Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies

@article{citeulike:2393038, abstract = {SummaryBackground Excess bodyweight, expressed as increased body-mass index (BMI), is associated with the risk of some common adult cancers. We did a systematic review and meta-analysis to assess the strength of associations between BMI and different sites of cancer and to investigate differences in these associations between sex and ethnic groups.Methods We did electronic searches on Medline and Embase (1966 to November 2007), and searched reports to identify prospective studies of incident cases of 20 cancer types. We did random-effects meta-analyses and meta-regressions of study-specific incremental estimates to determine the risk of cancer associated with a 5 kg/m2 increase in BMI.Findings We analysed 221 datasets (141 articles), including 282[punctuation space]137 incident cases. In men, a 5 kg/m2 increase in BMI was strongly associated with oesophageal adenocarcinoma (RR 1[middle dot]52, p<0[middle dot]0001) and with thyroid (1[middle dot]33, p=0[middle dot]02), colon (1[middle dot]24, p<0[middle dot]0001), and renal (1[middle dot]24, p <0[middle dot]0001) cancers. In women, we recorded strong associations between a 5 kg/m2 increase in BMI and endometrial (1[middle dot]59, p<0[middle dot]0001), gallbladder (1[middle dot]59, p=0.04), oesophageal adenocarcinoma (1[middle dot]51, p<0[middle dot]0001), and renal (1[middle dot]34, p<0[middle dot]0001) cancers. We noted weaker positive associations (RR <1[middle dot]20) between increased BMI and rectal cancer and malignant melanoma in men; postmenopausal breast, pancreatic, thyroid, and colon cancers in women; and leukaemia, multiple myeloma, and non-Hodgkin lymphoma in both sexes. Associations were stronger in men than in women for colon (p<0[middle dot]0001) cancer. Associations were generally similar in studies from North America, Europe and Australia, and the Asia-Pacific region, but we recorded stronger associations in Asia-Pacific populations between increased BMI and premenopausal (p=0[middle dot]009) and postmenopausal (p=0[middle dot]06) breast cancers.Interpretation Increased BMI is associated with increased risk of common and less common malignancies. For some cancer types, associations differ between sexes and populations of different ethnic origins. These epidemiological observations should inform the exploration of biological mechanisms that link obesity with cancer.}, author = {Renehan, Andrew G. and Tyson, Margaret and Egger, Matthias and Heller, Richard F. and Zwahlen, Marcel }, citeulike-article-id = {2393038}, doi = {10.1016/S0140-6736(08)60269-X}, journal = {The Lancet}, keywords = {cancer, meta-analysis, obesity}, number = {9612}, pages = {569--578}, posted-at = {2008-02-18 09:03:20}, priority = {2}, title = {Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies}, url = {http://dx.doi.org/10.1016/S0140-6736(08)60269-X}, volume = {371} }

TY - JOUR ID - citeulike:2393038 L3 - citeulike-article-id:2393038 TI - Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies JF - The Lancet VL - 371 IS - 9612 SP - 569 EP - 578 N2 - SummaryBackground Excess bodyweight, expressed as increased body-mass index (BMI), is associated with the risk of some common adult cancers. We did a systematic review and meta-analysis to assess the strength of associations between BMI and different sites of cancer and to investigate differences in these associations between sex and ethnic groups.Methods We did electronic searches on Medline and Embase (1966 to November 2007), and searched reports to identify prospective studies of incident cases of 20 cancer types. We did random-effects meta-analyses and meta-regressions of study-specific incremental estimates to determine the risk of cancer associated with a 5 kg/m2 increase in BMI.Findings We analysed 221 datasets (141 articles), including 282[punctuation space]137 incident cases. In men, a 5 kg/m2 increase in BMI was strongly associated with oesophageal adenocarcinoma (RR 1[middle dot]52, p<0[middle dot]0001) and with thyroid (1[middle dot]33, p=0[middle dot]02), colon (1[middle dot]24, p<0[middle dot]0001), and renal (1[middle dot]24, p <0[middle dot]0001) cancers. In women, we recorded strong associations between a 5 kg/m2 increase in BMI and endometrial (1[middle dot]59, p<0[middle dot]0001), gallbladder (1[middle dot]59, p=0.04), oesophageal adenocarcinoma (1[middle dot]51, p<0[middle dot]0001), and renal (1[middle dot]34, p<0[middle dot]0001) cancers. We noted weaker positive associations (RR <1[middle dot]20) between increased BMI and rectal cancer and malignant melanoma in men; postmenopausal breast, pancreatic, thyroid, and colon cancers in women; and leukaemia, multiple myeloma, and non-Hodgkin lymphoma in both sexes. Associations were stronger in men than in women for colon (p<0[middle dot]0001) cancer. Associations were generally similar in studies from North America, Europe and Australia, and the Asia-Pacific region, but we recorded stronger associations in Asia-Pacific populations between increased BMI and premenopausal (p=0[middle dot]009) and postmenopausal (p=0[middle dot]06) breast cancers.Interpretation Increased BMI is associated with increased risk of common and less common malignancies. For some cancer types, associations differ between sexes and populations of different ethnic origins. These epidemiological observations should inform the exploration of biological mechanisms that link obesity with cancer. KW - cancer KW - meta-analysis KW - obesity AU - Renehan, Andrew AU - Tyson, Margaret AU - Egger, Matthias AU - Heller, Richard AU - Zwahlen, Marcel UR - http://dx.doi.org/10.1016/S0140-6736(08)60269-X ER -