Body Mass Index Positively Associated With Many Cancers in UK Study

 İngiltere de yapılan bir çalışma, saygın tıp dergisinde olan Lancet dergisinde yayınlandı.

 5.24 milyon kişinin verileri 7.5 yıllık bir süre içinde elektronik sitem üzerinde taranarak çalışma yapılmış.

 -Vücut kütle indeksi ile en sık görülen 22 kanser arasındaki ilişki incelenmiş

 -Vücut ağırlığı artmasıyla 17 kanser arasında direk bir ilişki bulunmuş. Bu ilişki kanser gelişiminde suçlanan diğer faktörlerden bağımsız olarak saptanmış(sigara içmek vs.)

 Kanser artma özelikle, metre kare başına 5 kilogramdan fazla kilo alımı olduğunda doğrusal bir ilişki saptanmış.

 Kilo artışı ile( normal vücut indeksinin üstünde) , rahim, safra kesesi, böbrek, rahim ağzı, tiroit, lösemi arasında güçlü bir ilişki, bağırsak, yumurtalık, menopoz sonrası meme kanseri arasında anlamlı bir ilişki saptanmış.

 Fakat kilo artışı ile prostat kanseri, menopoz öncesi meme kanseri arasında ters bir ilişki saptanmış.

 Çalışmanın sonuçlarına göre, kilo artışıyla özelikle 10 kanser türünde (bağırsak, karaciğer, menopoz sonrası meme kanseri, rahim, safra kesesi, böbrek, rahim ağzı, yumurtalık, tiroit, lösemi) artış olacağı ve İngiltere de her yıl obeziteye nedeniyle diğer faktörlerden bağımsız olarak her bir 1 kg/m2 artışta 3500 yeni kanser vakasının olması öngörülüyor.


Body Mass Index Positively Associated With Many Cancers in UK Study
By Matthew Stenger
Posted: 8/19/2014 4:14:22 PM
Last Updated: 8/19/2014 4:14:22 PM

