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. 2023 May 10;114(7):2961–2972. doi: 10.1111/cas.15805

TABLE 2.

Risks of esophageal and gastric cancers by BMI category

Esophageal cancer
All Squamous cell carcinoma Adenocarcinoma
BMI kg/m2 Subjects (n) Person‐ years Ca (n) HR 95% CI HetP, I 2 Ca (n) HR 95% CI HetP, I 2 Ca (n) HR 95% CI HetP, I 2
All subjects
<18.5 21,466 254,959 129 1.48 1.14–1.91 0.3, 20 51 1.31 0.90–1.90 0.2, 28 0 ND –
18.5 to <21 79,688 1,108,234 394 1.31 1.15–1.50 0.9, 0 284 1.30 1.10–1.53 0.9, 0 19 0.91 0.48–1.72 0.9, 0
21 to <23 104,714 1,531,131 471 1.00 Reference – 320 1.00 Reference 27 1.00 Reference –
23 to <25 95,164 1,431,439 326 0.75 0.61–0.91 0.1, 40 231 0.76 0.62–0.93 0.3, 19 16 0.91 0.46–1.82 0.7, 0
25 to <30 85,053 1,300,950 235 0.64 0.55–0.76 0.4, 0 143 0.56 0.46–0.68 0.5, 0 23 0.95 0.52–1.71 0.6, 0
≥30 8162 123,394 14 0.64 0.37–1.10 0.8, 0 9 0.54 0.28–1.05 0.9, 0 1 1.19 0.15–9.22 –
Never smokers
<18.5 11,174 139,846 12 1.69 0.82–3.50 0.6, 0 6 1.60 0.62–4.14 0.9, 0 0 ND –
18.5 to <21 41,595 601,085 55 1.02 0.71–1.45 0.5, 0 34 0.92 0.59–1.45 0.5, 0 4 0.84 0.21–3.37 0.6, 0
21 to <23 56,251 852,112 85 1.00 Reference – 61 1.00 Reference 7 1.00 Reference –
23 to <25 51,834 803,621 83 0.93 0.68–1.27 0.4, 0 57 0.90 0.62–1.30 0.8, 0 2 1.18 0.11–13.05 –
25 to <30 48,999 770,799 75 0.83 0.60–1.14 0.5, 0 46 0.72 0.49–1.07 0.8, 0 9 0.65 0.20–2.14 0.8, 0
≥30 5032 78,149 5 1.28 0.49–3.33 0.5, 0 5 1.76 0.65–4.75 0.4, 0 0 ND –
Ever smokers
<18.5 8772 99,452 83 1.60 1.22–2.09 0.3, 14 44 1.44 0.96–2.15 0.2, 28 0 ND –
18.5 to <21 32,780 442,798 363 1.36 1.17–1.57 1, 0 245 1.37 1.15–1.64 1, 0 14 0.90 0.43–1.91 0.9, 0
21 to <23 41,232 586,281 366 1.00 Reference – 254 1.00 Reference 19 1.00 Reference –
23 to <25 36,736 537,031 228 0.69 0.57–0.85 0.2, 23 166 0.71 0.57–0.89 0.3, 13 13 1.23 0.54–2.77 0.9, 0
25 to <30 28,814 433,142 157 0.58 0.48–0.71 0.6, 0 90 0.51 0.40–0.65 0.7, 0 13 0.99 0.46–2.11 0.7, 0
≥30 2326 34,802 9 0.86 0.33–2.21 0.2, 42 4 0.71 0.26–1.92 0.8, 0 1 2.88 0.34–24.24 –
Gastric cancer
All Cardia cancer Noncardia cancer
BMI kg/m2 Subjects (n) Person‐ years Ca (n) HR 95% CI HetP, I 2 Ca (n) HR 95% CI HetP, I 2 Ca (n) HR 95% CI HetP, I 2
All subjects
<18.5 21,466 254,959 597 1.07 0.96–1.20 0.2, 32 32 1.16 0.79–1.70 0.9, 0 203 0.97 0.84–1.13 0.5, 0
18.5 to <21 79,688 1,108,234 2293 1.05 0.99–1.12 0.3, 19 106 0.78 0.61–0.99 0.5, 0 1058 1.04 0.96–1.13 0.5, 0
