Principal Scientist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA.
Scientific Director, Scientist Surveillance and Health Services Research, American Cancer Society, Atlanta, GA.
CA Cancer J Clin. 2019 Mar;69(2):88-112. doi: 10.3322/caac.21499. Epub 2018 Dec 12.
The prevalence of excess body weight and the associated cancer burden have been rising over the past several decades globally. Between 1975 and 2016, the prevalence of excess body weight in adults-defined as a body mass index (BMI) ≥ 25 kg/m -increased from nearly 21% in men and 24% in women to approximately 40% in both sexes. Notably, the prevalence of obesity (BMI ≥ 30 kg/m ) quadrupled in men, from 3% to 12%, and more than doubled in women, from 7% to 16%. This change, combined with population growth, resulted in a more than 6-fold increase in the number of obese adults, from 100 to 671 million. The largest absolute increase in obesity occurred among men and boys in high-income Western countries and among women and girls in Central Asia, the Middle East, and North Africa. The simultaneous rise in excess body weight in almost all countries is thought to be driven largely by changes in the global food system, which promotes energy-dense, nutrient-poor foods, alongside reduced opportunities for physical activity. In 2012, excess body weight accounted for approximately 3.9% of all cancers (544,300 cases) with proportion varying from less than 1% in low-income countries to 7% or 8% in some high-income Western countries and in Middle Eastern and Northern African countries. The attributable burden by sex was higher for women (368,500 cases) than for men (175,800 cases). Given the pandemic proportion of excess body weight in high-income countries and the increasing prevalence in low- and middle-income countries, the global cancer burden attributable to this condition is likely to increase in the future. There is emerging consensus on opportunities for obesity control through the multisectoral coordinated implementation of core policy actions to promote an environment conducive to a healthy diet and active living. The rapid increase in both the prevalence of excess body weight and the associated cancer burden highlights the need for a rejuvenated focus on identifying, implementing, and evaluating interventions to prevent and control excess body weight.
在过去几十年中,全球超重人口比例和与之相关的癌症负担一直在上升。1975 年至 2016 年期间,成年人超重的比例(定义为身体质量指数(BMI)≥25kg/m )从男性的近 21%和女性的 24%增加到男女两性均约为 40%。值得注意的是,男性肥胖症(BMI≥30kg/m )的患病率增加了四倍,从 3%增加到 12%,而女性肥胖症的患病率增加了一倍多,从 7%增加到 16%。这种变化加上人口增长,导致肥胖成年人的数量增加了 6 倍多,从 1 亿增加到 6.71 亿。肥胖症的绝对增长最大的是在高收入西方国家的男性和男孩以及中亚、中东和北非的女性和女孩中。几乎所有国家超重人口的同时增加,主要是由于全球食品系统的变化所致,该系统促进了高热量、低营养的食物,同时减少了身体活动的机会。2012 年,超重导致约 3.9%的所有癌症(544300 例),比例从低收入国家的不足 1%到一些高收入西方国家和中东及北非国家的 7%或 8%不等。女性(368500 例)的归因负担高于男性(175800 例)。鉴于高收入国家超重人口的流行程度以及中低收入国家超重比例的增加,未来与超重相关的全球癌症负担可能会增加。通过多部门协调实施促进健康饮食和积极生活环境的核心政策行动来控制肥胖症,这方面存在着共识。超重人口比例和与之相关的癌症负担的快速增加,突出表明需要重新关注确定、实施和评估预防和控制超重的干预措施。