Background/Objectives:Perinatal exposure to malnutrition has been hypothesised to influence the development of young-onset cancer (≤50 years of age). This study aimed to determine if perinatal malnutrition in individuals exposed to the Great Famine of China increased their risk of developing young-onset cancer compared to other individuals born prior to the famine.Subjects/Methods:This cross-sectional study involved 7272 participants from the China Health and Nutrition Survey who were classified into four groups based on birth year: participants born between 1953 and 1955 (before the famine) were designated as the pre-famine group (unexposed); the remainder formed perinatal exposure groups comprised of those exposed during the famine (1959–1961), those exposed in the early post-famine period (1962–1964), and those exposed in the late post-famine period (1965–1967). Multivariable adjusted log-binomial regression models were used to calculate the RR and 95% CI of young-onset cancer (including genitourinary cancer) across four groups.Results:Perinatal exposure to early post-famine (RR 2.08; 95%CI 1.04, 4.34;p= 0.043) and the female sex (RR 15.6, 95%CI 4.54, 60.3;p< 0.001) were noted to have a significantly increased risk of young-onset cancer. In addition, the early (RR 13.8; 95%CI 2.68, 253;p= 0.012) and late post-famine (RR 12.3; 95%CI 2.16, 231;p= 0.020) cohorts demonstrated a significantly increased risk of young-onset genitourinary cancer. The latter was accompanied by an increased risk of hypertension (RR 3.30; 95%CI 1.28, 7.87;p= 0.009).Conclusions:Perinatal exposure to famine, especially in females, was associated with a higher risk of young-onset cancer. This was particularly evident for young-onset genitourinary cancers. These findings highlight the potential long-term impact of perinatal malnutrition on young-onset carcinogenesis.
背景/目的：围产期营养不良被认为可能影响早发性癌症（≤50岁）的发生发展。本研究旨在探讨中国大饥荒时期经历围产期营养不良的个体，与饥荒前出生人群相比，是否具有更高的早发性癌症风险。 对象/方法：本横断面研究纳入中国健康与营养调查的7272名参与者，按出生年份分为四组：1953-1955年出生者（饥荒前）设为未暴露组；其余构成围产期暴露组，包括饥荒期暴露组（1959-1961年出生）、饥荒后早期暴露组（1962-1964年出生）和饥荒后晚期暴露组（1965-1967年出生）。采用多变量调整对数二项回归模型计算四组间早发性癌症（含泌尿生殖系统癌症）的相对危险度（RR）及95%置信区间（CI）。 结果：围产期经历饥荒后早期暴露（RR 2.08；95%CI 1.04-4.34；p=0.043）及女性性别（RR 15.6；95%CI 4.54-60.3；p<0.001）与早发性癌症风险显著升高相关。此外，饥荒后早期暴露组（RR 13.8；95%CI 2.68-253；p=0.012）和晚期暴露组（RR 12.3；95%CI 2.16-231；p=0.020）的早发性泌尿生殖系统癌症风险显著增加，后者同时伴有高血压风险升高（RR 3.30；95%CI 1.28-7.87；p=0.009）。 结论：围产期经历饥荒暴露，特别是女性个体，与更高的早发性癌症风险相关，这在早发性泌尿生殖系统癌症中尤为显著。这些发现揭示了围产期营养不良对早发性癌症发生的潜在长期影响。
Perinatal Famine Exposure and Young-Onset Cancer—Lessons from China Health and Nutrition Survey
肿瘤(癌症)患者之家