Association between body mass index and the risk of young-onset pancreatic cancer among young adults aged 20-39 years

초록

Object: Although the incidence of young-onset pancreatic cancer is rapidly increasing, the association between underweight or obesity and the risk of young-onset pancreatic cancer remains unclear. We aimed to investigate the dose-response association between body mass index and the risk of young-onset pancreatic cancer. Methods: This nationwide cohort study included 6,315,527 individuals aged 20-39 years who underwent national health screening under the Korean National Health Insurance Service between 2009 and 2012. The participants were followed up until December 2020 for the development of young-onset pancreatic cancer. Multivariable-adjusted Cox proportional hazards regression models were conducted to estimate the risk. Results: The risk of young-onset pancreatic cancer increases progressively with rising body mass index (BMI) (P for trend < 0.05). Compared to individuals with normal body weight (BMI 18.5-22.9 kg/m2), those who are overweight (BMI 23.0-24.9 kg/m2) or obese (BMI 25.0-29.9 kg/m2) had an elevated risk of young-onset pancreatic cancer (adjusted hazard ratio [aHR], 95% CI: 1.389, 1.210-1.595 and 1.388, 1.213-1.588, respectively). Young adults with severe obesity (BMI ≥30 kg/m2) exhibit the highest risk of young-onset pancreatic cancer (aHR, 95% CI: 1.958, 1.585, 2.421). Individuals who are underweight did not exhibit an increased risk of young-onset pancreatic cancer compared to those with normal body weight (aHR, 95% CI: 1.068, 0.840, 1.360). Conclusions: Both obesity and overweight, but not underweight, were associated with an increased risk of young-onset pancreatic cancer. Severe obesity was linked to the highest risk of young-onset pancreatic cancer. Education and management of obesity in young individuals are essential to reducing the risk of young-onset pancreatic cancer among the next generation.