A Prospective Study of Body Mass Index,Hypertension, and Smoking and the Risk of Renal Cell Carcinoma (United States)

Objective:We prospectively investigated the independent association of hypertension, thiazide use, body mass index, weight change, and smoking with the risk of renal cell carcinoma among men and women using biennial mailed questionnaires. Methods:The study population included 118,191 women participating in the Nurses’ Health Study and 48,953 men participating in the Health Professionals Follow-up Study Results:During 24 years of follow-up for women and 12 years for men, 155 and 110 incident cases of renal cell carcinoma were confirmed, respectively. In multivariate models including age, body mass index (BMI), smoking and hypertension, higher BMI was confirmed as a risk factor for women and smoking as a risk factor for men and women. After adjusting for age, updated BMI and smoking, an updated diagnosis of hypertension was associated with renal cell carcinoma (RCC); the relatve risk (RR) was 1.9 (95% CI 1.4–2.7) for women and 1.8 (95% CI 1.2–2.7) for men. Based on limited data regarding the use of thiazide diuretics, we did not observe a risk associated with their use, independent of the diagnosis of hypertension. Conclusions: Diagnosis of hypertension, higher BMI, and increasing pack-years of smoking appear to independently increase the risk of renal cell carcinoma.     

Hypertension,use of antihypertensive medications,and risk of epithelial ovarian cancer

Few studies have examined the associations of hypertension and antihypertensive medications with ovarian cancer. In particular, beta‐blockers, one of the most commonly prescribed medications to treat hypertension, may reduce ovarian cancer risk by inhibiting beta‐adrenergic signaling. We prospectively followed 90,384 women in the Nurses' Health Study (NHS) between 1988–2012 and 113,121 NHSII participants between 1989–2011. Hypertension and use of antihypertensive medications were self‐reported biennially. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). We documented 948 ovarian cancer cases during follow‐up. Similar results were observed in the two cohorts. While hypertension was not associated with ovarian cancer risk (Pooled HR = 1.01; 95% CI = 0.88, 1.16), current use of any antihypertensive medication was associated with slightly increased risk compared to never users (Pooled HR = 1.18; 95% CI: 1.02, 1.37). This increased risk was primarily due to use of thiazide diuretics (Pooled HR = 1.37; 95% CI: 1.13, 1.68). No associations were observed for beta‐blockers or angiotensin‐converting‐enzyme inhibitors. Calcium channel blockers (CCBs) were associated with suggestively reduced risk (NHS HR = 0.73; 95% CI: 0.53, 1.01), after adjusting for all antihypertensive medications. Associations were similar among hypertensive women and stronger for longer use of thiazide diuretics and CCBs. In conclusion, our results provided no evidence that beta‐blockers were associated with reduced ovarian cancer risk. In contrast, we observed an increased risk for use of thiazide diuretics that should be confirmed in other studies.     

A population--based case--control study of renal cell carcinoma

A population-based case-control study of renal cell carcinoma (495 cases and 697 controls) in the Minneapolis-St. Paul seven-county metropolitan area implicated cigarette smoking as a risk factor with an odds ratio (OR) among men of 1.6 (95% confidence intervals: 1.1-2.4) and among women of 1.9 (1.3-3.0). A statistically significant dose response was observed in both sexes for pack-years of cigarette use. On the basis of calculations of attributable risk, it was estimated that 30% of renal cell cancers among men and 24% among women were due to smoking. High relative adult weight as measured by the body mass index (BMI) was found to be a major risk factor among women but not among men, with those in the highest 5% of the BMI having an OR of 5.9 (1.8-20.4) in comparison to the lowest quartile. This association with excess weight was not seen at age 20, but it became more pronounced with increasing age, suggesting that the primary influence of weight gain is during the late stages of renal carcinogenesis. Excess risks were also related to ethnic background (particularly, German), which may account in part for the elevated incidence of renal cancer in the North Central area of the United States. In addition, positive associations were observed for long-term use of phenacetin-containing analgesics, heavy meat consumption, and heavy tea drinking (females only). An occupational clue was provided by an increased risk for exposure to petroleum, tar, and pitch products. Excesses of certain urologic and cardiovascular diseases were also observed among the cases compared to controls.     

