Epidemiological Evidence

The epidemiological evidence comes from a number of types of study. There have been large-scale population studies that have investigated the relationship between overweight and cancer at a range of sites. In addition, there have been studies of various types (cohort, case-control etc.) into the role of over weight in cancer at specific sites. Many of these studies are far from being unambiguous. Body wasting is a common symptom of cancer at many sites, particularly the lung, pancreas and the stomach. Loss of appetite and consequent loss of weight is a common response to the fear of cancer. By the time that a patient seeks medical advice and is diagnosed with cancer, underweight is a common feature. In consequence it is necessary to know the weight before the onset of symptoms. If the patient has been in regular contact with their general practitioner then the height and weight is likely be on the patient records. If not, then it would be necessary to use recall data, which are notoriously unreliable. For this reason, prospective studies of cohorts always give much more reliable information than can be obtained by using the case-control approach.

Large Population Studies

One of the early population cohort studies of note was the American Cancer Society 'One Million Study', in which the risk of cancer in relation to body weight was studied prospectively. This study showed (1) that there was an association between overweight and cancer of the colon, pancreas, stomach, kidney, gallbladder and prostate for men

International Textbook of Obesity. Edited by Per Bjorntorp. © 2001 John Wiley & Sons, Ltd.

Table 26.1 Relative risk of cancer at various sites in obese persons (BMI > 30 compared with 20-25) in three large cohort studies in the USA (1), Italy (3) and Denmark (4)

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