Oleh admin kalbemed pada January 31, 2018 06:00

Obesitas dan Kelebihan Berat Badan, Meningkatkan Risiko Kanker

Obesitas bukanlah suatu hal baru, terlebih di Amerika Serikat di tahun 2013-2014 kurang lebih sepertiga orang dewasa mengalami kelebihan berat badan dengan IMT 25,0-29,0 kg/m2 dan sepertiga lainnya mengalami obesitas dengan IMT ≥30 kg/m2. Setengah dari total populasi belum menyadari bahwa kelebihan berat badan dan obesitas dapat meningkatkan risiko kanker.

International Agency for Research ion Cancer (IARC) menyebutkan terdapat bukti yang cukup untuk sebuah hubungan antara kelebihan lemak tubuh termasuk kelebihan berat badan, obesitas, dan kenaikan berat badan- dengan setidaknya 13 jenis kanker. Kanker-kanker ini termasuk adenokarsinoma esofagus, kanker payudara (pada wanita pasca menopause), kanker kolon dan rektum, endometrium, kandung empedu, kardia gaster, ginjal (sel renal), hati, ovarium, pankreas dan tiroid; meningioma, dan mieloma multipel.

Kelebihan berat badan dan obesitas dapat meningkatkan risiko kanker melalui induksi dari abnormalitas metabolik dan endokrin, termasuk peningkatan dari inflamasi dan kadar insulin, insulin-like growth factor, dan hormon seks.

Dalam sebuah studi di tahun 2014, sebanyak 631.604 pasien di Amerika Serikat terdiagnosis mengalami kanker terkait kelebihan berat badan dan obesitas. Hal ini menjelaskan sekitar 40% dari 1,6 juta kanker yang terdiagnosis tiap tahunnya merupakan kanker terkait kelebihan berat badan dan obesitas (55% dari seluruh kanker pada pasien wanita; dan 24% dari pasien pria). Dari studi ini juga terlihat bahwa kanker terkait kelebihan berat badan dan obesitas insidensnya lebih banyak terjadi di wanita (218,1 tiap 100.000 populasi) dibandingkan dengan pria (115,0 tiap 100.000 populasi), sebagian karena kanker endometrium, ovarium, dan kanker payudara pada wanita pasca menopause sebanyak 42%.

Selain dari jenis kelamin, ras juga ditemukan mengalami perbedaan yang cukup bermakna. Angka insidens lebih tinggi terjadi diantara kulit hitam non-Hispanic dan kulit putih non-Hispanic dibandingkan dengan kelompok ras lainnya; meski demikian, pria kulit hitam dan Indian Amerika/ suku asli Alaska memiliki angka insidens yang lebih tinggi dibandingkan pria kulit putih.

Selain itu, ditemukan juga bukti konsisten terkait obesitas, dimana wanita yang kelebihan berat badan atau mengalami obesitas memiliki kecenderungan 4x lebih besar untuk mengalami kanker endometrium dibandingkan dengan wanita sehat.

Hal serupa dari sebuah studi lain di sebuah jurnal bedah, dimana pasien-pasien yang menjalani operasi bariatrik mengalami 33% penurunan risiko dari perkembangan kanker. Operasi bariatrik sendiri merupakan upaya operasi untuk menurunkan berat badan dan memperbaiki metabolisme pada pasien yang mengalami kelebihan berat badan ataupun obesitas. Dari studi ini, turut mendukung temuan bahwa kelebihan berat badan dan obesitas dapat meningkatkan risiko terjadinya kanker.

Terkait hal ini, perlu diingat bahwa tidak semua kanker bersumber dari kelebihan berat badan dan obesitas, namun bila faktor ini tidak dicegah tidak menutup kemungkinan penderita kanker akan semakin terus meningkat karena munculnya kanker terkait kelebihan berat badan dan obesitas yang semakin tinggi. Pemberi layanan kesehatan diharapkan mendukung pasien untuk mengelola berat badan yang ideal dan sehat.

Image: Ilustrasi
Referensi:
1. Steele CB, Thomas CC, Henley J, Massetti Gm, Galuska DA, Agurs-Collins T, et al. Trends in Incidence of Cancers Associated With Overweight and Obesity – United States, 2005-2014. Morbidity and Mortality Weekly Report. 2017;66(39):1052-58.
2.Schawer Dp, Feigelson HS, Koebnick C, Caan B, Weinmann S, Leonard AC, et al. Bariatric Surgery and the Risk of Cancer in a Large Multisite Cohort. Ann Surg. 2017 doi: 10.1097@sla.0000000000002525.

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