Relation between use of antihypertensive medications and risk of breast carcinoma among women ages 65-79 years

BACKGROUND: Limited data are available regarding the incidence of breast carcinoma among users of relatively recently introduced forms of antihypertensive therapy. Although it has been suggested that women who have taken calcium channel blockers (CCBs) have an increased risk and that women who have taken angiotensin-I-converting enzyme (ACE) inhibitors have a decreased risk, currently, no conclusions can be drawn. METHODS: A population-based case-control study of women ages 65-79 years was conducted in western Washington State. The responses of 975 women who were diagnosed with invasive breast carcinoma during 1997-1999 were compared with the responses of 1007 women in a control group. Associations between use of different types of antihypertensive medications and breast carcinoma incidence were evaluated using logistic regression. RESULTS: Overall, women who had ever used CCBs, beta-blockers, or ACE inhibitors did not have an altered risk of breast carcinoma relative to women who had never used antihypertensive medications. Although the use of immediate-release CCBs, thiazide diuretics, and potassium-sparing diuretics was associated with modestly increased risks of breast carcinoma (odds ratio [OR], 1.5; 95% confidence interval [95% CI], 1.0-2.1; OR, 1.4; 95% CI, 1.1-1.8; and OR, 1.6; 95% CI, 1.2-2.1, respectively), the absence of any trend in the size of excess risk with increasing duration or with current versus former use of these agents argues for a cautious interpretation. CONCLUSIONS: The use of particular types of antihypertensive medications, including immediate-release CCBs and certain diuretics, may increase the risk of breast carcinoma among older women. Additional studies are warranted to clarify these potential associations. Cancer 2003;98:1504-13.     

Effects of excess weight on cancer incidences depending on cancer sites and histologic findings among men: Korea National Health Insurance Corporation Study.

PURPOSE: The effects of excess weight on the development of cancers are controversial, and little is known for populations outside the United States and Europe. We conducted this study to assess the effects of excess weight with a large cohort of Koreans. METHODS: We assessed the relationship between body mass index (BMI) and various cancers in a 10-year follow-up cohort of 781,283 Korean men who were free of prior cancer at baseline. Weight and height were measured, and questionnaires related to health behaviors and medical history were completed. Data on newly developed cancers were obtained from two organizations in Korea. A proportional hazards model was used to examine the relationship between BMI and cancer. RESULTS: Adenocarcinoma in the colon and rectosigmoid, hepatocellular carcinoma, cholangiocarcinoma, adenocarcinoma in the prostate, renal cell carcinoma, papillary carcinoma in the thyroid, small-cell carcinoma in the lung, non-Hodgkin's lymphoma, and melanoma had positive dose-dependent relationships with BMI (all P < .05). Although no linear trend was found (P = .267), obese men who never smoked with a BMI of >or= 30 kg/m(2) had an increased risk of developing gastric adenocarcinoma (relative risk = 1.73). Other cancers, such as leukemia, multiple myeloma, and gallbladder and pancreatic cancer, did not show significant associations. CONCLUSION: These findings show that, even in Koreans, obesity clearly increases the risk of many types of cancers and the strength of the associations varies with the organ and histologic type. Because these obesity-related cancers are reported to be rapidly increasing in Korea and many other Asian countries, controlling obesity epidemics could be an effective tool for preventing these cancers in these areas.     

