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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Impact of Smoking and Excess Body Weight on Overall and Site-Specific Cancer Mortality Risk

Julia Meyer, Sabine Rohrmann, Matthias Bopp and David Faeh
Julia Meyer
Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
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Sabine Rohrmann
Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
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Matthias Bopp
Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
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David Faeh
Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
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  • For correspondence: david.faeh@uzh.ch
DOI: 10.1158/1055-9965.EPI-15-0415 Published October 2015
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Abstract

Background: Smoking and excess body weight are major preventable risk factors for premature death. This study aimed at analyzing their single and combined association with site-specific cancer mortality.

Methods: Our study population comprised 35,784 men and women of ages 14 to 99 years, who participated in population-based health surveys conducted 1977–1993 in Switzerland and were followed up for mortality until 2008. Multivariable Cox proportional hazards models were calculated for different cancer sites, and population attributable fractions were derived.

Results: The hazard ratio of dying from cancer (all sites) was 2.32 (95% confidence interval, 2.04–2.63) for heavy smokers (vs. never smokers) and 1.15 (1.01–1.32) for obese [body mass index (BMI) ≥ 30 kg/m2] vs. normal weight individuals. Heavy smoking (≥20 cigarettes/day) was associated with increased mortality due to cancer of the lung, upper aero-digestive tract, pancreas, bladder, liver, and the total of remaining sites. Obesity was associated with higher risk of dying from cancer of the liver and the female genital tract (essentially corpus or cervix uteri and ovary). More than 20% of all cancer deaths in our population were attributable to ever smoking and overweight (BMI ≥ 25 kg/m2).

Conclusions: Smoking was a much stronger risk factor for cancer than excess body weight. For lung, liver, and pancreatic cancer, the combination of excess body weight and smoking lead to cumulated higher risks.

Impact: Our findings support recommendations for obese persons to quit smoking despite potential postcessation weight gain. Cancer Epidemiol Biomarkers Prev; 24(10); 1516–22. ©2015 AACR.

This article is featured in Highlights of This Issue, p. 1435

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Received April 22, 2015.
  • Revision received July 8, 2015.
  • Accepted July 22, 2015.
  • ©2015 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 24 (10)
October 2015
Volume 24, Issue 10
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Impact of Smoking and Excess Body Weight on Overall and Site-Specific Cancer Mortality Risk
Julia Meyer, Sabine Rohrmann, Matthias Bopp and David Faeh for the Swiss National Cohort Study Group
Cancer Epidemiol Biomarkers Prev October 1 2015 (24) (10) 1516-1522; DOI: 10.1158/1055-9965.EPI-15-0415

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Impact of Smoking and Excess Body Weight on Overall and Site-Specific Cancer Mortality Risk
Julia Meyer, Sabine Rohrmann, Matthias Bopp and David Faeh for the Swiss National Cohort Study Group
Cancer Epidemiol Biomarkers Prev October 1 2015 (24) (10) 1516-1522; DOI: 10.1158/1055-9965.EPI-15-0415
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