Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults.

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N Engl J Med. 2003 Apr 24;348(17):1625-38.

Overweight, obesity, and mortality from cancer in a prospectively studied
cohort of U.S. adults.

Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ.

Department of Epidemiology and Surveillance Research, American Cancer
Society, Atlanta 30329, USA.

BACKGROUND: The influence of excess body weight on the risk of death from
cancer has not been fully characterized. METHODS: In a prospectively
studied population of more than 900,000 U.S. adults (404,576 men and
495,477 women) who were free of cancer at enrollment in 1982, there were
57,145 deaths from cancer during 16 years of follow-up. We examined the
relation in men and women between the body-mass index in 1982 and the risk
of death from all cancers and from cancers at individual sites, while
controlling for other risk factors in multivariate proportional-hazards
models. We calculated the proportion of all deaths from cancer that was
attributable to overweight and obesity in the U.S. population on the basis
of risk estimates from the current study and national estimates of the
prevalence of overweight and obesity in the U.S. adult population. RESULTS:
The heaviest members of this cohort (those with a body-mass index [the
weight in kilograms divided by the square of the height in meters] of at
least 40) had death rates from all cancers combined that were 52 percent
higher (for men) and 62 percent higher (for women) than the rates in men
and women of normal weight. For men, the relative risk of death was 1.52
(95 percent confidence interval, 1.13 to 2.05); for women, the relative
risk was 1.62 (95 percent confidence interval, 1.40 to 1.87). In both men
and women, body-mass index was also significantly associated with higher
rates of death due to cancer of the esophagus, colon and rectum, liver,
gallbladder, pancreas, and kidney; the same was true for death due to
non-Hodgkin's lymphoma and multiple myeloma. Significant trends of
increasing risk with higher body-mass-index values were observed for death
from cancers of the stomach and prostate in men and for death from cancers
of the breast, uterus, cervix, and ovary in women. On the basis of
associations observed in this study, we estimate that current patterns of
overweight and obesity in the United States could account for 14 percent of
all deaths from cancer in men and 20 percent of those in women.
CONCLUSIONS: Increased body weight was associated with increased death
rates for all cancers combined and for cancers at multiple specific sites.
Copyright 2003 Massachusetts Medical Society

NR

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