Public Health Agency of Canada, Ottawa, Ontario, Canada.
Health Promot Chronic Dis Prev Can. 2017 Jul;37(7):205-214. doi: 10.24095/hpcdp.37.7.01.
Excess body weight (body mass index [BMI] ≥ 25.00 kg/m2) is an established risk factor for diabetes, hypertension and cardiovascular disease, but its relationship to cancer is lesser-known. This study used population attributable fractions (PAFs) to estimate the cancer burden attributable to excess body weight in Canadian adults (aged 25+ years) in 2010.
We estimated PAFs using relative risk (RR) estimates from the World Cancer Research Fund International Continuous Update Project, BMI-based estimates of overweight (25.00 kg/m2-29.99 kg/m2) and obesity (30.00+ kg/m2) from the 2000-2001 Canadian Community Health Survey, and cancer case counts from the Canadian Cancer Registry. PAFs were based on BMI corrected for the bias in self-reported height and weight.
In Canada in 2010, an estimated 9645 cancer cases were attributable to excess body weight, representing 5.7% of all cancer cases (males 4.9%, females 6.5%). When limiting the analysis to types of cancer associated with high BMI, the PAF increased to 14.9% (males 17.5%, females 13.3%). Types of cancer with the highest PAFs were esophageal adenocarcinoma (42.2%), kidney (25.4%), gastric cardia (20.7%), liver (20.5%), colon (20.5%) and gallbladder (20.2%) for males, and esophageal adenocarcinoma (36.1%), uterus (35.2%), gallbladder (23.7%) and kidney (23.0%) for females. Types of cancer with the greatest number of attributable cases were colon (1445), kidney (780) and advanced prostate (515) for males, and uterus (1825), postmenopausal breast (1765) and colon (675) for females. Irrespective of sex or type of cancer, PAFs were highest in the Prairies (except Alberta) and the Atlantic region and lowest in British Columbia and Quebec.
The cancer burden attributable to excess body weight is substantial and will continue to rise in the near future because of the rising prevalence of overweight and obesity in Canada.
超重(体质指数[BMI]≥25.00kg/m2)是糖尿病、高血压和心血管疾病的既定危险因素,但它与癌症的关系鲜为人知。本研究使用人群归因分数(PAF)来估计 2010 年加拿大成年人(年龄≥25 岁)超重(BMI 为 25.00kg/m2-29.99kg/m2)和肥胖(BMI≥30.00kg/m2)导致的癌症负担。
我们使用世界癌症研究基金会国际持续更新项目的相对风险(RR)估计值、2000-2001 年加拿大社区健康调查中基于 BMI 的超重(25.00kg/m2-29.99kg/m2)和肥胖(BMI≥30.00kg/m2)估计值以及加拿大癌症登记处的癌症病例数来估计 PAF。PAF 基于 BMI 进行了校正,以纠正自我报告的身高和体重的偏差。
2010 年在加拿大,估计有 9645 例癌症病例归因于超重,占所有癌症病例的 5.7%(男性 4.9%,女性 6.5%)。当将分析仅限于与高 BMI 相关的癌症类型时,PAF 增加到 14.9%(男性 17.5%,女性 13.3%)。PAF 最高的癌症类型为男性的食管腺癌(42.2%)、肾癌(25.4%)、胃贲门癌(20.7%)、肝癌(20.5%)、结肠癌(20.5%)和胆囊癌(20.2%),以及女性的食管腺癌(36.1%)、子宫癌(35.2%)、胆囊癌(23.7%)和肾癌(23.0%)。归因病例最多的癌症类型为男性的结肠癌(1445 例)、肾癌(780 例)和晚期前列腺癌(515 例),以及女性的子宫癌(1825 例)、绝经后乳腺癌(1765 例)和结肠癌(675 例)。无论性别或癌症类型如何,草原地区(艾伯塔省除外)和大西洋地区的 PAF 最高,不列颠哥伦比亚省和魁北克省的 PAF 最低。
由于加拿大超重和肥胖的患病率不断上升,超重导致的癌症负担巨大且将在不久的将来继续上升。