Hospital-diagnosed overweight and obesity related to cancer risk: a 40-year Danish cohort study.,Journal of Internal Medicine

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Hospital-diagnosed overweight and obesity related to cancer risk: a 40-year Danish cohort study.
Journal of Internal Medicine ( IF 9.0 ) Pub Date : 2020-01-07 , DOI: 10.1111/joim.13013
S B Gribsholt _{1,

2} , D Cronin-Fenton ₁ , K Veres ₁ , R W Thomsen ₁ , A G Ording ₁ , B Richelsen ₃ , H T Sørensen ₁

Affiliation

BACKGROUND 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. OBJECTIVES To examine the overall cancer incidence and specific site-related cancer incidences among patients with overweight and obesity, compared to the general Danish population. METHODS 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. RESULTS 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. CONCLUSION In this large cohort study, overweight and obesity was associated with increased risk of several common cancers.

中文翻译：

医院诊断的超重和肥胖与癌症风险有关：一项为期40年的丹麦队列研究。

背景技术肥胖与代谢异常有关，代谢异常使患者更易患癌症。在医院诊断为超重和肥胖的患者中，有关特定癌症长期风险的当代数据很少。目的与丹麦普通人群相比，检查超重和肥胖患者的总体癌症发病率和特定部位相关的癌症发病率。方法在这项为期40年（1977年至2016年）的全国性丹麦队列研究中，我们回顾了医学数据库，以鉴定患有医院超重和肥胖症诊断的个体。与普通人群相比，我们计算了随后癌症的年龄和性别标准化发病率（SIR）。结果我们在313321名被诊断为超重和肥胖的患者中观察到20706例癌症（中位年龄43岁；中位随访时间为6.7年，范围为1至40年），而预期的癌症为18480种；因此，SIR为1.12 [95％置信区间（95％CI）：1.11-1.14]。与超重和肥胖相关的SIR伴随合并症而增加，例如2型糖尿病（SIR：1.18; 95％CI：1.13-1.23）和酒精中毒相关疾病（SIR：1.62; 95％CI：1.45-1.82）。对于先前确定为与肥胖相关的癌症，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 :)，SIR为1.31（95％CI：1.28-1.34）。 1.09-1.19）。肥胖/超重状态还提高了血液系统疾病（SIR：1.24; 95％CI：1.18-1.29）和神经系统癌症（SIR：1.19; 95％CI：1.11-1.27]的SIRs，而SIRs是1.01（95％CI ：0.97-1.05）（针对免疫相关癌症），0.88（95％CI：0.82-0.95）针对恶性黑色素瘤，除绝经后的乳腺癌外，其他激素相关的癌症为0.88（95％CI：0.85-0.92）。结论在这项大型队列研究中，超重和肥胖与几种常见癌症的风险增加相关。

更新日期：2020-01-07

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