Perinatal risk factors for cancer of the esophagus and gastric cardia: a nested case-control study

This is a nested case-control study of 67 cases of esophageal adenocarcinoma and 93 cases of cardia adenocarcinoma, whereas 50 cases of squamous cell carcinoma were studied for comparison. Birth records of cases were traced. Three matched controls per case were randomly selected. Perinatal data were extracted from birth records. Long gestational duration was associated with a decreased risk of cardia adenocarcinoma (P(trend) = 0.001) and a nonsignificant decreased risk of esophageal adenocarcinoma (P = 0.07), whereas no such association was found for esophageal squamous cell carcinoma (P = 0.96). Birth weight was not associated with risk of any of the studied cancers. Compared with lower maternal age (</=24 years) at giving birth, maternal age of 25 to 29 years were associated with a decreased risk of esophageal adenocarcinoma and squamous cell carcinoma (odds ratio, 0.4; 95% confidence interval, 0.2-0.9 and odds ratio, 0.3; 95% confidence interval, 0.1-0.8, respectively). Numerical constraints hamper inference, but these results are somewhat consistent with the idea that future risk of esophageal and cardia cancer may in part be determined already perinatally or in infancy and give some limited support to the hypothesis that timing of birth influences risk.