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Obesity and related risk factors in gastric cardia adenocarcinoma.
[esophageal adenocarcinoma]
Over
recent
decades
,
the
incidence
of
cancers
of
the
gastroesophageal
junction
,
including
gastric
cardia
tumors
,
has
increased
markedly
.
This
is
a
trend
that
has
been
well
documented
,
especially
in
studies
from
the
USA
and
northern
Europe
that
have
also
demonstrated
a
concomitant
rise
in
the
ratio
of
cardia
to
distal
gastric
cancers
.
The
rise
in
the
prevalence
of
gastric
cardia
adenocarcinoma
has
been
paralleled
by
the
worldwide
obesity
epidemic
,
with
almost
all
epidemiological
studies
reporting
increased
body
mass
index
and
obesity
increase
the
risk
of
cardia
cancer
development
.
However
,
the
strength
of
this
association
is
less
marked
than
the
link
between
obesity
and
esophageal
adenocarcinoma
,
and
the
mechanisms
remain
poorly
understood
.
Other
possible
confounders
of
the
relationship
between
obesity
and
cardia
cancer
include
the
decline
in
Helicobacter
pylori
infection
and
the
widespread
use
of
proton
pump
inhibitors
,
although
these
have
rarely
been
controlled
for
in
case-control
and
cohort
studies
investigating
associations
between
obesity
and
cardia
cancer
.
We
review
these
epidemiological
trends
and
discuss
proposed
mechanisms
for
the
association
,
drawing
attention
to
controversies
over
the
difficulty
of
defining
cardia
cancer
.
The
relative
paucity
of
high
-quality
epidemiological
studies
from
other
regions
of
the
world
should
prompt
further
investigation
of
this
issue
,
especially
in
populations
undergoing
rapid
socioeconomic
change
.
Diseases
Validation
Diseases presenting
"gastric cardia adenocarcinoma"
symptom
esophageal adenocarcinoma
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