studied for comparison. Birth records of cases were traced. Three matched controls per case were randomly selected. Perinatal data were extracted from birth records.

Results: Long gestational duration was associated with a decreased risk of cardia adenocarcinoma (P_trend = 0.001) and a nonsignificant decreased risk of esophageal adenocarcinoma (P = 0.07), whereas no such association was found for esophageal squamous cell carcinoma (P = 0.96). Birth weight was not associated with risk of any of the studied cancers. Compared with lower maternal age (24 years) at giving birth, maternal age of 25 to 29 years were associated with a decreased risk of esophageal adenocarcinoma and squamous cell carcinoma (odds ratio, 0.4; 95% confidence interval, 0.2-0.9 and odds ratio, 0.3; 95% confidence interval, 0.1-0.8, respectively).

Conclusions: Numerical constraints hamper inference, but our results are somewhat consistent with the idea that future risk of esophageal and cardia cancer may in part be determined already perinatally or in infancy and give some limited support to the hypothesis that timing of birth influences risk. (Cancer Epidemiol Biomarkers Prev 2006;15(5):867–71)