Don't want to get cancer, is there any good way to prevent it?
Yes, smoking cessation and weight control are two important cancer risk reduction factors. [1]
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"Smoking is harmful to health" should go without saying (it has been clearly printed in the outer packaging of the cigarette box), and the relationship between obesity and cancer is also very "solid".
According to the relevant data review of the International Agency for Research on Cancer (IARC) working group[1]:
Excess body fat increases the risk of cancer in the colorectum, liver, gallbladder, pancreas, kidneys, thyroid, breast (postmenopausal), endometrium, ovaries, esophagus (adenocarcinoma), gastric cardia, and can also lead to neuromas and multiple myelomas.
Not only that, according to the relevant research data released by the National Cancer Institute Journal (JNCI) some time ago, for breast cancer patients, if they are overweight or obese at the time of diagnosis, then their risk of developing a second cancer will increase.
In this issue of the NEJM journal, let's take a look at this study.
This article is from the NEJM Journal Watch
High BMI Increases Risk of Second Cancers in Women with Breast Cancer
High BMI increases the risk of second cancer in women with breast cancer
Review by William J. Gradishar, MD
< h1 class="pgc-h-arrow-right" data-track="60" > research background</h1>
Patients often ask them what factors they can control to reduce their risk of new or recurrent cancer. Discussions usually focus on diet, alcohol consumption, and exercise. Among them, breast cancer survivors have a higher risk of developing a second primary cancer compared to the general population. However, the effect of a high body mass index (BMI) on developing a second cancer is unclear.
So the researchers obtained BMI, tumor characteristics, treatment options, and other diagnostic information for cancers using tumor registry data and medical records from 7,500 women with non-metastatic breast cancer in kaiser Permanente.
Among these patients: at the time of initial diagnosis of breast cancer, 33% of women were overweight (BMI of 25 to <30 kg/㎡); 34% were obese (BMI≥30 kg/㎡); the average age was 61 years; and 82% were Caucasians.
Most patients are initially diagnosed with stage I breast cancer; however, obese patients are more likely to initially be diagnosed with stage II/III breast cancer than those with normal BMI.
<h1 class="pgc-h-arrow-right" data-track="81" > after further analysis of the data, the researchers found</h1>
1. During the average 88-month follow-up period, 12.7% of patients were diagnosed with a second cancer, of which 62% were associated with obesity (including postmenopausal breast cancer, colorectal cancer, uterine body cancer, ovarian cancer, pancreatic cancer, kidney cancer, thyroid cancer, multiple myeloma, meningioma, liver cancer, cardia cancer, gallbladder cancer and esophageal cancer).
2. In the multivariate analysis, for every 5 kg/㎡ increase in BMI, the risk of diagnosing a second cancer increased by 7%, the risk of diagnosing obesity-related cancer increased by 13%, the risk of diagnosing second breast cancer increased by 11%, and the risk of diagnosing second estrogen receptor (ER) positive breast cancer increased by 15%.
<h1 class="pgc-h-arrow-right" data-track="15" > comments</h1>
This study demonstrates an increased risk of developing a second cancer in overweight and obese breast cancer survivors. The authors acknowledge the study's limitations, including uncertainty about whether patient populations followed screening recommendations, exercise, and weight loss strategies. But the data still highlights the cancer-related risks faced by overweight patient populations. Whether weight loss can reduce the above risks is a concern in clinical studies.
Articles that are commented on
Feigelson HS et al. Body mass index and risk of second cancer among women with breast cancer. J Natl Cancer Inst 2021 Apr 5; [e-pub]. (https://doi.org/10.1093/jnci/djab053)
bibliography
Sun Han, Graham A Colditz, Yang Hong. New evidence suggests that obesity is clearly correlated with multiple cancers and requires serious consideration of how to prevent it[J]. British Medical Journal: Chinese Edition (BMJ), 2017(20):362.
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