Kim Kyuwoong, Choi Seulggie, Lee Gyeongsil, Jeong Su-Min, Kim Sung Min, Son Joung Sik, Yun Jae-Moon, Kim Yeon-Yong, Park Seong Yong, Park Sang Min
Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Cancer Epidemiol. 2019 Jun;60:86-92. doi: 10.1016/j.canep.2019.03.005. Epub 2019 Mar 30.
Smoking cessation may help the current smokers to reduce cancer risk. However, weight gain following smoking cessation may attenuate the protective association of cessation with cancer.
Our study included 1,278,794 men who were aged 20-39 years and underwent two consecutive health examinations by the National Health Insurance Service, without previous diagnosis of cancer. Participants were categorized into continual smokers, quitters with different degree of body weight change, and never smokers based on the biennial national health screening program (2002-2003 and 2004-2005) and were followed from January 1, 2006 to December 31, 2015. Cox proportional hazard models and restricted cubic spline model was used to evaluate the association of post-cessation weight change and cancer risk after adjustment for potential confounders.
During the 10 years of follow-up, the analyses included 1,278,794 men with 21,494 cancer incidences. Compared to continual smokers, quitters without weight gain of 2.0 kg had significantly lower risk of obesity-related cancer (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.79-0.97), smoking-related cancer (HR, 0.90; 95% CI, 0.83 to 0.98), and gastrointestinal cancer (HR, 89; 95% CI, 0.80 to 0.98). Weight gain among quitters attenuated the risk reduction of cancer compared to continual smoking. Among quitters, weight gain up to 5.0 kg with smoking cessation showed protective association with cancer risk among quitters without weight gain.
Excessive weight gain with smoking cessation among quitters was not associated with reduced risk of several cancer types. This association should be taken into account when recommending smoking cessation to prevent cancer.
戒烟可能有助于当前吸烟者降低患癌风险。然而，戒烟后体重增加可能会削弱戒烟与癌症之间的保护关联。
我们的研究纳入了1278794名年龄在20至39岁之间、接受过国民健康保险服务机构连续两次健康检查且此前未被诊断出患有癌症的男性。根据两年一次的全国健康筛查计划（2002 - 2003年和2004 - 2005年），参与者被分为持续吸烟者、体重有不同程度变化的戒烟者以及从不吸烟者，并从2006年1月1日至2015年12月31日进行随访。使用Cox比例风险模型和受限立方样条模型来评估在调整潜在混杂因素后戒烟后体重变化与癌症风险之间 的关联。
在10年的随访期间，分析纳入了1278794名男性，其中有21494例癌症发病病例。与持续吸烟者相比，体重增加未达2.0千克的戒烟者患肥胖相关癌症的风险显著更低（风险比[HR]，0.88；95%置信区间[CI]，0.79 - 0.97）、患吸烟相关癌症的风险（HR，0.90；95% CI，0.83至0.98）以及患胃肠道癌症的风险（HR，0.89；95% CI，0.80至'0.98）。与持续吸烟相比，戒烟者体重增加削弱了患癌风险的降低。在戒烟者中，戒烟时体重增加达5.0千克与体重未增加的戒烟者的癌症风险呈保护关联。
戒烟者因戒烟导致的体重过度增加与几种癌症类型风险降低无关。在推荐戒烟以预防癌症时应考虑到这种关联。
