This cohort study followed 6,313,338 Korean adults aged 20 to 39 without prior cancer. Participants came from the national health screening programme in the Korean National Health Insurance Service database, 2009 to 2021. BMI was grouped by Asian-specific criteria, and 151,893 cancers occurred over a mean follow-up of 11.2 years. Ten-year cumulative incidence was 1.84% at normal weight, 2.24% in class I obesity and 2.62% in class II obesity. Class I obesity with abdominal obesity had an incidence of 2.45%, above class II obesity without abdominal obesity at 2.20%. Participants were screening attenders rather than a representative sample, and confounding by smoking burden could not be excluded.
Why it is interesting: The study reports absolute as well as relative risks, drawn from over six million young adults. Waist circumference added information beyond BMI, and obesity was not linked to breast cancer diagnosed by age 50.
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