Department of Neurosciences, Psychiatry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
Int J Cancer. 2014 Apr 1;134(7):1751-7. doi: 10.1002/ijc.28495. Epub 2013 Oct 8.
Caloric restriction in animals is an effective way to reduce carcinogenesis. Anorexia nervosa (AN) is considered a model of extreme caloric restriction in humans. The aim of our study was to assess cancer incidence and mortality in women with AN. A total of 6,009 women with at least one inpatient treatment for AN during the period 1973-2003 were included in the study. Standardized incidence ratios (SIR) and standardized mortality ratios (SMR) were calculated. Overall, there was no statistically significant difference in cancer incidence compared to women in the general population. At a statistically significant or borderline significant level, a higher incidence for lung cancer and cancer of lymphoid, hematopoietic and related tissue was observed along with a reduced breast cancer incidence. Women with AN had twice as high mortality from cancer in general, and more specifically from melanoma, cancers of genital organs and cancers of ill-defined, secondary and unspecified sites. The increased lung cancer incidence may be due to smoking habits among women with AN. The worse prognosis with higher mortality from melanoma, cancers of genital organs and cancers of ill-defined, secondary and unspecified sites may be explained by AN-specific attitudes toward seeking medical care, adherence to treatment or worse biological precondition due to starvation and cachexia.
动物热量限制是减少致癌作用的有效方法。神经性厌食症（AN）被认为是人类极端热量限制的模型。我们的研究目的是评估 AN 女性的癌症发病率和死亡率。共有 6009 名女性在 1973 年至 2003 年期间至少因 AN 接受过一次住院治疗，纳入了本研究。计算了标准化发病比（SIR）和标准化死亡比（SMR）。总体而言，与普通人群相比，癌症发病率没有统计学显著差异。在统计学上显著或边缘显著水平上，观察到肺癌和淋巴造血及相关组织癌症的发病率较高，同时乳腺癌的发病率降低。AN 女性的癌症总死亡率高两倍，更具体地说，黑素瘤、生殖器官癌症和未明确、次要和未指定部位的癌症死亡率更高。肺癌发病率增加可能归因于 AN 女性的吸烟习惯。由于饥饿和恶病质导致的治疗依从性差或更差的生物学预后，黑素瘤、生殖器官癌症和未明确、次要和未指定部位的癌症的死亡率更高，可能解释了这一现象。
