Shuai Aidi, Ullah Shahid, Yu Yongfu, Pandol Stephen J, Barreto Savio George
College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia.
School of Public Health, Shanghai Medical College, Fudan University, Shanghai 200031, China.
Cancers (Basel). 2024 Jul 14;16(14):2537. doi: 10.3390/cancers16142537.
Perinatal exposure to malnutrition has been hypothesised to influence the development of young-onset cancer (≤50 years of age). This study aimed to determine if perinatal malnutrition in individuals exposed to the Great Famine of China increased their risk of developing young-onset cancer compared to other individuals born prior to the famine. This cross-sectional study involved 7272 participants from the China Health and Nutrition Survey who were classified into four groups based on birth year: participants born between 1953 and 1955 (before the famine) were designated as the pre-famine group (unexposed); the remainder formed perinatal exposure groups comprised of those exposed during the famine (1959-1961), those exposed in the early post-famine period (1962-1964), and those exposed in the late post-famine period (1965-1967). Multivariable adjusted log-binomial regression models were used to calculate the RR and 95% CI of young-onset cancer (including genitourinary cancer) across four groups. Perinatal exposure to early post-famine (RR 2.08; 95%CI 1.04, 4.34; = 0.043) and the female sex (RR 15.6, 95%CI 4.54, 60.3; < 0.001) were noted to have a significantly increased risk of young-onset cancer. In addition, the early (RR 13.8; 95%CI 2.68, 253; = 0.012) and late post-famine (RR 12.3; 95%CI 2.16, 231; = 0.020) cohorts demonstrated a significantly increased risk of young-onset genitourinary cancer. The latter was accompanied by an increased risk of hypertension (RR 3.30; 95%CI 1.28, 7.87; = 0.009). Perinatal exposure to famine, especially in females, was associated with a higher risk of young-onset cancer. This was particularly evident for young-onset genitourinary cancers. These findings highlight the potential long-term impact of perinatal malnutrition on young-onset carcinogenesis.
围产期营养不良被认为会影响青年期癌症（≤50岁）的发生发展。本研究旨在确定，与饥荒前出生的其他人相比，经历中国大饥荒的个体围产期营养不良是否会增加其患青年期癌症的风险。这项横断面研究纳入了中国健康与营养调查的7272名参与者，根据出生年份将他们分为四组：1953年至1955年出生（饥荒前）的参与者被指定为饥荒前组（未暴露组）；其余的组成围产期暴露组，包括饥荒期间（1959 - 1961年）暴露的人群、饥荒后早期（1962 - 1964年）暴露的人群以及饥荒后晚期（1965 - 1967年）暴露的人群。使用多变量调整后的对数二项回归模型计算四组中青年期癌症（包括泌尿生殖系统癌症）的风险比（RR）和95%置信区间（CI）。围产期暴露于饥荒后早期（RR 2.08；95%CI 1.04，4.34；P = 0.043）和女性（RR 15.6，95%CI 4.54，60.3；P < 0.001）被发现患青年期癌症的风险显著增加。此外，饥荒后早期（RR 13.8；95%CI 2.68，253；P = 0.012）和晚期（RR 12.3；95%CI 2.16，231；P = 0.020）队列显示患青年期泌尿生殖系统癌症的风险显著增加。后者还伴有高血压风险增加（RR 3.30；95%CI 1.28，7.87；P = 0.009）。围产期暴露于饥荒，尤其是女性，与患青年期癌症的较高风险相关。这在青年期泌尿生殖系统癌症中尤为明显。这些发现突出了围产期营养不良对青年期致癌作用的潜在长期影响。
