Body mass index at adolescence and risk of noncardia gastric cancer in a cohort of 1.79 million men and women

Zohar Levi, Jeremy D. Kark, Gilad Twig, Lior Katz, Adi Leiba, Estela Derazne, Dorit Tzur, Irena Liphshitz, Lital Keinan-Boker, Arnon Afek

Research output: Contribution to journalArticlepeer-review


BACKGROUND: This study assessed adolescent predictors of noncardia gastric cancer (NCGC) with a focus on the body mass index (BMI) in late adolescence. METHODS: This study analyzed a cohort of 1,087,358 Israeli Jewish males and 707,212 Israeli Jewish females who underwent a compulsory physical examination between the ages of 16 and 19 years from 1967 to 2002. By linkage to the national cancer registry, participants were followed for NCGC through December 31, 2012. With a median follow-up of 23 years, 515 NCGC cases occurred (379 men and 136 women), and the median age was 47.0 years (interquartile range, 39.3-53.4 years). Multivariate-adjusted Cox regression was used to estimate hazard ratios (HRs) for NCGC according to the US Centers for Disease Control and Prevention BMI percentiles at the baseline (normal weight, 5th to <85th percentile; overweight, 85th to <95th percentile; and obesity, ≥95th percentile) as well as the country of birth, residential socioeconomic status (SES), and education. RESULTS: In comparison with normal weight, adolescent obesity, but not overweight, was associated in both men and women with the risk of subsequent NCGC (unadjusted HR, 1.95; 95% confidence interval [CI], 1.25-3.06; adjusted HR, 1.78; 95% CI, 1.12-2.83). Immigration from the former Soviet Union (FSU), a low education level, and a low residential SES were also associated with the risk for NCGC with adjusted HRs of 2.67 (95% CI, 1.86-3.83), 1.85 (95% CI, 1.53–2.25), and 1.48 (95% CI, 1.13-1.93), respectively. CONCLUSIONS: The findings suggest that adolescent obesity, but not overweight, is associated with an increased risk for NCGC. Immigration from the FSU, a low residential SES, and a low education level are also significantly associated with the risk for NCGC. Cancer 2018;124:356-63.

Original languageEnglish
Pages (from-to)356-363
Number of pages8
Issue number2
StatePublished - 15 Jan 2018
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by research grants to Jeremy D. Kark from the Israel Cancer Research Fund (New York, New York) and the Environment and Health Fund (Jerusalem, Israel; award RGA 1002).

Publisher Copyright:
© 2017 American Cancer Society


  • adolescence
  • body mass index
  • noncardia gastric cancer
  • obesity
  • socioeconomic status

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


Dive into the research topics of 'Body mass index at adolescence and risk of noncardia gastric cancer in a cohort of 1.79 million men and women'. Together they form a unique fingerprint.

Cite this