Increased Risk of Young-Onset Pancreatic Cancer Among Adults Aged 20-39 Years with Overweight or Obesity, but Not Underweight: A Nationwide Cohort Study
Menée auprès de 6 315 055 adultes âgés de 20 à 39 ans (durée de suivi : 59 159 572 personnes-années), cette étude analyse l'association entre la catégorie de l'indice de masse corporelle et le risque de survenue précoce d'un cancer du pancréas (1 533 cas)
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, 1,533 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.
European Journal of Cancer , résumé, 2025