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Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk: meta-analysis of individual participant data of seven prospective cohorts in Europe.
Br J Cancer 2017; 116(11):1486-1497BJ

Abstract

BACKGROUND

We evaluated the associations of anthropometric indicators of general obesity (body mass index, BMI), an established risk factor of various cancer, and body fat distribution (waist circumference, WC; hip circumference, HC; and waist-to-hip ratio, WHR), which may better reflect metabolic complications of obesity, with total obesity-related and site-specific (colorectal and postmenopausal breast) cancer incidence.

METHODS

This is a meta-analysis of seven prospective cohort studies participating in the CHANCES consortium including 18 668 men and 24 751 women with a mean age of 62 and 63 years, respectively. Harmonised individual participant data from all seven cohorts were analysed separately and alternatively for each anthropometric indicator using multivariable Cox proportional hazards models.

RESULTS

After a median follow-up period of 12 years, 1656 first-incident obesity-related cancers (defined as postmenopausal female breast, colorectum, lower oesophagus, cardia stomach, liver, gallbladder, pancreas, endometrium, ovary, and kidney) had occurred in men and women. In the meta-analysis of all studies, associations between indicators of adiposity, per s.d. increment, and risk for all obesity-related cancers combined yielded the following summary hazard ratios: 1.11 (95% CI 1.02-1.21) for BMI, 1.13 (95% CI 1.04-1.23) for WC, 1.09 (95% CI 0.98-1.21) for HC, and 1.15 (95% CI 1.00-1.32) for WHR. Increases in risk for colorectal cancer were 16%, 21%, 15%, and 20%, respectively per s.d. of BMI, WC, HC, and WHR. Effect modification by hormone therapy (HT) use was observed for postmenopausal breast cancer (Pinteraction<0.001), where never HT users showed an ∼20% increased risk per s.d. of BMI, WC, and HC compared to ever users.

CONCLUSIONS

BMI, WC, HC, and WHR show comparable positive associations with obesity-related cancers combined and with colorectal cancer in older adults. For postmenopausal breast cancer we report evidence for effect modification by HT use.

Authors+Show Affiliations

Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69008 Lyon, France.Section of Cancer Surveillance, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69008 Lyon, France.Section of Cancer Surveillance, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69008 Lyon, France.UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, University Road, Belfast BT7 1NN, UK.Network Aging Research (NAR), Heidelberg University, Bergheimer Straβe 20, 69115 Heidelberg, Germany. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany. Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford OX2 6GG, UK.Hellenic Health Foundation, 13 Kaisareias &Alexandroupoleos, Athens 115 27, Greece. WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Athens 115 27, Greece.Department Agrotechnology and Food Sciences, Division of Human Nutrition, Wageningen University, PO Box 17, 6700AA Wageningen, The Netherlands.Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauβ-Allee 11, 93053 Regensburg, Germany.Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69008 Lyon, France.UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, University Road, Belfast BT7 1NN, UK.Hellenic Health Foundation, 13 Kaisareias &Alexandroupoleos, Athens 115 27, Greece. Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110 Ioannina, Greece. Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.Danish Cancer Society Research Center, Strandboulevarden 49, DK 2100 Copenhagen Ø Denmark.Hellenic Health Foundation, 13 Kaisareias &Alexandroupoleos, Athens 115 27, Greece. WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Athens 115 27, Greece.Hellenic Health Foundation, 13 Kaisareias &Alexandroupoleos, Athens 115 27, Greece. Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029-5674, USA.Hellenic Health Foundation, 13 Kaisareias &Alexandroupoleos, Athens 115 27, Greece. WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Athens 115 27, Greece.Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, South Kensington Campus, London SW7 2AZ, UK. Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands. Department of Social &Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain.Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany. Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany. German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway.Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69008 Lyon, France.

