乳腺癌生存者的肥胖风险迅速增加？美国全国健康问卷调查结果，1997年至2014年

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　　抗癌治疗达到癌症控制后，癌症患者成为癌症生存者。癌症生存者是在艰难抗癌治疗后的幸存者，因此又被称为癌症幸存者。既往研究发现，特定癌症确诊后的肥胖与预后不良有相关性。

　　2016年7月25日，美国临床肿瘤学会官方期刊《临床肿瘤学杂志》在线发表纽约哥伦比亚大学的研究报告，分析了美国近二十年来癌症生存者的肥胖现患趋势，并与那些无癌症史的成人进行了比较。

　　该研究基于538969位、18至85岁、1997年至2014年参与每年横断面全国健康问卷调查、有或无癌症史、非住院、美国成年人的全国有代表人群样本。肥胖被定义为非亚裔体重指数≥30kg/m²和亚裔体重指数≥27.5kg/m²。

　　结果发现，在经过确定的32447例癌症生存者中，最常见的癌症诊断为乳腺癌（6948例）、前列腺癌（3984例）、结直肠癌（2546例）。1997年至2014年，癌症生存者、无癌症史成人的肥胖现患率分别由22.4%增至31.7%、由20.9%增至29.5%（两组趋势P值均＜0.001）。在此期间，有癌症史的女性和男性与无癌症史者相比，肥胖现患的估算年增长率较高（所有交互P值均＜0.001）。女性和男性结直肠癌、乳腺癌、前列腺癌生存者肥胖现患的估算年增长率分别为3.1%和3.7%、3.0%、2.1%（所有P值均＜0.001）。在亚组分析中，肥胖负担增长率最高的人群为结直肠癌生存者、乳腺癌生存者、非西班牙裔黑人。

　　因此，从1997年至2014年，成人癌症生存者与总体人群相比，肥胖增加更迅速。结直肠、乳腺癌生存者和非西班牙裔黑人被确定为肥胖风险最高。

J Clin Oncol. 2016 Jul 25. [Epub ahead of print]

Trends in Obesity Prevalence in Adults With a History of Cancer: Results From the US National Health Interview Survey, 1997 to 2014.

Greenlee H, Shi Z, Sardo Molmenti CL, Rundle A, Tsai WY.

Columbia University, New York, NY.

PURPOSE: Obesity after a diagnosis of specific cancers has been associated with worse prognosis. We examined the trend in obesity prevalence among cancer survivors in the United States in the past two decades and compared trends with those of adults without a history of cancer.

PATIENTS AND METHODS: This was a population-based nationally representative sample of 538,969 noninstitutionalized US adults 18 to 85 years old with and without a history of cancer who participated in annual cross-sectional National Health Interview Surveys from 1997 to 2014. Obesity was defined as body mass index ≥ 30 kg/m² for non-Asians and body mass index ≥ 27.5 kg/m² for Asians.

RESULTS: Among 32,447 cancer survivors identified, the most common cancer diagnoses were breast (n = 6,948), prostate (n = 3,984), and colorectal (n = 2,546). From 1997 to 2014, the prevalence of obesity increased from 22.4% to 31.7% in cancer survivors and from 20.9% to 29.5% in adults without a history of cancer (P for trend < .001, both groups). Over this period, the estimated rate of annual increase in obesity prevalence was higher in women and men with a history of cancer compared with those without a history of cancer (all P for interaction < .001). The estimated rate of annual increase in obesity prevalence was 3.1% in female and 3.7% in male colorectal cancer survivors, 3.0% in breast cancer survivors, and 2.1% in prostate cancer survivors (all P < .001). In subgroup analyses, populations with the highest rates of increasing obesity burden were colorectal cancer survivors, breast cancer survivors, and non-Hispanic blacks.

CONCLUSION: From 1997 to 2014, obesity increased more rapidly among adult cancer survivors compared with the general population. Colorectal and breast cancer survivors and non-Hispanic blacks were identified as being at the highest risk for obesity.

PMID: 27458295

PII: JCO664391

DOI: 10.1200/JCO.2016.66.4391