Abstract
BackgroundChanges in lifestyle including obesity epidemic and reduced physical activity influenced greatly to increase the cancer burden in Korea. The purpose of the current study was to perform a systematic assessment of cancers attributable to obesity and physical inactivity in Korea.Methodology/Principal FindingsGender- and cancer site-specific population-attributable fractions (PAF) were estimated using the prevalence of overweight and obesity in 1992–1995 from a large-scale prospective cohort study, the prevalence of low physical activity in 1989 from a Korean National Health Examination Survey, and pooled relative risk estimates from Korean epidemiological studies. The overall PAF was then estimated using 2009 national cancer incidence data from the Korea Central Cancer Registry.Excess body weight was responsible for 1,444 (1.5%) and 2,004 (2.2%) cancer cases among men and women, respectively, in 2009 in Korea. Among men, 6.8% of colorectal, 2.9% of pancreatic, and 16.0% of kidney cancer was attributable to excess body weight. In women, 6.6% of colorectal, 3.9% of pancreatic, 18.7% of kidney, 8.2% of postmenopausal breast, and 32.7% of endometrial cancer was attributable to excess body weight. Low leisure-time physical activity accounted for 8.8% of breast cancer, whereas the PAF for overall cancer was low (0.1% in men, 1.4% in women). Projections suggest that cancers attributable to obesity will increase by 40% in men and 16% in women by 2020.Conclusions/SignificanceWith a significantly increasing overweight and physically inactive population, and increasing incidence of breast and colorectal cancers, Korea faces a large cancer burden attributable to these risk factors. Had the obese population of Korea remained stable, a large portion of obesity-related cancers could have been avoided. Efficient cancer prevention programs that aim to reduce obesity- and physical inactivity-related health problems are essential in Korea.
Highlights
Over the past several decades, industrialization and urbanization has led to major lifestyle changes in developed and developing countries
Because we found no reported examination of the association between colorectal cancer and physical activity in Korean women, we used the estimated risk value obtained from men
Compared with light to moderateleisure-time physical activity, low physical activity increased the risk of breast cancer by 10%, but was not associated with colorectal cancer
Summary
Over the past several decades, industrialization and urbanization has led to major lifestyle changes in developed and developing countries. These changes have resulted in steadily increasing overweight and obese populations, creating significant clinical and public health burdens worldwide. Associations between obesity and cancers of the prostate, stomach, and premenopausal breast have not yet been established [3,4]; lung cancer and esophageal squamous cell carcinoma have been suggested to have an inverse relationship with excess body weight, but conclusive evidence is currently lacking [5]. Changes in lifestyle including obesity epidemic and reduced physical activity influenced greatly to increase the cancer burden in Korea.
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