Arnold Melina, Touillaud Marina, Dossus Laure, Freisling Heinz, Bray Freddie, Margaritis Irène, Deschamps Valérie, Soerjomataram Isabelle
Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France.
Léon Bérard Cancer Centre, Lyon, France; Cancer Research Centre of Lyon, UMR Inserm 1052 CNRS 5286 Centre Léon Bérard, 28 Prom. Léa et Napoléon Bullukian, 69008, Lyon, France.
Cancer Epidemiol. 2018 Feb;52:15-19. doi: 10.1016/j.canep.2017.11.006. Epub 2017 Nov 20.
Overweight, as defined by high body mass index (BMI), is an established risk factor for various morbidities including cancer. Globally, its prevalence has increased markedly over the past decades. The aim of this study was to estimate the proportion and number of cancers that were attributable to high BMI in France in 2015.
Population attributable fractions (PAFs) and numbers of cancer cases attributable to high BMI (a population mean BMI above the optimum of 22kg/m) were estimated by age and sex, for cancer sites with convincing or probable evidence of an established causal link. Assuming a 10-year lag-period, PAFs were calculated using mean BMI estimates from a cross-sectional French population survey, and relative risk estimates from published meta-analyses.
An estimated 18,639 cancer cases diagnosed in France in 2015 were attributable to high BMI, corresponding to 5.3% of all cancer cases (6.7% in women and 4.1% in men). This included 4507 cases of postmenopausal breast and 3380 cases of colon cancer. The highest estimated PAFs were for oesophageal adenocarcinoma and corpus uteri cancer (37% and 34%, respectively).
High BMI is associated with a substantial number of cancer cases in France, a country with a low but increasing prevalence of overweight and obesity when compared to other European countries. Assuming that the association between high BMI and cancer is causal, these results highlight the need to prioritise the prevention of this risk factor as part of cancer control planning in France and elsewhere in Europe.
根据高体重指数（BMI）定义的超重是包括癌症在内的各种疾病的既定风险因素。在全球范围内，其患病率在过去几十年中显著上升。本研究的目的是估计2015年法国因高BMI导致的癌症比例和病例数。
对于有确凿或可能证据表明存在既定因果关系的癌症部位，按年龄和性别估计归因于高BMI（人群平均BMI高于最佳值22kg/m²）的人群归因分数（PAF）和癌症病例数。假设滞后10年，使用法国横断面人群调查的平均BMI估计值和已发表的荟萃分析中的相对风险估计值来计算PAF。
估计2015年在法国诊断出的18,639例癌症病例可归因于高BMI，占所有癌症病例的5.3%（女性为6.7%，男性为4.1%）。这包括4507例绝经后乳腺癌和3380例结肠癌。估计PAF最高的是食管腺癌和子宫体癌（分别为37%和34%）。
在法国，高BMI与大量癌症病例相关，与其他欧洲国家相比，该国超重和肥胖的患病率较低但呈上升趋势。假设高BMI与癌症之间的关联是因果关系，这些结果凸显了在法国和欧洲其他地区将预防这一风险因素作为癌症控制规划一部分的必要性。
