Hjartåker Anette, Langseth Hilde, Weiderpass Elisabete
Department of Etiological Research, Cancer Registry of Norway, Oslo, Norway.
Adv Exp Med Biol. 2008;630:72-93. doi: 10.1007/978-0-387-78818-0_6.
The prevalence of overweight (body mass index, BMI, between 25 and 30 kg/m2) and obesity (BMI of 30 kg/m2 or higher) is increasing rapidly worldwide, especially in developing countries and countries undergoing economic transition to a market economy. One consequence of obesity is an increased risk of developing type II diabetes. Overall, there is considerable evidence that overweight and obesity are associated with risk for some of the most common cancers. There is convincing evidence of a positive association between overweight/obesity and risk for adenocarcinoma of the oesophagus and the gastric cardia, colorectal cancer, postmenopausal breast cancer, endometrial cancer and kidney cancer (renal-cell). Premenopausal breast cancer seems to be inversely related to obesity. For all other cancer sites the evidence of an association between overweight/obesity and cancer is inadequate, although there are studies suggesting an increased risk of cancers of the liver, gallbladder, pancreas, thyroid gland and in lymphoid and haematopoietic tissue. Far less is known about the association between diabetes mellitus type I (also called insulin dependent diabetes mellitus or juvenile diabetes), type II diabetes (called non-insulin dependent diabetes mellitus or adult onset diabetes mellitus) and cancer risk. The most common type of diabetes mellitus, type II, seems to be associated with liver and pancreas cancer and probably with colorectal cancer. Some studies suggest an association with endometrial and postmenopausal breast cancer. Studies reporting on the association between type I diabetes mellitus, which is relatively rare in most populations and cancer risk are scanty, but suggest a possible association with endometrial cancer. Overweight and obesity, as well as type II diabetes mellitus are largely preventable through changes in lifestyle. The fundamental causes of the obesity epidemic-and consequently the diabetes type II epidemic-are societal, resulting from an environment that promotes sedentary lifestyles and over-consumption of energy. The health consequences and economic costs of the overweight, obesity and type II diabetes epidemics are enormous. Avoiding overweight and obesity, as well as preventing type II diabetes mellitus, is an important purpose to prevent cancer and other diseases. Prevention of obesity and type II diabetes should begin early in life and be based on the life-long health eating and physical activity patterns. Substantial public investments in preventing overweight, obesity and type II diabetes mellitus are both appropriate and necessary in order to have a major impact on their adverse health effects including cancer.
超重（体重指数，BMI，介于25至30kg/m²之间）和肥胖（BMI为30kg/m²及以上）在全球范围内迅速增加，尤其是在发展中国家和正在向市场经济转型的国家。肥胖的一个后果是患II型糖尿病的风险增加。总体而言，有大量证据表明超重和肥胖与一些最常见癌症的风险相关。有确凿证据表明超重/肥胖与食管癌、贲门癌、结直肠癌、绝经后乳腺癌、子宫内膜癌和肾癌（肾细胞癌）的风险呈正相关。绝经前乳腺癌似乎与肥胖呈负相关。对于所有其他癌症部位，超重/肥胖与癌症之间关联的证据并不充分，尽管有研究表明患肝癌、胆囊癌、胰腺癌、甲状腺癌以及淋巴和造血组织癌症的风险增加。关于I型糖尿病（也称为胰岛素依赖型糖尿病或青少年糖尿病）、II型糖尿病（称为非胰岛素依赖型糖尿病或成人发病型糖尿病）与癌症风险之间的关联，人们了解得要少得多。最常见的糖尿病类型II型糖尿病似乎与肝癌和胰腺癌有关，可能也与结直肠癌有关。一些研究表明与子宫内膜癌和绝经后乳腺癌有关。关于I型糖尿病（在大多数人群中相对罕见）与癌症风险之间关联的研究报告很少，但表明可能与子宫内膜癌有关。超重和肥胖以及II型糖尿病在很大程度上可通过生活方式的改变来预防。肥胖流行——进而II型糖尿病流行——的根本原因是社会性的，源于促进久坐不动生活方式和能量过度消耗的环境。超重、肥胖和II型糖尿病流行所带来的健康后果和经济成本是巨大的。避免超重和肥胖以及预防II型糖尿病是预防癌症和其他疾病的一个重要目标。预防肥胖和II型糖尿病应在生命早期开始，并基于终身健康的饮食和身体活动模式。为了对包括癌症在内的不良健康影响产生重大影响，对预防超重、肥胖和II型糖尿病进行大量公共投资既是适当的也是必要的。
