Kuriyama Shinichi, Tsubono Yoshitaka, Hozawa Atsushi, Shimazu Taichi, Suzuki Yoshinori, Koizumi Yayoi, Suzuki Yoko, Ohmori Kaori, Nishino Yoshikazu, Tsuji Ichiro
Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
Int J Cancer. 2005 Jan 1;113(1):148-57. doi: 10.1002/ijc.20529.
We conducted a population-based prospective cohort study in Japan to examine the relationship between body mass index (BMI) and the risk of incidence of any cancer and of cancer at individual sites. Body mass index was calculated from self-administered body weight and height at baseline. Relative risks (RR) and 95% confidence intervals (CI) were calculated in multivariate proportional-hazards models. Among 27,539 persons (15,054 women and 12,485 men) aged 40 years or older who were free of cancer at enrollment in 1984, 1,672 (668 women and 1,004 men) developed cancer during 9 years of follow-up. In women, after adjustment for potential confounders, the RR of all cancers associated with different BMI, relative to a BMI of 18.5-24.9, were 1.04 (95% CI = 0.85-1.27) for BMI = 25.0-27.4, 1.29 (1.00-1.68) for BMI = 27.5-29.9 and 1.47 (1.06-2.05) for BMI >/=30.0 (p for trend = 0.007). Higher BMI was also significantly associated with higher risk of cancers of the colorectum, breast (postmenopausal), endometrium and gallbladder in women. In men, we observed significantly increased all-cancer risk among only never-smokers. Overweight and obesity could account for 4.5% (all subjects) or 6.2% (never-smokers) of the risk of any cancer in women and -0.2% (all subjects) or 3.7% (never-smokers) in men. The value for women was within the range among women reported from Western populations (3.2%-8.8%). Our data demonstrate that excess weight is a major cancer risk among Japanese women.
我们在日本开展了一项基于人群的前瞻性队列研究,以探究体重指数(BMI)与患任意癌症及特定部位癌症风险之间的关系。BMI根据基线时自行报告的体重和身高计算得出。在多变量比例风险模型中计算相对风险(RR)和95%置信区间(CI)。在1984年入组时无癌症的27539名40岁及以上人群(15054名女性和12485名男性)中,有1672人(668名女性和1004名男性)在9年随访期间患癌。在女性中,调整潜在混杂因素后,相对于BMI为18.5 - 24.9,不同BMI水平下所有癌症的RR分别为:BMI = 25.0 - 27.4时为1.04(95%CI = 0.85 - 1.27),BMI = 27.5 - 29.9时为1.29(1.00 - 1.68),BMI≥30.0时为1.47(1.06 - 2.05)(趋势p值 = 0.007)。较高的BMI也与女性患结直肠癌、乳腺癌(绝经后)、子宫内膜癌和胆囊癌的较高风险显著相关。在男性中,仅在从不吸烟者中观察到所有癌症风险显著增加。超重和肥胖在女性患任意癌症风险中占4.5%(所有受试者)或6.2%(从不吸烟者),在男性中占 - 0.2%(所有受试者)或3.7%(从不吸烟者)。女性的这一数值在西方人群报告的女性范围内(3.2% - 8.8%)。我们的数据表明,超重是日本女性患癌的主要风险因素。