Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies
Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies
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DOI：
10.1093/ajcn/86.3.556
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发表时间：
2007-09-01
影响因子：
7.1
通讯作者：
Wolk, Alicja
中科院分区：
文献类型：
--
作者：
Larsson, Susanna C.;Wolk, Alicja
背景：虽然肥胖与男性结肠癌风险的增加有关，但在女性中观察到的相关性很弱或没有。直肠癌的研究结果也不一致。目的：进行荟萃分析，总结有关全身性肥胖和腹型肥胖与结肠癌和直肠癌风险之间关系的前瞻性研究的现有证据。设计：检索MEDLINE(1966-2007年4月)，检索相关文章的参考文献。结果：体重指数(BMI；单位为kg/m(2))的Meta分析纳入了30项前瞻性研究。总体而言，体重指数增加5个单位与男性(RR：1.3；95%CI：1.25，1.35)和女性(RR：1.12；95%CI：1.07，1.18)患结肠癌的风险增加有关，但这种关联在男性中更强(P<；0.001)。男性BMI与直肠癌呈正相关(RR：1.12；95%CI：1.09，1.16)，而女性BMI与直肠癌无相关性(RR：1.03；95%CI：0.99，1.08)。癌症部位之间的RR差异有统计学意义(男性P<；0.001，女性P=0.04)。男性(RR：1.33；95%CI：1.19，1.49)和女性(RR：1.16；95%CI：1.09，1.23)的腰围增加(RR：1.33；95%CI：1.19，1.49)，男性(RR：1.43；95%CI：1.19，1.71)和女性(RR：1.20；95%可信区间：1.08，1.33)。结论：肥胖与结直肠癌风险之间的关联因性别和肿瘤部位而异。
Background: Whereas obesity has been associated with an increased risk of colon cancer in men, a weak or no association has been observed in women. Results for rectal cancer have also been inconsistent.Objective: The objective was to perform a meta-analysis to summarize the available evidence from prospective studies on the associations of overall and abdominal obesity with the risk of colon and rectal cancer.Design: We searched MEDLINE (1966-April 2007) and the references of the retrieved articles. Study-specific relative risks (RRs) were pooled by using a random-effects model.Results: Thirty prospective studies were included in the metaanalysis of body mass index (BMI; in kg/m(2)). Overall, a 5-unit increase in BMI was related to an increased risk of colon cancer in both men (RR: 1.30; 95% CI: 1.25,1.35) and women (RR: 1.12; 95% CI: 1.07, 1.18), but the association was stronger in men (P < 0.001) . BMI was positively associated with rectal cancer in men (RR: 1.12; 95 % CI: 1.09,1.16) but not in women (RR: 1.03; 95 % CI: 0.99,1.08). The difference in RRs between cancer sites was statistically significant (P < 0.001 in men and P = 0.04 in women). Colon cancer risk increased with increasing waist circumference (per 10-cm increase) in both men (RR: 1.33; 95% CI: 1.19, 1.49) and women (RR: 1.16; 95% CI: 1.09, 1.23) and with increasing waist-hip ratio (per 0.1-unit increase) in both men (RR: 1.43; 95% CI: 1.19, 1.71) and women (RR: 1.20; 95% CI: 1.08, 1.33).Conclusions: The association between obesity and colon and rectal cancer risk varies by sex and cancer site.