AnaesthesiaUK (Stuff) 15-Feb-08

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Obesity associated with increased risk of some cancers

Adrienne Penfield

An article published in The Lancet reports that excess bodyweight, expressed as increased body mass index (BMI), is associated with a higher risk of some common adult cancers.

The authors carried out a literature search and identified prospective studies of incident cases of 20 cancer types between 1966 to November 2007. Following a systematic review and meta-analysis, they then assessed the strength of association between BMI and different cancers, and also examined differences in these associations between genders and ethnic groups.

They analysed 221 datasets, including 282 137 incident cases. They found that, in men, a 5 kg/m² increase in BMI was strongly associated with oesophageal adenocarcinoma (RR 1.52, p<0.0001) and with thyroid (1.33, p=0.02), colon (1.24, p<0.0001), and renal (1.24, p <0.0001) cancers. In women, there was a strong association between a 5 kg/m² increase in BMI and oesophageal adenocarcinoma (1.51, p<0.0001), and endometrial (1.59, p<0.0001), gallbladder (1.59, p=0.04) and renal (1.34, p<0.0001) cancers.

There were weaker positive associations (RR<1.20) between increased BMI and rectal cancer and malignant melanoma in men; postmenopausal breast, pancreatic, thyroid, and colon cancers in women; and leukaemia, multiple myeloma, and non-Hodgkin lymphoma in both sexes. Associations were stronger in men than in women for colon (p<0.0001) cancer. Although studies from North America, Europe and Australia, and the Asia–Pacific region showed generally similar results, there were stronger associations in Asia–Pacific populations between increased BMI and premenopausal (p=0.009) and postmenopausal (p=0.06) breast cancers.

The authors conclude that there is an association between increased BMI and an increased risk of common and less common malignancies, and that for some cancer types these associations differ according to gender and ethnic origin. Further studies should now explore the mechanisms giving rise to this link between obesity and cancer.

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