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      Overweight, obesity and risk of liver cancer: a meta-analysis of cohort studies

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      Author(s): 1 , * , 1
      Publication date (Electronic):
      Journal: British Journal of Cancer
      Publisher: Nature Publishing Group
      Keywords: body mass index, cohort studies, liver cancer, meta-analysis, obesity, review

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          Abstract

          Cohort studies of excess body weight and risk of liver cancer were identified for a meta-analysis by searching MEDLINE and EMBASE databases from 1966 to June 2007 and the reference lists of retrieved articles. Results from individual studies were combined using a random-effects model. We identified 11 cohort studies, of which seven on overweight (with a total of 5037 cases) and 10 on obesity (with 6042 cases) were suitable for meta-analysis. Compared with persons of normal weight, the summary relative risks of liver cancer were 1.17 (95% confidence interval (CI): 1.02–1.34) for those who were overweight and 1.89 (95% CI: 1.51–2.36) for those who were obese. This meta-analysis finds that excess body weight is associated with an increased risk of liver cancer.

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          Relation of body mass index to cancer risk in 362,552 Swedish men.

          Joseph Fraumeni, G Gridley, Bengt Järvholm … (2006)
          Obesity has been linked with increased risk for cancers of the colon, kidney, breast, endometrium and gallbladder. For other cancer sites, the relationship with obesity is less well quantified, and the effect of weight change on cancer risk is unclear. We examined the health records of 362,552 Swedish men who underwent at least one physical examination from 1971 to 1992, and were followed until death or the end of 1999. Incident cancer cases were identified by linkage to the Swedish cancer registry. Poisson regression models were used to estimate relative risks of cancer for both body-mass index (BMI) at baseline exam and, in a subgroup of 107,815 men, change in BMI after six years of follow-up, adjusting for age and smoking status. Compared to men of normal weight, obese men had a significantly increased risk of all cancers combined (RR = 1.1; 95% CI = 1.0-1.2). The risks were most pronounced for esophageal adenocarcinoma (RR = 2.7; 95% CI = 1.3-5.6), renal cell carcinoma (RR = 1.8; 95% CI = 1.4-2.4), malignant melanoma (RR = 1.4; 95% CI = 1.1-1.7), and cancers of the colon (RR = 1.7; 95% CI = 1.5-2.0), rectum (RR = 1.4; 95% CI = 1.1-1.7), and liver (RR = 3.6; 95% CI = 2.6-5.0). Risk of esophageal squamous cell carcinoma was elevated for underweight men whose BMI was less than 18.5 (RR = 3.1; 95% CI = 1.1-8.3). An excess risk for cancers of the pancreas and connective tissue was observed only among nonsmokers. Compared to men whose weight remained stable, men with more than a 15% increase in BMI after six years of follow-up had an elevated risk of pancreas and renal cell cancers. Obesity and weight gain increase the risk for several forms of cancer in men, and underscore the need for further study into carcinogenic mechanisms and preventive interventions.
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            Effects of excess weight on cancer incidences depending on cancer sites and histologic findings among men: Korea National Health Insurance Corporation Study.

            Yeong Yoon, S. H. Oh, MAL-SOON SHIN (2005)
            The effects of excess weight on the development of cancers are controversial, and little is known for populations outside the United States and Europe. We conducted this study to assess the effects of excess weight with a large cohort of Koreans. We assessed the relationship between body mass index (BMI) and various cancers in a 10-year follow-up cohort of 781,283 Korean men who were free of prior cancer at baseline. Weight and height were measured, and questionnaires related to health behaviors and medical history were completed. Data on newly developed cancers were obtained from two organizations in Korea. A proportional hazards model was used to examine the relationship between BMI and cancer. Adenocarcinoma in the colon and rectosigmoid, hepatocellular carcinoma, cholangiocarcinoma, adenocarcinoma in the prostate, renal cell carcinoma, papillary carcinoma in the thyroid, small-cell carcinoma in the lung, non-Hodgkin's lymphoma, and melanoma had positive dose-dependent relationships with BMI (all P or= 30 kg/m(2) had an increased risk of developing gastric adenocarcinoma (relative risk = 1.73). Other cancers, such as leukemia, multiple myeloma, and gallbladder and pancreatic cancer, did not show significant associations. These findings show that, even in Koreans, obesity clearly increases the risk of many types of cancers and the strength of the associations varies with the organ and histologic type. Because these obesity-related cancers are reported to be rapidly increasing in Korea and many other Asian countries, controlling obesity epidemics could be an effective tool for preventing these cancers in these areas.
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              A prospective study of obesity and cancer risk (Sweden).

              A. Wolk, G Gridley, M. Svensson … (2001)
              [corrected] We evaluated the relation between obesity and the risks for various forms of cancer. In a population-based cohort of 28,129 hospital patients (8165 men, 19,964 women) with any discharge diagnosis of obesity (9557 only diagnosis, 5266 primary, 13,306 secondary) during 1965-1993, cancer incidence was ascertained through 1993 by record linkage to the nationwide Swedish Cancer Registry. Cancer risk was estimated using the standardized incidence ratio (SIR, with 95% confidence interval), which is the ratio of the observed number of cancers to that expected. Overall, a 33% excess incidence of cancer was seen in obese persons, 25% in men and 37% in women. Significant risk elevations were observed for cancers of the small intestine (SIR = 2.8; 95% CI 1.6-4.5), colon (1.3; 1.1-1.5), gallbladder (1.6; 1.1-2.3), pancreas (1.5; 1.1-1.9), larynx (2.1; 1.1-3.5), renal parenchyma (2.3; 1.8-2.8), bladder (1.2; 1.0-1.6), cervix uteri (1.4; 1.1-1.9), endometrium (2.9; 2.5-3.4), ovary (1.2; 1.1-1.5), brain (1.5; 1.2-1.9), and connective tissue (1.9; 1.1-3.0), and for lymphomas (1.4; 1.0-1.7), with higher risk observed for Hodgkin's disease only in men (3.3; 1.4-6.5) and for non-Hodgkin's lymphoma only in women (1.6; 1.2-2.1). The association of obesity with risk of breast, prostate and pancreas cancers was modified by age. Obesity is associated with more forms of cancer than previously reported.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Br J Cancer
                Title: British Journal of Cancer
                Publisher: Nature Publishing Group
                ISSN (Print): 0007-0920
                ISSN (Electronic): 1532-1827
                Publication date (Electronic): 14 August 2007
                Publication date Collection: 02 October 2007
                Publication date (Print): 08 October 2007
                Volume: 97
                Issue: 7
                Pages: 1005-1008
                Affiliations
                [1 ]Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institutet, PO Box 210 Stockholm SE-17177, Sweden
                Author notes
                [* ]Author for correspondence: susanna.larsson@ 123456ki.se
                Article
                Publisher Item ID: 6603932
                DOI: 10.1038/sj.bjc.6603932
                PMC ID: 2360408
                PubMed ID: 17700568
                SO-VID: 44fe10e3-e5ee-4bdf-b997-52f054ff6459
                Copyright © Copyright 2007, Cancer Research UK
                History
                Date received : 13 June 2007
                Date revision received : 12 July 2007
                Date accepted : 17 July 2007
                Categories
                Subject: Epidemiology

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: body mass index,meta-analysis,review,liver cancer,obesity,cohort studies
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: body mass index, meta-analysis, review, liver cancer, obesity, cohort studies

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