肥胖更易致癌，而且不止一種

A review of more than a thousand studies has found solid evidence that being overweight or obese increases the risk for at least 13 types of cancer. The study was conducted by a working group of the International Agency for Research on Cancer, part of the World Health Organization.

一篇涵蓋了上千份研究的評(píng)論報(bào)告發(fā)現(xiàn)了確鑿證據(jù)：超重或肥胖會(huì)增加至少13種癌癥的患病風(fēng)險(xiǎn)。進(jìn)行這項(xiàng)研究的工作團(tuán)隊(duì)來(lái)自于隸屬世界衛(wèi)生組織(World Health Organization)的國(guó)際癌癥研究組織(International Agency for Research on Cancer)。

Strong evidence was already available to link five cancers to being overweight or obese: adenocarcinoma of the esophagus; colorectal cancer; breast cancer in postmenopausal women; and uterine and kidney cancers.

該團(tuán)隊(duì)已發(fā)現(xiàn)食道腺癌、結(jié)腸直腸癌、絕經(jīng)期乳腺癌、子宮癌及腎癌五種癌癥與超重或肥胖相關(guān)的有力證據(jù)。

This new review, published in The New England Journal of Medicine, links an additional eight cancers to excess fat: gastric cardia, a cancer of the part of the stomach closest to the esophagus; liver cancer; gallbladder cancer; pancreatic cancer; thyroid cancer; ovarian cancer; meningioma, a usually benign type of brain cancer; and multiple myeloma, a blood cancer.

這篇?jiǎng)倓偘l(fā)表在《新英格蘭醫(yī)學(xué)雜志》(New England Journal of Medicine)的評(píng)論還指出，另有八種癌癥也與人體積蓄過(guò)多脂肪有關(guān)，分別是賁門(mén)癌(在胃與食道連接處產(chǎn)生的癌癥)、肝癌、膀胱癌、胰臟癌、甲狀腺癌、卵巢癌、腦膜瘤(一種通常為良性的腦癌)，以及多發(fā)性骨髓癌(血癌的一種)。

According to the chairman of the working group, Dr. Graham Colditz, a professor of medicine and surgery at Washington University in St. Louis, these 13 cancers together account for 42 percent of all new cancer diagnoses.

該工作團(tuán)隊(duì)主席格雷厄姆?寇迪茲博士(Dr. Graham Colditz)是圣路易斯華盛頓大學(xué)(Washington University in St. Louis)的內(nèi)外全科教授，他表示，這13種癌癥加起來(lái)占了所有新發(fā)癌癥診斷的42%。

“Only smoking comes close” as an environmental factor affecting cancer risk, Dr. Colditz said. “And that’s an important message for nonsmokers. Obesity now goes to the top of the list of things to focus on.”

寇迪茲說(shuō)，作為會(huì)影響癌癥風(fēng)險(xiǎn)的環(huán)境因素，“只有抽煙能(與肥胖)相提并論。這對(duì)不抽煙的人來(lái)說(shuō)是重大警訊。如今肥胖問(wèn)題在所有注意事項(xiàng)里面排第一了。”

Obesity is associated with significant metabolic and hormone abnormalities, and with chronic inflammation, factors that may help explain its link to cancer.

肥胖與代謝及荷爾蒙顯著異常還與慢性炎癥相關(guān)，而這些因素或許能幫助解釋肥胖為何與癌癥有關(guān)。

Elizabeth A. Platz, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health and a widely published cancer researcher who was not involved in the report, said that this was a “high-caliber working group of respected epidemiologists and laboratory researchers,” and that women in particular should take note of the results.

伊莉莎白?A?普拉茲(Elizabeth A. Platz)是約翰·霍普金斯大學(xué)布隆博格公共衛(wèi)生學(xué)院(Johns Hopkins Bloomberg School of Public Health)的流行病學(xué)教授，也是發(fā)表了許多研究成果的癌癥專家，她沒(méi)有參與撰寫(xiě)這份評(píng)論，不過(guò)她表示這是一個(gè)“由備受敬重的流行病學(xué)家與實(shí)驗(yàn)室研究人員組成的高素質(zhì)工作團(tuán)隊(duì)”，女性尤其要注意該報(bào)告的結(jié)論。

“The strongest association they found,” she said, “is with uterine cancer. And postmenopausal breast cancer is also connected to obesity, especially estrogen receptor positive cancer. These are important messages that women need to hear.”

