Lukanova Annekatrin, Björ Ove, Kaaks Rudolf, Lenner Per, Lindahl Bernt, Hallmans Göran, Stattin Pär
Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA.
Int J Cancer. 2006 Jan 15;118(2):458-66. doi: 10.1002/ijc.21354.
Excess weight has been associated with increased risk of cancer. The effect of body mass index (BMI, kg/m(2)) on overall cancer risk and on risk of developing several common cancer types was examined in a population-based cohort study. Height and weight measurements were available for 35,362 women and 33,424 men recruited in the Northern Sweden Health and Disease Cohort between 1985 and 2003. Among cohort members, 2,691 incident cancer cases were identified. The association of BMI with cancer risk was examined using Poisson regression. Women with BMI > 27.1 (top quartile) had a 29% higher risk of developing any malignancy compared to women with BMI of 18.5-22.2 (lowest quartile), which increased to 47% in analysis limited to nonsmokers. Analyses according to WHO cut-off points showed that obese women (BMI > or = 30) had a 36% higher risk of cancer than women with BMI in the normal range (18.5-25). Individual cancer sites most strongly related to obesity were endometrium (risk for top quartile = 3.53, 95% confidence interval 1.86-7.43), ovary (2.09, 1.13-4.13) and colon (2.05, 1.04-4.41). BMI was inversely related to breast cancer occurring before age 49 (0.58, 0.29-1.11, p(trend) < 0.04). In men, there was no association of BMI with overall cancer risk. Obese men (BMI > or = 30), however, were at increased risk of developing kidney cancer (3.63, 1.23-10.7) and, after exclusion of cases diagnosed within 1 year of recruitment, colon cancer (1.77, 1.04-2.95). Our study provides further evidence that BMI is positively associated with cancer risk. In women from northern Sweden, up to 7% of all cancers were attributable to overweight and obesity and could be avoided by keeping BMI within the recommended range.
超重与患癌风险增加有关。在一项基于人群的队列研究中，研究了体重指数（BMI，kg/m²）对总体癌症风险以及几种常见癌症类型发病风险的影响。1985年至2003年间，瑞典北部健康与疾病队列研究招募了35362名女性和33424名男性，他们的身高和体重测量数据可得。在队列成员中，共确定了2691例新发癌症病例。使用泊松回归分析了BMI与癌症风险之间的关联。BMI>27.1（最高四分位数）的女性与BMI为18.5 - 22.2（最低四分位数）的女性相比，患任何恶性肿瘤的风险高29%，在仅限于非吸烟者的分析中，这一风险增加到47%。根据世界卫生组织的切点进行分析表明，肥胖女性（BMI≥30）患癌风险比BMI在正常范围（18.5 - 25）的女性高36%。与肥胖最密切相关的个别癌症部位是子宫内膜（最高四分位数风险=3.53，95%置信区间1.86 - 7.43）、卵巢（2.09，1.13 - 4.13）和结肠（2.05，1.04 - 4.41）。BMI与49岁之前发生的乳腺癌呈负相关（0.58，0.29 - 1.11，p趋势<0.04）。在男性中，BMI与总体癌症风险无关联。然而，肥胖男性（BMI≥30）患肾癌（3.63，1.23 - 10.7）以及在排除招募后1年内确诊的病例后，患结肠癌（1.77，1.04 - 2.95）的风险增加。我们的研究提供了进一步的证据表明BMI与癌症风险呈正相关。在瑞典北部的女性中，所有癌症中高达7%可归因于超重和肥胖，通过将BMI保持在推荐范围内可避免这些癌症。
