Obesity and the incidence of digestive system cancers: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

LI Xue ¹ , YAN Yumeng ¹ ,  PING Weiwei ^1,2

1. School of Public Health, Shanxi Medical University, Taiyuan 030000, P. R. China;
2. Department of Preventive Medicine, Changzhi Medical College, Changzhi 046000, P. R. China;

Corresponding author：

PING Weiwei, Email: weiweip@czmc.edu.cn

Keywords：

Digestive system; Cancer; Obesity; Incidence; Systematic review; Meta-analysis; Cohort study

DOI：

10.7507/1672-2531.202205086

Video：

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Objective To systematically review the relationship between obesity and the incidence of digestive system cancers. Methods The PubMed, EMbase, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect cohort studies on the relationship between obesity and digestive system cancers from January 1^st, 2001 to October 31^st, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. Results A total of 16 cohort studies were included. The results of meta-analysis revealed that compared with normal weight, obesity increased the incidence rate of various cancers of the digestive system, including colorectal cancer (RR=1.25, 95% CI 1.13 to 1.39, P<0.000 1), liver cancer (RR=1.65, 95%CI 1.41 to 1.92, P<0.000 01), pancreatic cancer (RR=1.34, 95%CI 1.19 to 1.51, P<0.000 01), gastric cancer (RR=1.09, 95%CI 1.05 to 1.14, P<0.000 1), and esophageal cancer (RR=2.39, 95%CI 1.98 to 2.89, P<0.000 01). Conclusion The current evidence indicates that obesity can increase the incidence rate of digestive system cancers. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： LI Xue, YAN Yumeng, PING Weiwei. Obesity and the incidence of digestive system cancers: a systematic review. Chinese Journal of Evidence-Based Medicine, 2022, 22(10): 1155-1160. doi: 10.7507/1672-2531.202205086 Copy

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4.	顾卫琼, 王卫庆. 肥胖与癌症关系及临床. 中国实用内科杂志, 2011, 31(9): 684-686.
5.	Moghaddam AA, Woodward M, Huxley R. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70, 000 events. Cancer Epidemiol Biomarkers Prev, 2007, 16(12): 2533-2547.
6.	Tanaka K, Tsuji I, Tamakoshi A, et al. Obesity and liver cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population. Jpn J Clin Oncol, 2012, 42(3): 212-221.
7.	Momayez Sanat Z, Masoudi S, Mansouri M, et al. Diabetes mellitus, obesity, and risk of pancreatic ductal adenocarcinoma: a large case-control study from Iran. Middle East J Dig Dis, 2021, 13(1): 15-20.
8.	Kim HJ, Kim N, Kim HY, et al. Relationship between body mass index and the risk of early gastric cancer and dysplasia regardless of Helicobacter pylori infection. Gastric Cancer, 2015, 18(4): 762-773.
9.	Ljung R, Martin L, Lagergren J. Oral disease and risk of oesophageal and gastric cancer in a nationwide nested case-control study in Sweden. Eur J Cancer, 2011, 47(14): 2128-2132.
10.	李洋, 傅华. 肥胖的重新定义和处理. 上海预防医学, 2001, 13(4): 161-162.
11.	Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Oxford: Oxford University, 2000.
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13.	Liu PH, Wu K, Ng K, et al. Association of obesity with risk of early-onset colorectal cancer among women. JAMA Oncol, 2019, 5(1): 37-44.
14.	Lin J, Zhang SM, Cook NR, et al. Body mass index and risk of colorectal cancer in women (United States). Cancer Causes Control, 2004, 15(6): 581-589.
15.	Kuriyama S, Tsubono Y, Hozawa A, et al. Obesity and risk of cancer in Japan. Int J Cancer, 2005, 113(1): 148-157.
16.	Liu Y, Warren Andersen S, Wen W, et al. Prospective cohort study of general and central obesity, weight change trajectory and risk of major cancers among Chinese women. Int J Cancer, 2016, 139(7): 1461-1470.
17.	Lukanova A, Björ O, Kaaks R, et al. Body mass index and cancer: results from the Northern Sweden Health and Disease Cohort. Int J Cancer, 2006, 118(2): 458-466.
18.	Terry PD, Miller AB, Rohan TE. Obesity and colorectal cancer risk in women. Gut, 2002, 51(2): 191-194.
19.	Oh SW, Yoon YS, Shin SA. Effects of excess weight on cancer incidences depending on cancer sites and histologic findings among men: Korea National Health Insurance Corporation Study. J Clin Oncol, 2005, 23(21): 4742-4754.
20.	Hagström H, Tynelius P, Rasmussen F. High BMI in late adolescence predicts future severe liver disease and hepatocellular carcinoma: a national, population-based cohort study in 1. 2 million men. Gut, 2018, 67(8): 1536-1542.
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23.	Reeves GK, Pirie K, Beral V, et al. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ, 2007, 335(7630): 1134.
24.	Shyam S, Greenwood D, Mai CW, et al. Traditional and novel adiposity indicators and pancreatic cancer risk: findings from the UK women's cohort study. Cancers (Basel), 2021, 13(5): 1036.
25.	Choi IY, Choi YJ, Shin DW, et al. Association between obesity and the risk of gastric cancer in premenopausal and postmenopausal women: A nationwide cohort study. J Gastroenterol Hepatol, 2021, 36(10): 2834-2840.
26.	Engeland A, Tretli S, Bjørge T. Height and body mass index in relation to esophageal cancer; 23-year follow-up of two million Norwegian men and women. Cancer Causes Control, 2004, 15(8): 837-843.
27.	Merry AH, Schouten LJ, Goldbohm RA, et al. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study. Gut, 2007, 56(11): 1503-1511.
28.	杨若明, 杨林, 田字彬. 肥胖对消化系统肿瘤发生的影响及其相关机制研究进展. 胃肠病学, 2016, 21(10): 620-622.
29.	魏萌, 杨旭庆, 程露阳, 等. 肥胖相关癌症的研究进展. 承德医学院学报, 2017, 34(4): 336-339.