Diuretics may increase risk of renal cell carcinoma

The risk for kidney cancer was examined in a Danish cohort of 192,133 people on a hospital discharge register who had been given a diagnosis of hypertension, heart failure, or edema, and were presumed to be probable users of diuretics. The subjects were identified from 1977 to 1987 and followed-up for cancer through 1987. A total of 10,630 cancers was observed. While the risk for all cancers was increased slightly (standard mortality ratio [SMR]=122, 95 percent confidence interval [CI]=120–124), the risk for renal cell carcinoma was more than doubled (SMR_men=221, CI=192–253; SMR_women=246, CI=213–283). Increased risks were found in all age groups, and, although surveillance bias was present initially, the risk increased consistently in the years following discharge. Risk estimates for individuals discharged with hypertension were similar to those for the total cohort. Use of diuretics was validated in a random sample of 100 individuals. More than 70 percent were taking diuretics at the time of discharge. The increased risk for renal cell carcinoma in this cohort may indicate either that diuretics are involved in the etiology of renal cell carcinoma or that the risk can be attributed to confounders, including smoking, which affect risk for both the discharge diagnosis and renal cell carcinoma.Authors are with the Danish Cancer Registry, Danish Cancer Society, Rosenvængets Hovedvej 38, Box 839 Copenhagen DK-2100ø, Denmark. Address correspondence to Dr Mellemgaard.     

Obesity, high energy intake, lack of physical activity, and the risk of kidney cancer.

The authors conducted a population-based case-control study of 810 cases with histologically confirmed incident kidney cancer and 3,106 controls to assess the effect of obesity, energy intake, and recreational physical activity on renal cell and non-renal cell cancer risk in Canada from 1994 to 1997. Compared with normal body mass index (BMI; 18.5 to <25.0 kg/m2), obesity (BMI, >or=30.0 kg/m2) was associated with multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95% CI) of 2.57 (2.02-3.28) for renal cell cancer and 2.79 (1.70-4.60) for non-renal cell cancer. The OR (95% CI) associated with the highest quartiles of calorie intake was 1.30 (1.02-1.66) for renal cell cancer and 1.53 (0.92-2.53) for non-renal cell cancer. Compared with the lowest quartile of total recreational physical activity, the highest quartile of total activity was associated with an OR (95% CI) of 1.00 (0.78-1.28) and 0.79 (0.46-1.36) for the two subtypes. There were no apparent differences between men and women about these associations. The influence of obesity and physical activity on the risk of renal cell and non-renal cell cancer did not change by age, whereas the effect of excess energy intake was stronger among older people. No significant effect modifications of physical activity on BMI among both genders and of energy intake on BMI among men were observed, with a synergic effect of obesity and high energy intake on renal cell cancer risk found among women. This study suggests that obesity and excess energy intake are important etiologic risk factors for renal cell and non-renal cell cancer. The role of physical activity needs further investigation.     

Obesity and renal cell cancer--a quantitative review

Obesity has been associated with an increased risk of renal cell cancer among women, while the evidence for men is considered weaker. We conducted a quantitative summary analysis to evaluate the existing evidence that obesity increases the risk of renal cell cancer both among men and women. We identified all studies examining body weight in relation to kidney cancer, available in MEDLINE from 1966 to 1998. The quantitative summary analysis was limited to studies assessing obesity as body mass index (BMI, kg m(-2)), or equivalent. The risk estimates and the confidence intervals were extracted from the individual studies, and a mixed effect weighted regression model was used. We identified 22 unique studies on each sex, and the quantitative analysis included 14 studies on men and women, respectively. The summary relative risk estimate was 1.07 (95% CI 1.05-1.09) per unit of increase in BMI (corresponding to 3 kg body weight increase for a subject of average height). We found no evidence of effect modification by sex. Our quantitative summary shows that increased BMI is equally strongly associated with an increased risk of renal cell cancer among men and women.     

