The influence of excess body weight on the risk of death from cancer has not been
fully characterized.
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.
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.
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