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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2021.130    [Accepted]
Association Between the Persistence of Obesity and the Risk of Gastric Cancer: A Nationwide Population-Based Study
Joo Hyun Lim1, Cheol Min Shin2, Kyung-Do Han3, Seung Woo Lee4, Eun Hyo Jin1, Yoon Jin Choi5, Hyuk Yoon2, Young Soo Park2, Nayoung Kim2, Dong Ho Lee2
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
Correspondence  Cheol Min Shin ,Tel: 82-31-787-7057, Fax: 82-31-787-4052, Email: scm6md@gmail.com
Kyung-Do Han ,Tel: 82-2-820-7025, Fax: 82-2-823-1746, Email: hkd917@naver.com
Received: January 26, 2021;  Accepted: April 30, 2021.  Published online: May 4, 2021.
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 five years (never-obesity group) and those with obesity diagnosis during the five 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), 1.117-1.284), followed by non-persistent obesity group (IR, 0.83/1,000 person-years; HR, 1.113; 95% CI, 1.056-1.172) 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 1.094-1.538; persistent obesity: HR 1.351, 95% CI 1.076-1.698).
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.
Key words: Obesity, Stomach neoplasms, Dose-response relationship
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