Esophageal cancer and body mass index: results from a prospective study of 220,000 men in China and a meta-analysis of published studies

Several epidemiological studies have reported on the association between body mass index (BMI) and risk of esophageal cancer, but these were mostly in Western populations where many are overweight or obese. There is little direct evidence about the relationship in China where the mean BMI is relatively low and the disease rate is high. We examined the data from a population-based prospective study of 220,000 Chinese men aged 40-79 without a previous history of cancer (mean BMI 21.7 kg/m(2)), which included 1,082 esophageal cancer deaths during 10 years of follow-up. Adjusted hazard ratios for death from esophageal cancer by baseline BMI category were calculated using Cox proportional hazards models. Even among men with good self-assessed health and BMI >or= 18.5 kg/m(2), there was a strong inverse association between BMI and death from esophageal cancer, with each 5 kg/m(2) higher BMI associated with 25% (95%CI: 11-36%) lower esophageal cancer mortality. This inverse association persisted when analysis was restricted to men who had never smoked or when the first 5 years of follow-up were excluded. The strength of the relationship was consistent with the pooled estimate for squamous cell carcinoma of the esophagus in a meta-analysis of prospective studies (31% lower relative risk per 5 kg/m(2) higher BMI; 95% CI: 25-37%), but contrasted with that for adenocarcinoma which showed a positive association with BMI. Together, these data provide reliable evidence that in many populations low BMI is associated with an increased risk of squamous cell carcinoma of the esophagus.     

Calcium, vitamin D, sunshine exposure, dairy products and colon cancer risk (United States)

Objective: Epidemiologic studies on calcium, vitamin D and colon cancer are inconsistent, whereas experimental studies more regularly show a protective effect. To evaluate potential sources of inconsistencies, data from a large case–control study were analyzed, stratifying on potential effect modifiers. Methods: Data were collected by certified interviewers in Northern California, Utah and Minnesota. Analyses included 1993 incident colon cancer cases and 2410 population-based controls. Multivariate logistic regression models included age, sex, BMI, family history, physical activity, intake of energy, dietary fiber, aspirin and NSAIDs. Results: Dietary calcium was inversely associated with colon cancer risk in men (OR highest vs lowest quintile = 0.6, 95% CI = 0.5–0.9) and women (OR = 0.6, 95% CI = 0.4–0.9). No statistically significant associations were observed for dietary vitamin D or sunshine exposure. Consumption of total low-fat dairy products was associated with a statistically significantly decreased risk in men and women (ORs highest vs lowest category of intake = 0.8 and 0.7 respectively). Calcium supplement use was inversely associated with risk in both sexes (ORs use vs non-use = 0.8). Vitamin D supplements were inversely associated with risk in men (OR = 0.5) and women (OR = 0.6) but confidence limits included 1.0. Conclusions: These data provide additional support of an inverse association between high levels of calcium intake and colon cancer risk.     

Relation of body mass index to cancer risk in 362,552 Swedish men

Background Obesity has been linked with increased risk for cancers of the colon, kidney, breast, endometrium and gallbladder. For other cancer sites, the relationship with obesity is less well quantified, and the effect of weight change on cancer risk is unclear. Methods We examined the health records of 362,552 Swedish men who underwent at least one physical examination from 1971 to 1992, and were followed until death or the end of 1999. Incident cancer cases were identified by linkage to the Swedish cancer registry. Poisson regression models were used to estimate relative risks of cancer for both body-mass index (BMI) at baseline exam and, in a subgroup of 107,815 men, change in BMI after six years of follow-up, adjusting for age and smoking status. Results Compared to men of normal weight, obese men had a significantly increased risk of all cancers combined (RR = 1.1; 95% CI = 1.0–1.2). The risks were most pronounced for esophageal adenocarcinoma (RR = 2.7; 95% CI = 1.3–5.6), renal cell carcinoma (RR = 1.8; 95% CI = 1.4–2.4), malignant melanoma (RR = 1.4; 95% CI = 1.1–1.7), and cancers of the colon (RR = 1.7; 95% CI = 1.5–2.0), rectum (RR = 1.4; 95% CI = 1.1–1.7), and liver (RR = 3.6; 95% CI = 2.6–5.0). Risk of esophageal squamous cell carcinoma was elevated for underweight men whose BMI was less than 18.5 (RR = 3.1; 95% CI = 1.1–8.3). An excess risk for cancers of the pancreas and connective tissue was observed only among nonsmokers. Compared to men whose weight remained stable, men with more than a 15% increase in BMI after six years of follow-up had an elevated risk of pancreas and renal cell cancers. Conclusions Obesity and weight gain increase the risk for several forms of cancer in men, and underscore the need for further study into carcinogenic mechanisms and preventive interventions.     

