title: Incident cancer burden attributable to excess body mass index in 30 European countries.
abstract: Excess adiposity is associated with increased risks of developing adult malignancies. To inform public health policy and guide further research, the incident cancer burden attributable to excess body mass index (BMI >or= 25 kg/m(2)) across 30 European countries were estimated. Population attributable risks (PARs) were calculated using European- and gender-specific risk estimates from a published meta-analysis and gender-specific mean BMI estimates from a World Health Organization Global Infobase. Country-specific numbers of new cancers were derived from Globocan2002. A ten-year lag-period between risk exposure and cancer incidence was assumed and 95% confidence intervals (CI) were estimated in Monte Carlo simulations. In 2002, there were 2,171,351 new all cancer diagnoses in the 30 countries of Europe. Estimated PARs were 2.5% (95% CI 1.5-3.6%) in men and 4.1% (2.3-5.9%) in women. These collectively corresponded to 70,288 (95% CI 40,069-100,668) new cases. Sensitivity analyses revealed estimates were most influenced by the assumed shape of the BMI distribution in the population and cancer-specific risk estimates. In a scenario analysis of a plausible contemporary (2008) population, the estimated PARs increased to 3.2% (2.1-4.3%) and 8.6% (5.6-11.5%), respectively, in men and women. Endometrial, post-menopausal breast and colorectal cancers accounted for 65% of these cancers. This analysis quantifies the burden of incident cancers attributable to excess BMI in Europe. The estimates reported here provide a baseline for future modelling, and underline the need for research into interventions to control weight in the context of endometrial, breast and colorectal cancer.
authors: Department of Surgery, School of Cancer, Enabling Sciences and Technology, University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom. arenehan@picr.man.ac.uk
authors: Andrew G
authors: AG
authors: Renehan
authors: Isabelle
authors: I
authors: Soerjomataram
authors: Margaret
authors: M
authors: Tyson
authors: Matthias
authors: M
authors: Egger
authors: Marcel
authors: M
authors: Zwahlen
authors: Jan Willem
authors: JW
authors: Coebergh
authors: Iain
authors: I
authors: Buchan
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015984:Causality; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015201:Meta-Analysis as Topic; D009010:Monte Carlo Method; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D050177:Overweight / Q000150:complications / Q000453:epidemiology*; D012306:Risk