Assessment of Familiality, Obesity, and Other Risk Factors for Early Age of Cancer Diagnosis in Adenocarcinomas of the Esophagus and Gastroesophageal Junction
tobacco; alcohol; Gastroenterology & Hepatology; symptoms; body-mass index; abdominal obesity; barretts-esophagus; esophagogastric junction; gastric cardia; intestinal metaplasia; reflux disease
OBJECTIVES: Adenocarcinomas of the esophagus and adenocarcinomas of the gastroesophageal junction are postulated to be complex genetic diseases. Combined influences of environmental factors and genetic susceptibility likely influence the age at which these cancers develop. The aim of this study was to determine whether familiality and other recognized risk factors are associated with the development of these cancers at an earlier age. METHODS: A structured validated questionnaire was utilized to collect self-reported data on gastroesophageal reflux symptoms, risk factors for Barrett's esophagus (BE) and family history, including age of cancer diagnosis in affected relatives from probands with BE, adenocarcinoma of the esophagus, or adenocarcinoma of the gastroesophageal junction, at five tertiary care academic hospitals. Medical records of all relatives reported to be affected were requested from hospitals providing this cancer care to confirm family histories. Familiality of BE/cancer, obesity (defined as body mass index >30), gastroesophageal reflux symptoms, and other risk factors were assessed for association with a young age of cancer diagnosis. RESULTS: A total of 356, 216 non-familial and 140 familial, cancers were studied. The study population consisted of 292 (82%) men and 64 (18%) women. Mean age of cancer diagnosis was no different in a comparison of familial and non-familial cancers, 62.6 vs. 61.9 years, P=0.70. There were also no significant differences in symptoms of gastroesophageal reflux, body mass index, race, gender, and smoking history between familial and non-familial cancers. Mean age of cancer diagnosis was significantly younger in those who were obese 1 year before diagnosis as compared to those who were non-obese, mean age 58.99 vs. 63.6 years, P=0.008. Multivariable modeling of age at cancer diagnosis showed that obesity 1 year before diagnosis was associated with a younger age of cancer diagnosis (P=0.005) after adjustment for heartburn and regurgitation duration. CONCLUSIONS: Obesity is associated with the development of esophageal and gastroesophageal junctional adenocarcinomas at an earlier age. Familial cancers arise at the same age as non-familial cancers and have a similar risk factor profile.
Chak A; Falk G; Grady W M; Kinnard M; Elston R; Mittal S; King J F; Willis J E; Kondru A; Brock W; Barnholtz-Sloan J
American Journal of Gastroenterology
2009
2009-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1038/ajg.2009.241" target="_blank" rel="noreferrer noopener">10.1038/ajg.2009.241</a>
Epidemiology of brainstem high-grade gliomas in children and adolescents in the united states, 2000-2017.
Brainstem; CBTRUS; DIPG; Glioma; High-Grade Glioma
BACKGROUND: Limited population-based data exists for the brainstem gliomas for children ages ≤19 years, which includes high-grade aggressively-growing tumors such as diffuse intrinsic pontine glioma (DIPG). We examined the overall incidence and survival patterns in children with brainstem High-Grade glioma (HGG) by age, sex, and race and ethnicity. METHODS: We used data from Central Brain Tumor Registry of the United States (CBTRUS), obtained through data use agreements with the Centers for Disease Control (CDC) and the National Cancer Institute (NCI) from 2000 - 2017, and survival data from the CDC's National Program of Cancer Registries (NPCR), from 2001 - 2016 for malignant brainstem HGG for ages ≤19 years (per WHO ICD-O-3 codes). HGG was determined by established histologic and/or imaging criteria. Age-adjusted incidence rates and survival data were used to assess differences overall and by age, sex race, and ethnicity. RESULTS: The incidence of brainstem HGG was higher among the female and Non-Hispanic population. Majority (69.8%) of these tumors were diagnosed radiographically. Incidence was higher in children aged 01-09 years compared to older children. Whites had a higher incidence compared to Blacks. However, the risk of death was higher among Blacks and Other race compared to Whites. There was no difference in survival by sex. CONCLUSIONS: We report the most comprehensive incidence and survival data on these lethal brainstem HGGs. Incidence and survival among patients with brainstem HGGs differed significantly by race, ethnicity, age-groups and grade.
Patil N; Kelly ME; Yeboa DN; Buerki RA; Cioffi G; Balaji S; Ostrom QT; Kruchko C; Barnholtz-Sloan J
Neuro-oncology
2020
2020-12-21
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1093/neuonc/noaa295" target="_blank" rel="noreferrer noopener">10.1093/neuonc/noaa295</a>