The association of increased weight, body mass index, and tissue density with the risk of breast carcinoma in Vermont

BACKGROUND: Etiologic studies of breast carcinoma have indicated that weight, body mass index (BMI), and breast tissue density are important determinants of a woman's risk for the disease. This study looked at the independent effects of these risk factors. METHODS: Data from the Vermont Breast Cancer Surveillance System (VBCSS), collected between May 1996 and November 1997, were used to identify 529 breast carcinoma cases with no prior history of the disease. Each case was matched to four randomly chosen women of the same age who had mammograms during the same time period and had no biopsy-confirmed breast carcinoma. Logistic regression was used to assess the effects of weight, BMI, and breast tissue density on breast carcinoma risk for pre- and postmenopausal women. RESULTS: Weight and BMI were found to be significantly associated with postmenopausal breast carcinoma after adjustment for breast density, and vice versa. The density-adjusted odds ratio for women weighing over 81 kg, relative to women weighing under 63 kg, was 2.1, with a 95% confidence interval (CI) of 1.3-3.2. Relative to women with breasts consisting entirely of fat, the weight-adjusted odds ratios for women with heterogeneously dense and extremely dense breasts were 2.3 (CI: 1.3-4.3) and 4.5 (CI: 1.9-10.6), respectively. CONCLUSIONS: Among postmenopausal Vermont women, weight, BMI, and breast density were independently associated with breast carcinoma risk. Because breast density and weight or BMI are inversely related, estimates of their independent effects should be used when evaluating a woman's risk for breast carcinoma.     

Lung cancer in Europe in 2000: epidemiology,prevention, and early detection

Lung cancer is the most common cancer in the world. In men, the highest incidence rates are seen in Europe (especially eastern Europe) and North America. In women, high incidence rates are found in North America and in Europe, particularly in northern and western Europe. It is estimated that there were about 375000 cases of lung cancer in Europe in 2000; 303000 in men and 72000 in women. The number of resulting deaths was about 347000 (280000 in men and 67000 in women). Tobacco smoking is well established as the main cause of lung cancer and about 90% of cases are thought to be tobacco related. There is a clear dose-response relation between lung-cancer risk and the number of cigarettes smoked per day, degree of inhalation, and age at initiation of smoking. Someone who has smoked all their life has a lung-cancer risk 20-30 times greater than a non-smoker. However, risk of lung cancer decreases with time since smoking cessation. Recently, there has been renewed interest in screening because spiral computerised tomography can detect small asymptomatic lesions more effectively than conventional radiography. Although cure rates for such lesions are very good, there is to date no evidence for effectiveness of mass-screening strategies.     

索拉非尼在晚期肾癌治疗中所致高血压及其处理

目的:观察索拉非尼治疗晚期肾癌期间高血压的发生及其处理,评估高血压对索拉非尼疗效的预测作用.方法:对30例晚期肾癌患者给予索拉非尼治疗,观察不良反应高血压的发生情况,对高血压进行分级并采取相应的降压治疗措施,观察索拉非尼所致高血压对降压治疗的反应,并采用单因素分析评估高血压对索拉非尼疗效的预测作用.结果:30例晚期肾癌患者服用索拉非尼后,发生高血压的中位时间为15d (6～58d),高血压发生率为30.0％ (9/30),其中大多数(8/9,88.9％)为1～2级.降压治疗后血压控制稳定,未出现高血压危象及相关心脏事件.无患者因严重高血压导致索拉非尼治疗减量或中断.发生高血压对索拉非尼疗效的预测无统计学意义(x2=0.635,P=0.637).结论:索拉非尼治疗晚期肾癌的高血压发生率较高,但以轻至中度为主,降压治疗效果较好.高血压对索拉非尼疗效无预测作用.     

