Height and cancer incidence in the Million Women Study: prospective cohort, and meta-analysis of prospective studies of height and total cancer risk.
Height and cancer incidence in the Million Women Study: prospective cohort, and meta-analysis of prospective studies of height and total cancer risk.
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DOI：
10.1016/s1470-2045(11)70154-1
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发表时间：
2011-08
期刊：
影响因子：
51.1
通讯作者：
Beral, Valerie
中科院分区：
文献类型：
--
作者：
Green, Jane;Cairns, Benjamin J.;Casabonne, Delphine;Wright, F. Lucy;Reeves, Gillian;Beral, Valerie
流行病学研究表明，高个子患癌症的风险更高，但尚不清楚与身高相关的风险是因癌症部位而异，还是受吸烟和社会经济地位等其他因素的影响。我们的目的是在一大批英国前瞻性队列中调查这些相关性，这些队列有关于癌症发生的足够信息，以便能够直接比较不同癌症部位的身高相关风险，以及与主要潜在混杂和修饰因素的关系。1996-2001年间，对没有癌症病史的中年妇女进行了癌症发病率的随访，获得了身高和其他与癌症相关的因素的信息。我们使用COX回归模型，以达到的年龄作为潜在的时间变量，计算总发病率癌症和17个特定癌症部位的测量身高每增加10厘米的调整后相对危险度(RR)。我们还对发表的与身高有关的总癌症风险的前瞻性研究结果进行了荟萃分析。对纳入本研究的1例 297 124例妇女进行了总计1170万人年的随访，平均每名妇女9.4年，IQR8.4~10.2，在此期间发生了97例 376癌症。身高每增加10 cm，全癌的相对危险度为1.16(95%可信区间为1.14~1.17；P<；0.0001)。在我们评估的17个癌症部位中，有15个部位的风险增加，其中10个部位的风险显著增加：结肠(身高每10厘米增加1·25，95%可信区间1·19-1·30)，直肠(1·14，1·07-1·22)，恶性黑色素瘤(1·32，1·24-1·40)，乳房(1·17，1·15-1·19)，子宫内膜(1·19，1·13-1·24)，卵巢(1·17，1·11-1·23)，肾(1·29，中枢神经系统(1·20、1·12-1·29)、非霍奇金淋巴瘤(1·21、1·14-1·29)、白血病(1·26、1·15-1·38)。身高每增加10厘米，总癌症风险的增加与社会经济地位或我们评估的其他10个个人特征没有显著差异，但在目前的情况下显著低于从不吸烟的人(p<；0.0001)。在现在的吸烟者中，与吸烟相关的癌症与身高的相关性不像其他癌症那样强烈(每10厘米身高增加的相对危险度分别为1.05，95%可信区间1.01-1.09和1.17，1.13-1.22；p=0.0004)。在对我们的研究和其他十项前瞻性研究进行的荟萃分析中，全癌与身高相关的RR在欧洲、北美、澳大拉西亚和亚洲几乎没有变化。在大多数癌症部位，癌症发病率随着成年人身高的增加而增加。不同人群身高与总癌症相对危险度的关系相似。英国癌症研究中心和英国医学研究理事会。
Epidemiological studies have shown that taller people are at increased risk of cancer, but it is unclear if height-associated risks vary by cancer site, or by other factors such as smoking and socioeconomic status. Our aim was to investigate these associations in a large UK prospective cohort with sufficient information on incident cancer to allow direct comparison of height-associated risk across cancer sites and in relation to major potential confounding and modifying factors. Information on height and other factors relevant for cancer was obtained in 1996–2001 for middle-aged women without previous cancer who were followed up for cancer incidence. We used Cox regression models to calculate adjusted relative risks (RRs) per 10 cm increase in measured height for total incident cancer and for 17 specific cancer sites, taking attained age as the underlying time variable. We also did a meta-analysis of published results from prospective studies of total cancer risk in relation to height. 1 297 124 women included in our analysis were followed up for a total of 11·7 million person-years (median 9·4 years per woman, IQR 8·4–10·2), during which time 97 376 incident cancers occurred. The RR for total cancer was of 1·16 (95% CI 1·14–1·17; p<0·0001) for every 10 cm increase in height. Risk increased for 15 of the 17 cancer sites we assessed, and was statistically significant for ten sites: colon (RR per 10 cm increase in height 1·25, 95% CI 1·19–1·30), rectum (1·14, 1·07–1·22), malignant melanoma (1·32, 1·24–1·40), breast (1·17, 1·15–1·19), endometrium (1·19, 1·13–1·24), ovary (1·17, 1·11–1·23), kidney (1·29, 1·19–1·41), CNS (1·20, 1·12–1·29), non-Hodgkin lymphoma (1·21, 1·14–1·29), and leukaemia (1·26, 1·15–1·38). The increase in total cancer RR per 10 cm increase in height did not vary significantly by socioeconomic status or by ten other personal characteristics we assessed, but was significantly lower in current than in never smokers (p<0·0001). In current smokers, smoking-related cancers were not as strongly related to height as were other cancers (RR per 10 cm increase in height 1·05, 95% CI 1·01–1·09, and 1·17, 1·13–1·22, respectively; p=0·0004). In a meta-analysis of our study and ten other prospective studies, height-associated RRs for total cancer showed little variation across Europe, North America, Australasia, and Asia. Cancer incidence increases with increasing adult height for most cancer sites. The relation between height and total cancer RR is similar in different populations. Cancer Research UK and the UK Medical Research Council.