Obesity and cancer risk among white and black United States veterans
Obesity and cancer risk among white and black United States veterans
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DOI：
10.1023/b:caco.0000016573.79453.ba
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发表时间：
2004-02-01
影响因子：
2.3
通讯作者：
Fraumeni, JF
中科院分区：
文献类型：
--
作者：
Samanic, C;Gridley, G;Fraumeni, JF
背景：肥胖与许多癌症的高风险有关，但对于某些类型的证据仍然薄弱。尽管肥胖的患病率因种族而异，但很少有关于肥胖相关癌症风险的研究包括非白人受试者。 方法：在 1969 年至 1996 年间因诊断肥胖而住院的一大群美国男性退伍军人（3,668,486 名白人；832,214 名黑人）中，我们检查了所有主要癌症部位和亚部位的风险。人年是从首次肥胖诊断之日起直至首次癌症发生、死亡或观察期结束（1996 年 9 月 30 日）为止累积的。我们计算了白人和黑人退伍军人的年龄和日历年调整后的癌症相对风险 (RR) 和 95% 置信区间 (CI)，将肥胖男性与因其他原因住院的男性进行比较，肥胖状况随时间变化。对于选定的癌症，我们根据与肥胖和这些癌症风险相关的特定医疗状况进行了分层分析。为了确定白人和黑人之间与肥胖相关的癌症风险是否存在显着差异，我们评估了每个癌症部位的风险异质性。结果：在白人退伍军人中，多种癌症的风险显着升高，包括下食道癌、贲门癌、小肠癌、结肠癌、直肠癌、胆囊癌和壶腹癌、男性乳腺癌、前列腺癌、膀胱癌、甲状腺癌和结缔组织癌，以及恶性黑色素瘤、多发性骨髓瘤、慢性淋巴细胞癌白血病（CLL）和急性髓性白血病（AML）。最初观察到的肝癌和胰腺癌风险过高在没有糖尿病或酗酒史的男性中仍然存在。在黑人退伍军人中，患结肠癌、肝外胆管癌、前列腺癌、甲状腺癌以及恶性黑色素瘤、多发性骨髓瘤、CLL 和 AML 的风险显着升高。结论：肥胖男性患几种主要癌症以及许多罕见恶性肿瘤的风险增加，这一模式在白人和黑人男性中通常相似。由于全世界肥胖和超重的患病率不断增加，阐明体重超重对癌症的影响并阐明其相关机制非常重要。
Background: Obesity has been linked to excess risk for many cancers, but the evidence remains tenuous for some types. Although the prevalence of obesity varies by race, few studies of obesity-related cancer risk have included non-white subjects.Methods: In a large cohort of male US veterans (3,668,486 whites; 832,214 blacks) hospitalized with a diagnosis of obesity between 1969 and 1996, we examined risk for all major cancer sites and subsites. Person-years accrued from the date of first obesity diagnosis until the occurrence of a first cancer, death, or the end of the observation period (September 30, 1996). We calculated age- and calendar-year adjusted relative risks (RR) and 95% confidence intervals (CI) for cancer among white and black veterans, comparing obese men to men hospitalized for other reasons, with obesity status as time-dependent. For selected cancers, we performed additional analyses stratified by specific medical conditions related to both obesity and risk of those cancers. To determine whether obesity-related cancer risks differed significantly between white and black men, we evaluated heterogeneity of risk for each cancer site.Results: Among white veterans, risk was significantly elevated for several cancers, including cancers of the lower esophagus, gastric cardia, small intestine, colon, rectum, gallbladder and ampulla of vater, male breast, prostate, bladder, thyroid, and connective tissue, and for malignant melanoma, multiple myeloma, chronic lymphocytic leukemia (CLL), and acute myeloid leukemia (AML). Excess risks initially observed for cancers of the liver and pancreas persisted among men without a history of diabetes or alcoholism. Among black veterans, risks were significantly elevated for cancers of the colon, extrahepatic bile ducts, prostate, thyroid, and for malignant melanoma, multiple myeloma, CLL and AML.Conclusions: Obese men are at increased risk for several major cancers as well as a number of uncommon malignancies, a pattern generally similar for white and black men. Due to the increasing prevalence of obesity and overweight worldwide, it is important to clarify the impact of excess body weight on cancer and to elucidate the mechanisms involved.