From the, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Denmark.
J Intern Med. 2020 Apr;287(4):435-447. doi: 10.1111/joim.13013. Epub 2020 Jan 7.
Obesity is associated with metabolic abnormalities that predispose patients to increased cancer risk. Contemporary data on the long-term risk of specific cancers are sparse among patients with hospital-diagnosed overweight and obesity.
To examine the overall cancer incidence and specific site-related cancer incidences among patients with overweight and obesity, compared to the general Danish population.
For this 40-year (1977-2016), nationwide, Danish cohort study, we reviewed medical databases to identify individuals with hospital-based overweight and obesity diagnoses. We computed age- and gender-standardized incidence ratios (SIRs) for subsequent cancer compared to the general population.
We observed 20 706 cancers among 313 321 patients diagnosed with overweight and obesity (median age 43 years; median follow-up 6.7 years, range 1-40 years) compared to the 18 480 cancers expected; thus, the SIR was 1.12 [95% confidence interval (95% CI): 1.11-1.14]. The SIR associated with overweight and obesity was increased with concomitant comorbidities, like type 2 diabetes (SIR: 1.18; 95% CI: 1.13-1.23) and alcoholism-related diseases (SIR: 1.62; 95% CI: 1.45-1.82). The SIR was 1.31 (95% CI: 1.28-1.34) for cancers previously identified as obesity-related, including pancreatic (SIR: 1.38; 95% CI; 1.27-1.49) and postmenopausal breast cancer (SIR: 1.14; 95% CI: 1.09-1.19). Obesity/overweight status also elevated the SIRs for haematological (SIR: 1.24; 95% CI: 1.18-1.29) and neurological cancers (SIR: 1.19; 95% CI: 1.11-1.27]. In contrast, SIRs were 1.01 (95% CI: 0.97-1.05) for immune-related cancers, 0.88 (95% CI: 0.82-0.95) for malignant melanoma, and 0.88 (95% CI: 0.85-0.92) for hormone-related cancers, other than postmenopausal breast cancer.
In this large cohort study, overweight and obesity was associated with increased risk of several common cancers.
肥胖与代谢异常有关，使患者更容易患癌症。在医院诊断为超重和肥胖的患者中，关于特定癌症的长期风险的当代数据很少。
检查超重和肥胖患者的总体癌症发病率和特定部位相关癌症发病率，与丹麦一般人群相比。
在这项 40 年（1977-2016 年）的全国性丹麦队列研究中，我们查阅了医疗数据库，以确定有医院诊断的超重和肥胖患者。我们计算了与一般人群相比，随后癌症的年龄和性别标准化发病率比（SIR）。
我们观察到 313321 名超重和肥胖患者（中位年龄 43 岁；中位随访 6.7 年，范围 1-40 年）中有 20706 例癌症，而预期的癌症为 18480 例；因此，SIR 为 1.12（95%置信区间（95%CI）：1.11-1.14）。超重和肥胖相关的 SIR 随着伴发的合并症而增加，如 2 型糖尿病（SIR：1.18；95%CI：1.13-1.23）和与酒精有关的疾病（SIR：1.62；95%CI：1.45-1.82）。先前确定与肥胖有关的癌症（包括胰腺癌（SIR：1.38；95%CI：1.27-1.49）和绝经后乳腺癌（SIR：1.14；95%CI：1.09-1.19））的 SIR 为 1.31（95%CI：1.28-1.34）。肥胖/超重状态还提高了血液系统（SIR：1.24；95%CI：1.18-1.29）和神经癌症（SIR：1.19；95%CI：1.11-1.27）的 SIR。相比之下，免疫相关癌症的 SIR 为 1.01（95%CI：0.97-1.05），恶性黑色素瘤为 0.88（95%CI：0.82-0.95），除绝经后乳腺癌外，激素相关癌症为 0.88（95%CI：0.85-0.92）。
在这项大型队列研究中，超重和肥胖与多种常见癌症的风险增加有关。
