Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.
Prev Med. 2019 May;122:49-64. doi: 10.1016/j.ypmed.2019.03.014.
The increasing prevalence of obesity among Canadians has important implications for newly diagnosed cases of cancer given that excess body weight and abdominal adiposity are known to increase the risk of several cancers. The purpose of this analysis was to estimate the current attributable and future avoidable burden of cancer related to excess body weight and abdominal adiposity among Canadian adults. We estimated the population attributable risk (PAR) for all cancers associated with excess body weight and abdominal adiposity using contemporary cancer incidence, relative risk and exposure prevalence data for body mass index (BMI), waist circumference and waist-to-hip-ratio. Using the partial impact fraction (PIF), we also estimated the future avoidable burden of cancer from 2015 to 2042 in Canada, and by province, through various hypothetical intervention scenarios. In 2003, approximately half (50.5%) of the Canadian population was estimated to be overweight (BMI 25.0-29.9) or obese (BMI ≥30.0), 56.5% to have excess abdominal adiposity and 56.8% with a high waist-to-hip ratio. In 2015, the estimated PARs of all incident cancers associated with excess body weight, excess abdominal adiposity and high waist-to-hip ratio were 7.2%, 8.9% and 10.0%, respectively. If the population BMI could revert to its 1994 distribution, 72,157 associated cancer cases could be prevented cumulatively by 2042. A reduction in excess body weight and abdominal adiposity has the potential to decrease the future cancer burden in Canada substantially, and hence efforts to reverse increasing trends in obesity should be prioritized.
加拿大肥胖症的患病率不断上升，这对新诊断出的癌症病例产生了重要影响，因为超重和腹部肥胖已知会增加多种癌症的风险。本分析的目的是估计加拿大成年人超重和腹部肥胖与癌症相关的当前可归因和未来可避免的负担。我们使用当代癌症发病率、体重指数（BMI）、腰围和腰臀比的相对风险和暴露流行率数据，估计了与超重和腹部肥胖相关的所有癌症的人群归因风险（PAR）。使用部分影响分数（PIF），我们还通过各种假设干预情景，估计了加拿大 2015 年至 2042 年的癌症未来可避免负担，以及各省的情况。2003 年，估计有一半（50.5%）的加拿大人口超重（BMI 25.0-29.9）或肥胖（BMI≥30.0），56.5%有过多的腹部肥胖，56.8%有较高的腰臀比。2015 年，与超重、腹部肥胖和高腰臀比相关的所有新发癌症的估计 PAR 分别为 7.2%、8.9%和 10.0%。如果人口 BMI 能够恢复到 1994 年的分布，到 2042 年，将累计预防 72157 例相关癌症病例。减少超重和腹部肥胖有可能大大降低加拿大未来的癌症负担，因此应优先努力扭转肥胖症的上升趋势。
