ScholarWorks@성균관대학교

초록

Background and aims The incidence of young-onset pancreatic cancer is rapidly increasing worldwide. However, the association between body mass index (BMI), particularly overweight and mild obesity, and the risk of young-onset pancreatic cancer remains poorly defined. This study aimed to investigate the dose–response relationship between BMI and the risk of young-onset pancreatic cancer. Methods This nationwide cohort study included 6,315,055 adults aged 20–39 years who underwent national health screenings between 2009 and 2012. BMI categories were defined according to World Health Organization Asia-Pacific guidelines. Participants were followed until December 2020. Multivariable-adjusted Cox proportional hazards models estimated pancreatic cancer risk. Results During 59,159,572 person-years of follow-up, 1533 incident pancreatic cancer cases were identified. Compared with individuals with normal weight status, individuals with overweight or class I obesity had a significantly higher risk of pancreatic cancer (adjusted hazard ratio [aHR], 1.389; 95 % CI, 1.210–1.595 and aHR, 1.388; 95 % CI, 1.213–1.588, respectively). Individuals with class II obesity had the highest risk (aHR, 1.958; 95 % CI, 1.585–2.421), whereas underweight individuals had no significantly increased risk (aHR, 1.068; 95 % CI, 0.840–1.360).These associations did not differ significantly across subgroups defined by age, sex, smoking status, alcohol intake, physical activity, or diabetes (all P > 0.05 for interaction). Conclusions Overweight and class I obesity during early adulthood may serve as previously underrecognized yet modifiable risk factors for young-onset pancreatic cancer. Proactive weight-control interventions among young adults, starting from overweight status, may help reduce the increasing burden of pancreatic cancer in younger populations.

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