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 multivari-
ate
proportional-hazards models. We calculated the proportion of all deaths from
can-
cer 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 over-
weight and obesity
in the U.S. adult population
Results
The heaviest members
of this cohort (those with a body-mass index [the weight in kilo-
grams 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. Signif-
icant 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 com-
bined and for
cancers at multiple specific sites