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis

Language

eng

PubMed ID

28441380

Citation

Freisling, Heinz, et al. "Comparison of General Obesity and Measures of Body Fat Distribution in Older Adults in Relation to Cancer Risk: Meta-analysis of Individual Participant Data of Seven Prospective Cohorts in Europe." British Journal of Cancer, vol. 116, no. 11, 2017, pp. 1486-1497.
Freisling H, Arnold M, Soerjomataram I, et al. Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk: meta-analysis of individual participant data of seven prospective cohorts in Europe. Br J Cancer. 2017;116(11):1486-1497.
Freisling, H., Arnold, M., Soerjomataram, I., O'Doherty, M. G., Ordóñez-Mena, J. M., Bamia, C., ... Jenab, M. (2017). Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk: meta-analysis of individual participant data of seven prospective cohorts in Europe. British Journal of Cancer, 116(11), pp. 1486-1497. doi:10.1038/bjc.2017.106.
Freisling H, et al. Comparison of General Obesity and Measures of Body Fat Distribution in Older Adults in Relation to Cancer Risk: Meta-analysis of Individual Participant Data of Seven Prospective Cohorts in Europe. Br J Cancer. 2017 May 23;116(11):1486-1497. PubMed PMID: 28441380.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk: meta-analysis of individual participant data of seven prospective cohorts in Europe. AU - Freisling,Heinz, AU - Arnold,Melina, AU - Soerjomataram,Isabelle, AU - O'Doherty,Mark George, AU - Ordóñez-Mena,José Manuel, AU - Bamia,Christina, AU - Kampman,Ellen, AU - Leitzmann,Michael, AU - Romieu,Isabelle, AU - Kee,Frank, AU - Tsilidis,Konstantinos, AU - Tjønneland,Anne, AU - Trichopoulou,Antonia, AU - Boffetta,Paolo, AU - Benetou,Vassiliki, AU - Bueno-de-Mesquita,H B As, AU - Huerta,José María, AU - Brenner,Hermann, AU - Wilsgaard,Tom, AU - Jenab,Mazda, Y1 - 2017/04/25/ PY - 2016/11/12/received PY - 2017/03/03/revised PY - 2017/03/27/accepted PY - 2017/4/26/pubmed PY - 2017/8/16/medline PY - 2017/4/26/entrez SP - 1486 EP - 1497 JF - British journal of cancer JO - Br. J. Cancer VL - 116 IS - 11 N2 - BACKGROUND: We evaluated the associations of anthropometric indicators of general obesity (body mass index, BMI), an established risk factor of various cancer, and body fat distribution (waist circumference, WC; hip circumference, HC; and waist-to-hip ratio, WHR), which may better reflect metabolic complications of obesity, with total obesity-related and site-specific (colorectal and postmenopausal breast) cancer incidence. METHODS: This is a meta-analysis of seven prospective cohort studies participating in the CHANCES consortium including 18 668 men and 24 751 women with a mean age of 62 and 63 years, respectively. Harmonised individual participant data from all seven cohorts were analysed separately and alternatively for each anthropometric indicator using multivariable Cox proportional hazards models. RESULTS: After a median follow-up period of 12 years, 1656 first-incident obesity-related cancers (defined as postmenopausal female breast, colorectum, lower oesophagus, cardia stomach, liver, gallbladder, pancreas, endometrium, ovary, and kidney) had occurred in men and women. In the meta-analysis of all studies, associations between indicators of adiposity, per s.d. increment, and risk for all obesity-related cancers combined yielded the following summary hazard ratios: 1.11 (95% CI 1.02-1.21) for BMI, 1.13 (95% CI 1.04-1.23) for WC, 1.09 (95% CI 0.98-1.21) for HC, and 1.15 (95% CI 1.00-1.32) for WHR. Increases in risk for colorectal cancer were 16%, 21%, 15%, and 20%, respectively per s.d. of BMI, WC, HC, and WHR. Effect modification by hormone therapy (HT) use was observed for postmenopausal breast cancer (Pinteraction<0.001), where never HT users showed an ∼20% increased risk per s.d. of BMI, WC, and HC compared to ever users. CONCLUSIONS: BMI, WC, HC, and WHR show comparable positive associations with obesity-related cancers combined and with colorectal cancer in older adults. For postmenopausal breast cancer we report evidence for effect modification by HT use. SN - 1532-1827 UR - https://www.unboundmedicine.com/medline/citation/28441380/Comparison_of_general_obesity_and_measures_of_body_fat_distribution_in_older_adults_in_relation_to_cancer_risk:_meta_analysis_of_individual_participant_data_of_seven_prospective_cohorts_in_Europe_ L2 - http://dx.doi.org/10.1038/bjc.2017.106 DB - PRIME DP - Unbound Medicine ER -