title: Body Mass Index and Cancer Mortality Among Korean Older Middle-Aged Men: A Prospective Cohort Study.
abstract: The association of body mass index (BMI; kg/m) with overall and site-specific cancer mortality in Asians is not well understood. A total of 113,478 men from the Korean Veterans Health Study who returned a postal survey in 2004 were followed up until 2010. The adjusted hazard ratios (HRs) of cancer mortality were calculated using a Cox model. During 6.4 years of follow-up, 3478 men died from cancer. A reverse J-curve association with a nadir at 25.0 to 27.4 kg/m was observed. Below 25 kg/m, the HRs of death for each 5 kg/m decrease in BMI were 1.72 (95% confidence interval = 1.57-1.90) for overall cancer; 3.63 (2.57-5.12) for upper aerodigestive tract (UADT) cancers, including oral cavity and larynx [HR = 4.21 (2.18-8.12)] and esophagus [HR = 2.96 (1.82-4.81)] cancers; 1.52 (1.35-1.71) for non-UADT and non-lung cancers, including stomach [HR = 2.72 (2.13-3.48)] and large intestine [HR = 1.68 (1.20-2.36)] cancers; and 1.93 (1.59-2.34) for lung cancer. In the range of 25 to 47 kg/m, the HRs for each 5 kg/m increase in BMI were 1.27 (1.03-1.56) for overall cancer mortality and 1.57 (1.02-2.43) for lung cancer mortality. In individuals <25 kg/m, inverse associations with mortality from overall cancer and non-UADT and non-lung cancer were stronger in never-smokers than in current smokers. Both low and high BMI were strong predictors of mortality from overall and several site-specific cancers in Korean men. Further research is needed to evaluate whether interventions involving weight change (loss or gain) reduce the risk of cancer or improve the survival.
authors.affiliation: From the Department of Healthcare Management, Cheongju University College of Health Sciences, Cheongju (J-SH); Department of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine, Gangneung (S-WY); Institute for Clinical and Translational Research (S-WY), Institute for Occupational and Environmental Health, Catholic Kwandong University, Gangneung (J-JY); Department of Preventive Medicine, Graduate School of Public Health, Yonsei University, Seoul (SH); Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul (HO); and Department of Preventive Medicine, Yonsei University College of Medicine (HO), Seoul, Republic of Korea.
authors.forename: Jae-Seok
authors.initials: JS
authors.lastname: Hong
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Yi
authors.forename: Jee-Jeon
authors.initials: JJ
authors.lastname: Yi
authors.forename: Seri
authors.initials: S
authors.lastname: Hong
authors.forename: Heechoul
authors.initials: H
authors.lastname: Ohrr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D015444:Exercise; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*