Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg,
Eur J Cancer Prev. 2011 Sep;20(5):438-43. doi: 10.1097/CEJ.0b013e32834761c0.
Obesity is associated with a risk of at least 20 different cancers. We aimed at defining cancer risks in prospectively recruited patients with a novel subgroup, those with a family history of obesity. We defined a cohort of 30 020 patients who had been hospitalized since 1964. Cancer risks in these patients were followed through 2006. Standardized incidence ratios were calculated for cancer using those not hospitalized for obesity as a reference population. We could also identify persons who had been hospitalized for type 2 diabetes. A total of 1721 patients were diagnosed with cancer after hospitalization for obesity, showing an increased risk for 12 cancers and a decrease for breast cancer. The largest increases were found for nervous system hemangioma (13.64, 95% confidence interval 2.57-40.37) and other male genital (3.94, 1.24-9.26), bone (3.41, 1.23-7.47), small intestinal (2.93, 1.60-4.93), kidney (2.46, 1.97-3.02), and endometrial (2.32, 2.01-2.66) cancers. Among endocrine cancers, adrenal tumors showed the highest risk, of 3.74 (1.86-6.72). The overall risk was 1.19 (1.13-1.25). Family history of obesity was associated with formerly unrecognized increased risks of gallbladder and colon cancers and ocular melanoma. Cancer risks in this relatively young obese population differed quantitatively from those found after type 2 diabetes. The novel findings included rare and relatively benign tumors, probably found in endocrinological and other medical examinations for obesity and related conditions. Similarly, male genital cancer may be related to sexual behavior, and bone cancers, found in old individuals, could be related to propensity for fractures.
肥胖与至少 20 种不同癌症的风险相关。我们旨在定义具有新型亚组（即有肥胖家族史的患者）的前瞻性招募患者的癌症风险。我们定义了一个队列，其中包含自 1964 年以来住院的 30020 名患者。通过 2006 年随访这些患者的癌症风险。使用未因肥胖住院的人群作为参考人群，计算癌症的标准化发病比。我们还可以识别因 2 型糖尿病住院的人。共有 1721 名患者在因肥胖住院后被诊断患有癌症，显示出 12 种癌症的风险增加，而乳腺癌的风险降低。最大的增加发生在神经系统血管瘤（13.64，95%置信区间 2.57-40.37）和其他男性生殖器官（3.94，1.24-9.26）、骨骼（3.41，1.23-7.47）、小肠（2.93，1.60-4.93）、肾脏（2.46，1.97-3.02）和子宫内膜（2.32，2.01-2.66）癌症。在内分泌癌中，肾上腺肿瘤的风险最高，为 3.74（1.86-6.72）。总体风险为 1.19（1.13-1.25）。肥胖的家族史与以前未被识别的胆囊癌和结肠癌以及眼部黑色素瘤风险增加有关。这个相对年轻的肥胖人群的癌症风险在数量上与 2 型糖尿病后发现的风险不同。新发现包括罕见且相对良性的肿瘤，这些肿瘤可能在肥胖和相关疾病的内分泌和其他医学检查中发现。同样，男性生殖器官癌症可能与性行为有关，而在老年人中发现的骨骼癌症可能与骨折倾向有关。
