Table 2.

Epidemiological links between obesity and processes involved in oesophageal adenocarcinoma development.

Links with gastro-oesophageal reflux

Positive association between obesity and GORD in individual studies and meta-analyses

BMI > 30 associated with double risk of GORD

Increase in each BMI unit associated with increased risk of GORD

Obesity associated with increased oesophageal acid exposure

More acid reflux episodes in patients with obesity

Reduction in GORD symptoms with weight loss

Visceral adiposity independently associated with erosive oesophagitis and GORD symptoms

Links with Barrett’s oesophagus

Inconsistent association reported between overall measures of obesity and the prevalence of Barrett’s oesophagus

Independent association between waist circumference and waist:hip ratio and Barrett’s oesophagus, more marked in men

Inverse association between gluteofemoral obesity and Barrett’s oesophagus

Positive association between visceral adipose tissue as assessed by CT scan and Barrett’s oesophagus

Positive association between central obesity and risk of Barrett’s oesophagus reported in meta-analysis

Links with oesophageal adenocarcinoma

Obesity associated with increased risk of oesophageal adenocarcinoma

Linear increase in adenocarcinoma risk with increasing BMI

Increase in cancer risk with obesity independent of reflux symptoms

Stronger association between increasing abdominal fat and risk of adenocarcinoma than other measures of obesity

Increased visceral fat as shown on CT scan in patients with oesophageal adenocarcinoma compared with controls

Inconsistent associations reported between obesity and oesophageal cancer survival

BMI, body mass index; CT, computed tomography; GORD, gastro-oesophageal reflux disease.