The Risk for Malignant Primary Adult-Onset Glioma in a Large,Multiethnic, Managed-Care Cohort: Cigarette Smoking and Other Lifestyle Behaviors

PURPOSE: To determine the risk for malignant primary adult-onset glioma (MPAG) associated with cigarette smoking and other lifestyle behaviors in a large, multiethnic, managed-care cohort. METHODS: The study population included a cohort of 133,811 subscribers to the Kaiser Permanente Medical Care Program of Northern California who had received a multiphasic health checkup and questionnaire between 1977 and 1985, were at least 25 years old at their start of follow-up, and had no prior history of benign or malignant brain tumors. In this cohort, patients were followed for up to 21 years for the development of MPAG. RESULTS: Risk for MPAG among women increased with increasing packs of cigarettes smoked per day (p-for-trend = 0.04), adjusting for cigar and pipe smoking, patient age, sex, race, education, alcohol use and coffee consumption. A similar pattern was not observed for men. Individuals who smoked marijuana at least once a month, adjusting for cigarette smoking (packs smoked per day) and for the factors noted above, had a 2.8-fold (CI = 1.3-6.2) increased risk for MPAG. Relative risk for MPAG increased with increasing consumption of coffee (p-for-trend = 0.05). CONCLUSIONS: Cigarette smoking was associated with an increased risk for MPAG among women but not among men. Individuals who smoked marijuana at least once a month had an increased risk for MPAG, although no dose-response relation was observed. Drinkers of >7 cups of coffee per day had a 70% increased risk for MPAG and smaller risk elevation for lower consumption. Alcohol usage was not associated with an increased risk for MPAG.     

Update on renal cell carcinoma

Authors have selected and presented radiofrequency tissue ablation for primary renal tumors and cellular therapy with dendritic cells or nonmyeloablative allogeneic transplantation as the main results in 2000-2001 on renal cell carcinoma. Furthermore other points are developed as hypertension increasing the risk of renal cell carcinoma, chromosomal events until renal cell carcinoma and prognosis of incidentally detected tumors.     

Carcinoma of the cervix and tobacco smoking: collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies

Tobacco smoking has been classified as a cause of cervical cancer, but the effect of different patterns of smoking on risk is unclear. The International Collaboration of Epidemiological Studies of Cervical Cancer has brought together and combined individual data on 13,541 women with and 23,017 women without cervical carcinoma, from 23 epidemiological studies. Relative risks (RRs) and 95% confidence intervals (CIs) of carcinoma of the cervix in relation to tobacco smoking were calculated with stratification by study, age, sexual partners, age at first intercourse, oral contraceptive use and parity. Current smokers had a significantly increased risk of squamous cell carcinoma of the cervix compared to never smokers (RR = 1.60 (95% CI: 1.48-1.73), p<0.001). There was increased risk for past smokers also, though to a lesser extent (RR = 1.12 (1.01-1.25)), and there was no clear trend with time since stopping smoking (p-trend = 0.6). There was no association between smoking and adenocarcinoma of the cervix (RR = 0.89 (0.74-1.06) and 0.89 (0.72-1.10) for current and past smokers respectively), and the differences between the RRs for smoking and squamous cell and adenocarcinoma were statistically significant (current smoking p<0.001 and past smoking p = 0.01). In current smokers, the RR of squamous cell carcinoma increased with increasing number of cigarettes smoked per day and also with younger age at starting smoking (p<0.001 for each trend), but not with duration of smoking (p-trend = 0.3). Eight of the studies had tested women for cervical HPV-DNA, and in analyses restricted to women who tested positive, there was a significantly increased risk in current compared to never smokers for squamous cell carcinoma (RR = 1.95 (1.43-2.65)), but not for adenocarcinoma (RR = 1.06 (0.14-7.96)). In summary, smokers are at an increased risk of squamous cell but not of adenocarcinoma of the cervix. The risk of squamous cell carcinoma increases in current smokers with the number of cigarettes smoked per day and with younger age at starting smoking.     

