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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

Freisling H 1 , Arnold M 2 , Soerjomataram I 2 , O'Doherty MG 3 , Ordóñez-Mena JM 4 , Bamia C 5 Show all authors , Kampman E 6 , Leitzmann M 7 , Romieu I 1 , Kee F 3 , Tsilidis K 5 , Tjønneland A 8 , Trichopoulou A 5 , Boffetta P 5 , Benetou V 5 , Bueno-de-Mesquita HBA 9 , Huerta JM 10 , Brenner H 11 , Wilsgaard T 12 , Jenab M 1

Affiliations 

  • 1 Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69008 Lyon, France
  • 2 Section of Cancer Surveillance, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69008 Lyon, France
  • 3 UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, University Road, Belfast BT7 1NN, UK
  • 4 Network Aging Research (NAR), Heidelberg University, Bergheimer Straße 20, 69115 Heidelberg, Germany
  • 5 Hellenic Health Foundation, 13 Kaisareias &Alexandroupoleos, Athens 115 27, Greece
  • 6 Department Agrotechnology and Food Sciences, Division of Human Nutrition, Wageningen University, PO Box 17, 6700AA Wageningen, The Netherlands
  • 7 Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
  • 8 Danish Cancer Society Research Center, Strandboulevarden 49, DK 2100 Copenhagen Ø Denmark
  • 9 Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
  • 10 Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain
  • 11 Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
  • 12 Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
Br J Cancer, 2017 May 23;116(11):1486-1497.
PMID: 28441380 DOI: 10.1038/bjc.2017.106

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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