Cancer Res Treat.  2022 Jan;54(1):199-207. 10.4143/crt.2021.130.

Association between the Persistence of Obesity and the Risk of Gastric Cancer: A Nationwide Population-Based Study

Affiliations
  • 1Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
  • 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 3Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
  • 4College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 5Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

Abstract

Purpose
There remains controversy about relationship between obesity and gastric cancer. We aimed to examine the association using obesity-persistence.
Materials and Methods
We analyzed a nationwide population-based cohort which underwent health check-up between 2009 and 2012. Among them, those who had annual examinations during the last 5 years were selected. Gastric cancer risk was compared between those without obesity during the 5 years (never-obesity group) and those with obesity diagnosis during the 5 years (non-persistent obesity group; persistent obesity group).
Results
Among 2,757,017 individuals, 13,441 developed gastric cancer after median 6.78 years of follow-up. Gastric cancer risk was the highest in persistent obesity group (incidence rate [IR], 0.89/1,000 person-years; hazard ratio [HR], 1.197; 95% confidence interval [CI], 1.117 to 1.284), followed by non-persistent obesity group (IR, 0.83/1,000 person-years; HR, 1.113; 95% CI, 1.056 to 1.172) compared with never-obesity group. In subgroup analysis, this positive relationship was true among those < 65 years old and male. Among heavy-drinkers, the impact of obesity-persistence on the gastric cancer risk far increased (non-persistent obesity: HR, 1.297; 95% CI, 1.094 to 1.538; persistent obesity: HR, 1.351; 95% CI, 1.076 to 1.698).
Conclusion
Obesity-persistence is associated with increased risk of gastric cancer in a dose-response manner, especially among male < 65 years old. The risk raising effect was much stronger among heavy-drinkers.

Keyword

Obesity; Stomach neoplasms; Dose-response relationship

Figure

  • Fig. 1 Study flow chart showing patient enrollment. BMI, body mass index; NHIC, National Health Insurance Corporation.

  • Fig. 2 Kaplan-Meier curves depicting the incidence probability for gastric cancer in never-obesity, non-persistent obesity and persistent obesity group.

  • Fig. 3 The impact of obesity-persistence on the risk of gastric cancer in different subgroups. Forest plots of hazard ratios (HRs; middle markings on the bars) and 95% confidence intervals (CI; error bars) under adjustment with age, sex, diabetes, dyslipidemia, hypertension, alcohol consumption (none, < 30 g/day vs. ≥ 30 g/day), regular exercise, and smoking (never, former vs. current) were illustrated. The vertical dotted lines mean hazard ratio 1.


Reference

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