21 to <23 104,714 1,531,131 2975 1.00 Reference 206 1.00 Reference – 1517 1.00 Reference –
23 to <25 95,164 1,431,439 2715 0.98 0.91–1.05 0.1, 45 176 0.89 0.69–1.14 0.2, 24 1446 0.98 0.91–1.05 0.5, 0
25 to <30 85,053 1,300,950 2304 0.96 0.90–1.03 0.2, 30 196 1.12 0.92–1.37 0.5, 0 1275 0.96 0.89–1.03 0.6, 0
≥30 8162 123,394 211 1.05 0.88–1.25 0.2, 22 12 1.04 0.57–1.87 0.5, 0 121 1.04 0.76–1.43 0.1, 48
Never smokers
<18.5 11,174 139,846 238 1.22 1.02–1.45 0.2, 26 12 1.90 0.96–3.76 0.9, 0 81 1.02 0.75–1.41 0.1, 37
18.5 to <21 41,595 601,085 788 1.07 0.94–1.23 0.04, 48 33 0.92 0.59–1.41 0.9, 0 389 1.08 0.92–1.27 0.2, 25
21 to <23 56,251 852,112 1066 1.00 Reference 61 1.00 Reference – 577 1.00 Reference –
23 to <25 51,834 803,621 1085 1.04 0.94–1.15 0.2, 21 68 1.08 0.76–1.54 0.7, 0 574 0.97 0.86–1.09 0.6, 0
25 to <30 48,999 770,799 1074 1.05 0.96–1.15 0.4, 5 76 1.19 0.83–1.68 0.6, 0 595 0.99 0.88–1.11 0.6, 0
≥30 5032 78,149 110 1.14 0.91–1.43 0.3, 12 8 1.94 0.85–4.43 0.6, 0 63 1.19 0.85–1.66 0.2, 27
Ever smokers
<18.5 8772 99,452 326 1.00 0.87–1.15 0.2, 23 19 1.23 0.74–2.06 0.8, 0 111 0.93 0.72–1.21 0.2, 30
18.5 to <21 32,780 442,798 1388 1.04 0.97–1.12 0.7, 0 67 0.72 0.53–0.97 0.6, 0 625 1.02 0.92–1.14 0.4, 7
21 to <23 41,232 586,281 1739 1.00 Reference 136 1.00 Reference – 866 1.00 Reference –
23 to <25 36,736 537,031 1483 0.96 0.86–1.06 0.01, 50 95 0.83 0.63–1.08 0.5, 0 797 0.99 0.89–1.11 0.3, 15
25 to <30 28,814 433,142 1066 0.90 0.79–1.02 0.03, 58 108 1.14 0.88–1.47 0.7, 0 597 0.94 0.85–1.05 0.6, 0
≥30 2326 34,802 82 1.05 0.84–1.32 0.8, 0 1 0.77 0.10–5.71 – 48 1.24 0.92–1.67 0.8, 0

Note: HRs were calculated by a random effects model by pooling study‐specific HR adjusted for sex, age, area (for multicentric studies, namely JPHC‐I, JPHC‐II, JACC, and LSS), pack‐years (0, 0< and ≤20, >20), alcohol consumption (nondrinker, occasional drinker [<1 day/week], and current drinker [1–4 days/week, ≥5 days/week and <23 ethanol g/day, ≥5 days/week and ≥23 ethanol g/day]), and history of diabetes. HRs values in bold show statistical significance (p < 0.05). In esophageal squamous cell carcinoma and esophageal adenocarcinoma, we excluded MIYAGI‐II, in which no information on histological type was available.

Abbreviations: BMI, body mass index; Ca, cases; CI, confidence interval; HetP, P value from test of heterogeneity; HR, hazard ratio; JACC, Japan Collaborative Cohort Study; JPHC, Japan Public Health Center‐based Prospective Study; LSS, Life Span Study; ND, no cases in this stratum.