Chang Shine, Mâsse Louise C, Moser Richard P, Dodd Kevin W, Arganaraz Facundo, Fuemmler Bernard F, Jemal Ahmedin
Office of Preventive Oncology, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland, USA.
Obesity (Silver Spring). 2008 Jul;16(7):1636-50. doi: 10.1038/oby.2008.228. Epub 2008 Apr 17.
Given links between obesity and cancer, we estimated incident cancer burden due to overweight and obesity at the state level in the United States.
Using state rankings by per capita burden of incident cancer cases diagnosed in 2003 that were related to overweight and obesity, we examined the frequency with which states ranked in the highest and lowest quintiles of weight-related burden for cancers of the postmenopausal breast, endometrium, kidney, colon, and prostate. In this study, data from the Behavioral Risk Factor Surveillance System (BRFSS), US Census, US Mortality Public Use Data Tapes, and National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program were used.
Western states had the lowest weight-related cancer burden for both sexes. Iowa, South Dakota, and West Virginia had the highest burden for all three types of male cancers. West Virginia is the only state that ranked in the quintile of highest weight-related burden for all four cancers considered in women.
For certain cancers, including endometrial, postmenopausal breast, and colon cancers, states with high burdens clustered in geographic regions, warranting further inquiry. Although state ranks for the total cancer burden and the prevalence of overweight and obesity correlated with state ranks for weight-related incident cancer burden, they often served poorly as its proxy. Such a finding cautions against simply targeting states with high overweight and obesity or high total burdens of cancers for which overweight and obesity are risk factors, as this approach may not reach areas of unrecognized burden.
鉴于肥胖与癌症之间的联系,我们估算了美国各州因超重和肥胖导致的癌症发病负担。
利用2003年诊断的与超重和肥胖相关的癌症病例人均负担的州排名,我们研究了各州在绝经后乳腺癌、子宫内膜癌、肾癌、结肠癌和前列腺癌与体重相关负担的最高和最低五分位数中的排名频率。在本研究中,使用了行为危险因素监测系统(BRFSS)、美国人口普查、美国死亡率公共使用数据磁带以及国家癌症研究所监测、流行病学和最终结果(SEER)计划的数据。
西部各州男女与体重相关的癌症负担最低。爱荷华州、南达科他州和西弗吉尼亚州在所有三种男性癌症中负担最高。西弗吉尼亚州是唯一一个在女性所考虑的所有四种癌症中与体重相关负担最高的五分位数中排名的州。
对于某些癌症,包括子宫内膜癌、绝经后乳腺癌和结肠癌,负担高的州集中在地理区域,值得进一步探究。尽管州的总癌症负担排名以及超重和肥胖患病率与体重相关癌症发病负担的州排名相关,但它们往往不能很好地作为其替代指标。这一发现提醒我们,不要简单地将目标对准超重和肥胖率高或总癌症负担高且超重和肥胖是危险因素的州,因为这种方法可能无法覆盖未被认识到负担的地区。