A case-control study of oesophageal adenocarcinoma in women: a preventabledisease

The incidence of adenocarcinoma of the oesophagus in British women is among the highest in the world. To investigate its aetiology, we conducted a mul ti-centre, population based case-control study in four regions in England a nd Scotland. We included 74 incident cases in women with histologically con firmed diagnoses of adenocarcinoma of the oesophagus, and 74 female control s matched by age and general practice. High body mass index (BMI) around th e age of 20 years (highest vs lowest quartile, adjusted odds ratio (OR) = 6 .04, 95% confidence interval (CI) 1.28-28.52) and low consumption of fruit (highest vs lowest quartile, adjusted OR = 0.08, 95% CI 0.01-0.49) were ass ociated with increases in risk. Breastfeeding by women was associated with reduced risk of their subsequently developing this cancer lever vs never, a djusted OR = 0.41, 95% CI 0.20-0.82) and there was a significant dose-respo nse effect with total duration of breastfeeding. The summary population att ributable risk from these three factors was 96% (90% if breastfeeding is ex cluded). We conclude that high BMI in early adulthood and low consumption o f fruit are important risk factors for adenocarcinoma of the oesophagus. Br eastfeeding may confer a protective effect but this needs confirmation. Thi s cancer is a largely preventable disease in women. (C) 2000 Cancer Researc h Campaign.