Body size in different periods of life, diabetes mellitus, hypertension, and risk of postmenopausal endometrial cancer (Sweden)

Objective: To measure the association between endometrial cancer risk and obesity at age 18 and recently, adult weight gain, diabetes mellitus and hypertension. Methods: We performed a population-based, nationwide case–control study among postmenopausal women aged 50–74 years in Sweden, including 709 incident cases with histopathologically verified endometrial cancer and 3368 controls. Results: Compared to lean women (recent body mass index (BMI), i.e. kg/m² below 22.5), overweight women (recent BMI 28–29.99) had a 50% increase in risk for endometrial cancer (OR 1.5, 95% CI 1.0–2.1). Obese women (recent BMI 30–33.99) had a 3-fold increased risk (OR 2.9, 95% CI 2.0–4.0), and markedly obese women (recent BMI 34) a 6-fold increased risk (OR 6.3, 95% CI 4.2–9.5). The OR for Type 2 diabetes mellitus was 1.5 (95% CI 1.0–2.1) and for Type 1 diabetes mellitus it was 13.3 (3.1–56.4). The effect of recent BMI was similar for tumors having different degrees of differentiation and myometrial invasion, and did not vary with age, time since menopause, smoking status, diabetes mellitus, and use of contraceptives. Hypertension increased risk only among obese women. BMI at age 18, height, and adult weight change were not independent risk factors. Conclusions: Recent overweight/obesity and diabetes mellitus (Types 1 and 2) are associated with endometrial cancer risk. Hypertension increases risk among obese women.     

Body Mass Index,Body Height,and Subsequent Risk of Colorectal Cancer in Middle-Aged and Elderly Japanese Men and Women: Japan Public Health Center-Based Prospective Study

Objective To investigate the association of body mass index (BMI) or body height with colorectal cancer incidence in a population-based prospective study.Methods We identified 986 (626 men and 360 women) newly diagnosed cases of colorectal cancer during the 9.4-year follow-up of a cohort consisting of 102,949 (49,158 male and 53,791 female) middle-aged and elderly Japanese.Results Lower BMI groups (lower than 23) were not associated with colorectal cancer compared with the 23–24.9 BMI group. Any categories of 25–26.9, 27–29.9, or 30 or more BMI were associated with an increased risk of colorectal cancer compared with the lower than 25 BMI (RR, 1.2 for 25–26.9, 1.4 for 27–29.9, and 1.5 for 30 or more; p for trend, 0.004) in men. These associations were more evident only in invasive-type cancer analysis. BMI was not associated with the risk of colorectal cancer in women. No significant association with height was obtained for either men or women.Conclusions The association of BMI with colorectal cancer was confirmed in a Japanese population as well as Western populations. Only invasive-cancer analysis suggested that BMI was important for tumor growth and proliferation. Approximately 6.7% of colorectal cancer was attributable to a BMI of 25 or higher in middle-aged and elderly Japanese men.     

Histologic type of lung cancer and asbestos exposure

The histologic types of lung cancer in 855 patients (747 men and 107 women) from three hospitals and one international study of insulation workers were evaluated. Of these, 196 cases had asbestos exposure. About one half of the cases were diagnosed from surgical slides and one half from autopsy slides. Squamous cell carcinoma constituted the largest percentage of tumor types and was found with the same frequency in exposed and nonexposed groups. Small cell carcinoma was found in 25% of the exposed and in 15% of the nonexposed patients. Upper lung sites were involved in about two thirds of the cases with asbestos exposure and lower lobes in the other one third. There was little difference in histologic type in cases regardless of whether upper or lower lobes were involved. Cigarette smokers who smoked until their cancer diagnosis showed no difference in histologic type by amount smoked, and slight but not statistically significant differences from ex-cigarette smokers.