Key Points:
• There was an association of increased BMI and increased risk for most cancers.
• Approximately linear positive associations were observed for uterine, gallbladder, kidney, cervical, and thyroid cancers and leukemia.
In a UK population-based cohort study of associations between body mass index (BMI) and 22 specific cancers reported in The Lancet by Bhaskaran et al, positive associations were found for most cancers and were strongest for uterine, gallbladder, kidney, cervix, thyroid, liver, colon, ovarian, and postmenopausal breast cancers and leukemia. Inverse associations were observed for prostate and premenopausal breast cancers.
Study Details
The study involved primary care data from individuals in the Clinical Practice Research Datalink with BMI data for 5.24 million persons. Relationships with BMI were assessed for the following cancers: female breast, prostate, colon, rectum, lung, malignant melanoma, bladder, stomach, esophageal, non-Hodgkin lymphoma, leukemia, ovary, pancreas, multiple myeloma, uterus body, brain and CNS, liver, kidney, cervix, oral cavity, thyroid, and gallbladder. Cox models were used to analyze associations adjusting for potential confounders. Hazard ratios (HRs) were estimated using a separate model for each cancer with a linear BMI term, adjusted for age, diabetes status, smoking, alcohol use, socioeconomic status, and calendar year and stratified by sex
Follow-up ended a mean of 7.5 years after the first eligible BMI measurement. Cancer developed in 201,504 persons (3.8%), with the study cancers developing in 166,955 (3.2%).
Positive Associations
Each 5 kg/m2 increase in BMI was approximately linearly associated with increased risk of uterine cancer (HR = 1.62, P .0001; 1.63, P .0001 in neversmokers only), gallbladder cancer (1.31, P .0001; 1.50, P .001, in never-mokers),kidney cancer (125, P .0001; 1.25, P .0001, in neve-smokers), ervical cancer (1.10, P = .00035; 1.14, P = .0010, in never-smokers), thyroid cancer (1.09, P = .0088; 1.11, P = .017, in never-smokers), and leukemia (1.09, P < .0001; 1.07, P = .0011, in never-smokers).
Each 5 kg/m2 increase in BMI was also positively associated (all P .0001) with liver cancer (HR = 1.19; 1.26, P .0001, for never-sokers), colon cancer (1.10 1.11, P .0001, for never-smokers), ovarian cancer (1.09; 1.0, P = .00036, in never-smokers), and postmenopausal breast cancer (1.05; 1.05, P < .0001, in never-smokers), but these effects varied by underlying BMI or individual-level characteristics.
Positive associations were also observed for rectal cancer (HR = 1.04, P = .017; 1.05, P = .0024, in never-smokers) and pancreas cancer (1.05, P = .012; 1.11, P = .00024, in never-smokers). There was no significant positive association for esophageal cancer (1.03, P = .056), gastric cancer (1.03, P = .16), or bladder cancer overall (1.03, P = .062), but a significant association in patients with these cancers who were never-smokers (1.16, P < .0001; 1.08, P = .013; and 1.05, P = .033).
Inverse Associations
Each 5 kg/m2 increase in BMI was associated with reduced risk for prostate cancer (HR = 0.98, P = .0042; 0.96, P = .0021, in never-smokers) and premenopausal breast cancer (0.89, P .0001; 0.89, P .0001, in neve-smokers). A significant inverse association was observed among all patients with lung cancer (0.82, P .0001) and oral cavity cancer (0.81, P .01), but not among never-smokers withthese cancers (0.99, P = .55; and 1.7, P = .26). An inverse association was observed among patients with malignant melanoma who were never-smokers (0.96, P = .013) but not among all patients (0.99, P = .39).
No significant associations with BMI among all patients or among never-smokers were observed for brain and CNS cancers, non-Hodgkin lymphoma, or multiple myeloma.
The investigators estimated that, assuming causality, 41% of uterine caners and ≥ 10% of gallbladder, kidney, liver, and colon cancers could be attributable to excess weight and that a 1 kg/m2 population-wide increase in BMI would result in development of 1 of the 10 cancers most positively associated with BMI in an additional 3,790 UK persons each year.
The investigators concluded: “BMI is associated with cancer risk, with substantial population-level effects. The heterogeneity in the effects suggests that different mechanisms are associated with different cancer sites and different patient subgroups.”
Krishnan Bhaskaran, PhD, of London School of Hygiene and Tropical Medicine, is the corresponding author for The Lancet article.
Source: DGNews | Posted 6 days ago
Obesity Linked to 10 Common Cancers and Over 12,000 Cases Every Year
• HPV/ Cervical Cancer
• Obesity
• Renal Cancer
• Thyroid Disorders
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NEW YORK — August 13, 2014 — A higher body mass index (BMI) increases the risk of developing 10 of the most common cancers, according to the largest study of its kind on BMI and cancer, involving more than 5 million adults in the UK, and published in The Lancet.
The authors of the study estimate that over 12 000 cases of these 10 cancers each year are attributable to being overweight or obese, and calculate that if the average BMI in the population continues to increase, there could be over 3,500 extra cancers every year as a result.
“The number of people who are overweight or obese is rapidly increasing both in the UK and worldwide,” said Krishnan Bhaskaran, MD, National Institute for Health Research, and London School of Hygiene & Tropical Medicine, London, United Kingdom. “It is well recognised that this is likely to cause more diabetes and cardiovascular disease. Our results show that if these trends continue, we can also expect to see substantially more cancers as a result.”
Using data from general practitioner records in the UK’s Clinical Practice Research Datalink (CPRD), the researchers identified 5.24 million individuals aged 16 years and older who were cancer-free and had been followed for an average of 7.5 years. The risk of developing 22 of the most common cancers, which represent 90% of the cancers diagnosed in the UK, was measured according to BMI after adjusting for individual factors such as age, sex, smoking status, and socioeconomic status.
A total of 166,955 people developed 1 of the 22 cancers studied over the follow-up period. BMI was associated with 17 out of the 22 specific types of cancer examined.
Each 5 kg/m² increase in BMI was clearly linked with higher risk of cancers of the uterus (62% increase), gallbladder (31%), kidney (25%), cervix (10%), thyroid (9%), and leukaemia (9%). Higher BMI also increased the overall risk of liver (19% increase), colon (10%), ovarian (9%), and breast cancers (5%), but the effects on these cancers varied by underlying BMI and by individual-level factors such as sex and menopausal status. Even within normal BMI ranges, higher BMI was associated with increased risk of some cancers.
There was some evidence that those with high BMI were at a slightly reduced risk of prostate cancer and premenopausal breast cancer.
“There was a lot of variation in the effects of BMI on different cancers,” explained Dr. Bhaskaran. “For example, risk of cancer of the uterus increased substantially at higher body mass index; for other cancers, we saw more modest increases in risk, or no effect at all. For some cancers like breast cancer occurring in younger women before the menopause, there even seemed to be a lower risk at higher BMI. This variation tells us that BMI must affect cancer risk through a number of different processes, depending on the cancer type.”
Based on the results, the researchers estimate that excess weight could account for 41% of uterine and 10% or more of gallbladder, kidney, liver, and colon cancers in the UK. They also estimate that a population-wide 1 kg/m² increase in average BMI (roughly an extra 3-4 kg [8-10 lbs] per adult), which would occur every 12 years or so based on recent trends, would result in an additional 3,790 cases of these 10 cancers in the UK each year.
In an accompanying commentary, Peter Campbell, MD, American Cancer Society, Atlanta, Georgia, wrote: “We have sufficient evidence that obesity is an important cause of unnecessary suffering and death from many forms of cancer…More research is not needed to justify, or even demand, policy changes aimed at curbing overweight and obesity. Some of these policy strategies have been enumerated recently, all of which focus on reducing caloric intake or increasing physical activity, and include taxes on calorically dense, nutritionally sparse foods; subsidies for healthier foods, especially in economically disadvantaged groups; agricultural policy changes; and urban planning aimed at encouraging walking and other modes of physical activity. Research strategies that identify population-wide or community-based interventions and policies that effectively reduce overweight and obesity should be particularly encouraged and supported. Moreover, we need a political environment, and politicians with sufficient courage, to implement such policies effectively.”
SOURCE: The Lancet


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