Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
School of Population Health, The University of Queensland, Brisbane, Queensland, Australia.
Lancet Oncol. 2015 Jan;16(1):36-46. doi: 10.1016/S1470-2045(14)71123-4. Epub 2014 Nov 26.
High body-mass index (BMI; defined as 25 kg/m(2) or greater) is associated with increased risk of cancer. To inform public health policy and future research, we estimated the global burden of cancer attributable to high BMI in 2012.
In this population-based study, we derived population attributable fractions (PAFs) using relative risks and BMI estimates in adults by age, sex, and country. Assuming a 10-year lag-period between high BMI and cancer occurrence, we calculated PAFs using BMI estimates from 2002 and used GLOBOCAN2012 data to estimate numbers of new cancer cases attributable to high BMI. We also calculated the proportion of cancers that were potentially avoidable had populations maintained their mean BMIs recorded in 1982. We did secondary analyses to test the model and to estimate the effects of hormone replacement therapy (HRT) use and smoking.
Worldwide, we estimate that 481,000 or 3.6% of all new cancer cases in adults (aged 30 years and older after the 10-year lag period) in 2012 were attributable to high BMI. PAFs were greater in women than in men (5.4% vs 1.9%). The burden of attributable cases was higher in countries with very high and high human development indices (HDIs; PAF 5.3% and 4.8%, respectively) than in those with moderate (1.6%) and low HDIs (1.0%). Corpus uteri, postmenopausal breast, and colon cancers accounted for 63.6% of cancers attributable to high BMI. A quarter (about 118,000) of the cancer cases related to high BMI in 2012 could be attributed to the increase in BMI since 1982.
These findings emphasise the need for a global effort to abate the increasing numbers of people with high BMI. Assuming that the association between high BMI and cancer is causal, the continuation of current patterns of population weight gain will lead to continuing increases in the future burden of cancer.
World Cancer Research Fund International, European Commission (Marie Curie Intra-European Fellowship), Australian National Health and Medical Research Council, and US National Institutes of Health.
高身体质量指数（BMI；定义为 25kg/m(2)或更高）与癌症风险增加有关。为了为公共卫生政策和未来的研究提供信息，我们估计了 2012 年全球因 BMI 过高而导致的癌症负担。
在这项基于人群的研究中，我们根据年龄、性别和国家，从成年人的相对风险和 BMI 估计值中得出人群归因分数（PAF）。假设 BMI 过高与癌症发生之间存在 10 年的潜伏期，我们使用 2002 年的 BMI 估计值计算 PAF，并使用 GLOBOCAN2012 数据估计因 BMI 过高而导致的新癌症病例数。我们还计算了如果人群保持 1982 年记录的平均 BMI，本可以避免的癌症病例比例。我们进行了二次分析来测试模型，并估计激素替代疗法（HRT）使用和吸烟的影响。
我们估计，2012 年全球 481,000 例或所有成年新癌症病例（10 年潜伏期后 30 岁及以上）的 3.6%归因于 BMI 过高。女性的 PAF 高于男性（5.4%对 1.9%）。高和极高人类发展指数（HDI）国家的归因病例负担高于中（1.6%）和低 HDI（1.0%）国家。子宫体、绝经后乳腺癌和结肠癌占归因于 BMI 过高的癌症的 63.6%。2012 年与 BMI 过高相关的癌症病例中，约有四分之一（约 118,000 例）可归因于 1982 年以来 BMI 的增加。
这些发现强调了全球需要努力减少 BMI 过高的人数。假设 BMI 与癌症之间的关联是因果关系，那么目前的人口体重增长模式将继续导致未来癌症负担的持续增加。
世界癌症研究基金会国际、欧盟委员会（玛丽·居里欧洲内部奖学金）、澳大利亚国家卫生和医学研究理事会和美国国立卫生研究院。
