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

Abstract

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.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta 30329, USA. jcalle@cancer.org

    , ,

    Source

    The New England journal of medicine 348:17 2003 Apr 24 pg 1625-38

    MeSH

    Adult
    Aged
    Body Mass Index
    Cohort Studies
    Confounding Factors (Epidemiology)
    Female
    Humans
    Male
    Middle Aged
    Neoplasms
    Obesity
    Prevalence
    Proportional Hazards Models
    Prospective Studies
    Risk
    Risk Factors
    Surveys and Questionnaires
    United States

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    12711737

    Citation

    Calle, Eugenia E., et al. "Overweight, Obesity, and Mortality From Cancer in a Prospectively Studied Cohort of U.S. Adults." The New England Journal of Medicine, vol. 348, no. 17, 2003, pp. 1625-38.
    Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625-38.
    Calle, E. E., Rodriguez, C., Walker-Thurmond, K., & Thun, M. J. (2003). Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. The New England Journal of Medicine, 348(17), pp. 1625-38.
    Calle EE, et al. Overweight, Obesity, and Mortality From Cancer in a Prospectively Studied Cohort of U.S. Adults. N Engl J Med. 2003 Apr 24;348(17):1625-38. PubMed PMID: 12711737.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. AU - Calle,Eugenia E, AU - Rodriguez,Carmen, AU - Walker-Thurmond,Kimberly, AU - Thun,Michael J, PY - 2003/4/25/pubmed PY - 2003/4/30/medline PY - 2003/4/25/entrez SP - 1625 EP - 38 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 348 IS - 17 N2 - 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. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/12711737/full_citation L2 - https://www.nejm.org/doi/10.1056/NEJMoa021423?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=www.ncbi.nlm.nih.gov DB - PRIME DP - Unbound Medicine ER -