“他們發(fā)現(xiàn)有最強(qiáng)烈關(guān)聯(lián)的，”普拉茲說(shuō)，“是子宮癌。絕經(jīng)期乳腺癌也與肥胖有關(guān)，特別是雌激素受體檢驗(yàn)呈陽(yáng)性的癌癥。女性同胞要把這些重要訊息聽(tīng)進(jìn)去。”

Most of the studies the researchers looked at were observational so can’t prove cause and effect, though researchers considered evidence sufficient if an association could not be explained by chance, bias or other confounding factors. And most compared any increases in risk to that of an adult of normal weight having a body mass index of 18.5 to 24.9.

這些專家學(xué)者所檢視的大多都是觀察型研究，所以不能證明肥胖與這些癌癥有因果關(guān)系，不過(guò)他們認(rèn)為其間的相關(guān)性若沒(méi)有其他意外、偏差或混淆因素的話，證據(jù)已經(jīng)足夠。而大部分癌癥風(fēng)險(xiǎn)增加的情形，都是與體重正常、身體質(zhì)量指數(shù)(body mass index, BMI)介于18.5與24.9之間的成人比較出來(lái)的結(jié)果。

For some cancers, the group found that the fatter the person, the greater the risk. In endometrial cancer, for example, compared with a woman of normal weight, one with a B.M.I. of 25 to 25.9 was at a 50 percent higher relative risk. But her risk more than doubled at B.M.I.s between 30 and 34.9 and more than quadrupled at B.M.I.s of 35 to 39.9. A woman with a B.M.I. of 40 or more was at seven times the risk for endometrial cancer as a woman of normal weight.

該研究團(tuán)隊(duì)發(fā)現(xiàn)，人越胖，罹患某些癌癥的風(fēng)險(xiǎn)就越高。拿子宮內(nèi)膜癌來(lái)當(dāng)例子，與體重正常的女性相較，一個(gè)BMI指數(shù)介于25與25.9之間的女性罹患此種癌癥的相對(duì)風(fēng)險(xiǎn)提高了50%。當(dāng)她的BMI指數(shù)達(dá)30到34.9之間，罹病風(fēng)險(xiǎn)達(dá)兩倍;BMI指數(shù)介于35到39.9之間，風(fēng)險(xiǎn)則是4倍。一位BMI指數(shù)達(dá)到或超過(guò)40的女性，罹患此癥的風(fēng)險(xiǎn)是體重正常女性的7倍。

The group found only limited evidence that obesity could be linked to three additional types of cancer: male breast cancer; prostate cancer; and diffuse large B-cell lymphoma, the most common form of non-Hodgkin’s lymphoma.

至于肥胖與男性乳腺癌、前列腺癌、彌漫性大B細(xì)胞淋巴癌(最常見(jiàn)的一種非霍奇金氏淋巴癌)這另外三種癌癥的關(guān)聯(lián)，該團(tuán)隊(duì)僅找到有限證據(jù)。

They found no adequate evidence to link obesity with squamous-cell esophageal cancer, gastric noncardia cancer, cancer of the biliary tract, lung cancer, cutaneous melanoma, testicular cancer, urinary tract cancer, or glioma of the brain or spinal cord.

食道鱗狀細(xì)胞癌、非賁門(mén)型胃癌、膽道癌、肺癌、黑色素皮膚癌、睪丸癌、尿道癌、腦部或脊髓膠質(zhì)母細(xì)胞瘤這幾種癌癥，他們則沒(méi)有找到足夠證據(jù)支持其與肥胖有關(guān)。

Does losing weight reduce the risk? Although animal studies suggest that it does, Dr. Colditz said, “it’s hard to study in humans because so few people lose weight and keep it off. But the priority of avoiding weight gain is the first thing we need to address.”

減重是否可以降低風(fēng)險(xiǎn)?雖然動(dòng)物研究的結(jié)果顯示可以，但寇迪茲博士表示：“我們很難對(duì)人類進(jìn)行研究，因?yàn)闇p重又保持不復(fù)胖的人太少了。讓民眾把避免體重增加當(dāng)作要事來(lái)看待，是我們?cè)撟钕戎值摹?rdquo;