Oh Sang Woo, Yoon Yeong Sook, Shin Soon-Ae
Center for Health Promotion and Obesity Research, Ilsan-Paik Hospital, College of Medicine, Inje University, Goyang-Si, Gyeonggi-Do, South Korea.
J Clin Oncol. 2005 Jul 20;23(21):4742-54. doi: 10.1200/JCO.2005.11.726.
The effects of excess weight on the development of cancers are controversial, and little is known for populations outside the United States and Europe. We conducted this study to assess the effects of excess weight with a large cohort of Koreans.
We assessed the relationship between body mass index (BMI) and various cancers in a 10-year follow-up cohort of 781,283 Korean men who were free of prior cancer at baseline. Weight and height were measured, and questionnaires related to health behaviors and medical history were completed. Data on newly developed cancers were obtained from two organizations in Korea. A proportional hazards model was used to examine the relationship between BMI and cancer.
Adenocarcinoma in the colon and rectosigmoid, hepatocellular carcinoma, cholangiocarcinoma, adenocarcinoma in the prostate, renal cell carcinoma, papillary carcinoma in the thyroid, small-cell carcinoma in the lung, non-Hodgkin's lymphoma, and melanoma had positive dose-dependent relationships with BMI (all P < .05). Although no linear trend was found (P = .267), obese men who never smoked with a BMI of >or= 30 kg/m(2) had an increased risk of developing gastric adenocarcinoma (relative risk = 1.73). Other cancers, such as leukemia, multiple myeloma, and gallbladder and pancreatic cancer, did not show significant associations.
These findings show that, even in Koreans, obesity clearly increases the risk of many types of cancers and the strength of the associations varies with the organ and histologic type. Because these obesity-related cancers are reported to be rapidly increasing in Korea and many other Asian countries, controlling obesity epidemics could be an effective tool for preventing these cancers in these areas.
超重对癌症发生发展的影响存在争议,而对于美国和欧洲以外的人群了解甚少。我们开展本研究以评估大量韩国人群中超重的影响。
我们在一个10年随访队列中评估了781283名基线时无既往癌症的韩国男性的体重指数(BMI)与各种癌症之间的关系。测量了体重和身高,并完成了与健康行为和病史相关的问卷。新发生癌症的数据来自韩国的两个机构。采用比例风险模型来检验BMI与癌症之间的关系。
结肠和直肠乙状结肠腺癌、肝细胞癌、胆管癌、前列腺腺癌、肾细胞癌、甲状腺乳头状癌、肺小细胞癌、非霍奇金淋巴瘤和黑色素瘤与BMI呈正剂量依赖关系(所有P <.05)。虽然未发现线性趋势(P =.267),但BMI≥30 kg/m²且从不吸烟的肥胖男性患胃腺癌的风险增加(相对风险 = 1.73)。其他癌症,如白血病、多发性骨髓瘤以及胆囊癌和胰腺癌,未显示出显著关联。
这些发现表明,即使在韩国人群中,肥胖也明显增加了多种癌症的风险,且关联强度因器官和组织学类型而异。由于据报道这些与肥胖相关的癌症在韩国和许多其他亚洲国家正在迅速增加,控制肥胖流行可能是这些地区预防这些癌症的有效手段。