Diabetes and adiposity: a heavy load for cancer
A partir des données Globocan portant sur 175 pays, cette étude analyse, pour l'année 2012, la part des cancers attribuable à un diabète ou à un indice de masse corporelle élévé (5,6 % des cancers en 2012, 12 types différents, 792 600 nouveaux cas)
Cancer is the second leading cause of death from non-communicable diseases in the world.1 In 2015, there were 17·5 million new cases of cancer and 8·7 million cancer-related deaths, with 208·3 million disability-adjusted life-years.2 Cancer incidence is expected to continue to increase, partly due to changes in the prevalence of risk factors such as obesity, diabetes, and other lifestyle factors. Obesity, defined as body-mass index (BMI) of 30 kg/m2 or more, has become increasingly common in all age groups and every country over the past few decades, irrespective of the country's sociodemographic status or region.3 Many countries have experienced a rapid change in their populations' BMIs from underweight to overweight and obesity, which has coincided with an increase in the prevalence of diabetes.4 In 2016, 125 million children and adolescents aged 5–19 years were obese and an additional 213 million were overweight worldwide, while among adults, 671 million were obese and 1·3 billion were overweight.3
A sizeable body of evidence supports causal links between obesity and diabetes and many types of cancer, suggesting that many cancer cases might be due to obesity and diabetes. On this basis, Jonathan Pearson-Stuttard and colleagues assessed the impact of the prevalence of high BMI—overweight and obese defined as a BMI greater than or equal to 25 kg/m2—and diabetes on the number of new cancer cases 2012, assuming a 10-year lag for cancer development.5 Overall, 5·6% of all cancer in 2012 was attributable to high BMI and diabetes in 2002. When the estimation was restricted to 12 obesity-related cancers and six diabetes-related cancers, 15·0% of cancer cases in men and 13·3% of cases in women were due to the combined effect of high BMI and diabetes. However, there was substantial variation in a proportion of cancer due to high BMI and diabetes by cancer sites—for example, 23·3% of liver cancer, 18·0% of pancreatic cancer, and 8·6% of colorectal cancer cases in men were attributable to the combined effect of high BMI and diabetes. Pearson-Stuttard and colleagues suggest that 26·1% of diabetes-related cancers and 31·9% of cancers related to high BMI in 2012 were due to increases in the prevalence of these risk factors from 1980 to 2002. The burden of cancer due to diabetes and high BMI is projected to continue to increase in the future: in 2035, more than a third of liver cancer cases in men and half of endometrial cancer cases in women will be attributable to a combination of diabetes and high BMI. (...)
The Lancet Diabetes & Endocrinology , commentaire en libre accès, 2016