1. 刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-13.
2. 那彦群, 黄健. 中国泌尿外科疾病诊断治疗指南手册. 北京: 人民卫生出版社, 2014.
3. Eduardo LP. Second expert report, food, nutrition, physical activity and the prevention of cancer: a global perspective. Salud Publica Mex, 2009, 51: S678-S80.
4. 顾卫琼, 王卫庆. 肥胖与癌症关系及临床. 中国实用内科杂志, 2011, 31(9): 684-686.
5. Moghaddam AA, Woodward M, Huxley R. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70, 000 events. Cancer Epidemiol Biomarkers Prev, 2007, 16(12): 2533-2547.
6. Tanaka K, Tsuji I, Tamakoshi A, et al. Obesity and liver cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population. Jpn J Clin Oncol, 2012, 42(3): 212-221.
7. Momayez Sanat Z, Masoudi S, Mansouri M, et al. Diabetes mellitus, obesity, and risk of pancreatic ductal adenocarcinoma: a large case-control study from Iran. Middle East J Dig Dis, 2021, 13(1): 15-20.
8. Kim HJ, Kim N, Kim HY, et al. Relationship between body mass index and the risk of early gastric cancer and dysplasia regardless of Helicobacter pylori infection. Gastric Cancer, 2015, 18(4): 762-773.
9. Ljung R, Martin L, Lagergren J. Oral disease and risk of oesophageal and gastric cancer in a nationwide nested case-control study in Sweden. Eur J Cancer, 2011, 47(14): 2128-2132.
10. 李洋, 傅华. 肥胖的重新定义和处理. 上海预防医学, 2001, 13(4): 161-162.
11. Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Oxford: Oxford University, 2000.
12. Zheng R, Du M, Zhang B, et al. Body mass index (BMI) trajectories and risk of colorectal cancer in the PLCO cohort. Br J Cancer, 2018, 119(1): 130-132.
13. Liu PH, Wu K, Ng K, et al. Association of obesity with risk of early-onset colorectal cancer among women. JAMA Oncol, 2019, 5(1): 37-44.
14. Lin J, Zhang SM, Cook NR, et al. Body mass index and risk of colorectal cancer in women (United States). Cancer Causes Control, 2004, 15(6): 581-589.
15. Kuriyama S, Tsubono Y, Hozawa A, et al. Obesity and risk of cancer in Japan. Int J Cancer, 2005, 113(1): 148-157.
16. Liu Y, Warren Andersen S, Wen W, et al. Prospective cohort study of general and central obesity, weight change trajectory and risk of major cancers among Chinese women. Int J Cancer, 2016, 139(7): 1461-1470.
17. Lukanova A, Björ O, Kaaks R, et al. Body mass index and cancer: results from the Northern Sweden Health and Disease Cohort. Int J Cancer, 2006, 118(2): 458-466.
18. Terry PD, Miller AB, Rohan TE. Obesity and colorectal cancer risk in women. Gut, 2002, 51(2): 191-194.
19. Oh SW, Yoon YS, Shin SA. Effects of excess weight on cancer incidences depending on cancer sites and histologic findings among men: Korea National Health Insurance Corporation Study. J Clin Oncol, 2005, 23(21): 4742-4754.
20. Hagström H, Tynelius P, Rasmussen F. High BMI in late adolescence predicts future severe liver disease and hepatocellular carcinoma: a national, population-based cohort study in 1. 2 million men. Gut, 2018, 67(8): 1536-1542.
21. Jee SH, Yun JE, Park EJ, et al. Body mass index and cancer risk in Korean men and women. Int J Cancer, 2008, 123(8): 1892-1896.
22. Samanic C, Chow WH, Gridley G, et al. Relation of body mass index to cancer risk in 362, 552 Swedish men. Cancer Causes Control, 2006, 17(7): 901-909.
23. Reeves GK, Pirie K, Beral V, et al. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ, 2007, 335(7630): 1134.
24. Shyam S, Greenwood D, Mai CW, et al. Traditional and novel adiposity indicators and pancreatic cancer risk: findings from the UK women's cohort study. Cancers (Basel), 2021, 13(5): 1036.
25. Choi IY, Choi YJ, Shin DW, et al. Association between obesity and the risk of gastric cancer in premenopausal and postmenopausal women: A nationwide cohort study. J Gastroenterol Hepatol, 2021, 36(10): 2834-2840.
26. Engeland A, Tretli S, Bjørge T. Height and body mass index in relation to esophageal cancer; 23-year follow-up of two million Norwegian men and women. Cancer Causes Control, 2004, 15(8): 837-843.
27. Merry AH, Schouten LJ, Goldbohm RA, et al. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study. Gut, 2007, 56(11): 1503-1511.
28. 杨若明, 杨林, 田字彬. 肥胖对消化系统肿瘤发生的影响及其相关机制研究进展. 胃肠病学, 2016, 21(10): 620-622.
29. 魏萌, 杨旭庆, 程露阳, 等. 肥胖相关癌症的研究进展. 承德医学院学报, 2017, 34(4): 336-339.

Chinese Journal of Evidence-Based Medicine

Obesity and the incidence of digestive system cancers: a systematic review

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