Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States - PubMed (original) (raw)

Meta-Analysis

. 2016 Sep;31(9):893-904.

doi: 10.1007/s10654-016-0169-z. Epub 2016 Jun 14.

Heinz Freisling 2, Rachael Stolzenberg-Solomon 3, Frank Kee 4, Mark George O'Doherty 4, José Manuel Ordóñez-Mena 5 6, Tom Wilsgaard 7, Anne Maria May 8, Hendrik Bas Bueno-de-Mesquita 9 10 11 12, Anne Tjønneland 13, Philippos Orfanos 14, Antonia Trichopoulou 14 15, Paolo Boffetta 14 16, Freddie Bray 17, Mazda Jenab 18, Isabelle Soerjomataram 17; CHANCES consortium

Collaborators, Affiliations

Meta-Analysis

Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States

Melina Arnold et al. Eur J Epidemiol. 2016 Sep.

Abstract

Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing different forms of cancer. Study participants from seven European and one US cohort study with two or more weight assessments during follow-up were included (n = 329,576). Trajectories of body mass index (BMI) across ages were estimated using a quadratic growth model; overweight duration (BMI ≥ 25) and cumulative weighted overweight years were calculated. In multivariate Cox models and random effects analyses, a longer duration of overweight was significantly associated with the incidence of obesity-related cancer [overall hazard ratio (HR) per 10-year increment: 1.36; 95 % CI 1.12-1.60], but also increased the risk of postmenopausal breast and colorectal cancer. Additionally accounting for the degree of overweight further increased the risk of obesity-related cancer. Risks associated with a longer overweight duration were higher in men than in women and were attenuated by smoking. For postmenopausal breast cancer, increased risks were confined to women who never used hormone therapy. Overall, 8.4 % of all obesity-related cancers could be attributed to overweight at any age. These findings provide further insights into the role of overweight duration in the etiology of cancer and indicate that weight control is relevant at all ages. This knowledge is vital for the development of effective and targeted cancer prevention strategies.

Keywords: Ageing; CHANCES; Cancer; Cohort; Obesity; Prevention.

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Conflict of interest statement

Conflict of interest statement: The authors declare no conflict of interest.

Figures

Fig 1

Fig 1

Flowchart of participant inclusion

Fig 2

Fig 2

Hazard ratios (HR)* and their 95% confidence intervals (95% CI) for overweight (BMI≥25) duration and weighted cumulative overweight years (OWY), by cohort and cancer site, men and women combined. *results from random-effects meta-analysis with adjustments for sex, smoking status, physical activity (yes/no), alcohol consumption and education level (Model 3) abreast, colorectum, pancreas, kidney, gallbladder, endometrium, ovary, liver, lower oesophagus, cardia stomach bpancreas, kidney, gallbladder, endometrium, ovary, liver, lower oesophagus, cardia stomach

Fig 3

Fig 3

Hazard ratios (HR) and their 95% confidence intervals (95%CI) for the association between (A) overweight (BMI≥25) duration, (B) weighted cumulative overweight years (OWY) and cancer risk, men and women combined abreast, colorectum, pancreas, kidney, gallbladder, endometrium, ovary, liver, lower oesophagus, cardia stomach bpancreas, kidney, gallbladder, endometrium, ovary, liver, lower oesophagus, cardia stomach The figure shows a 3-knot spline of the relation between overweight duration and cancer risk, allowing for non-linear effects and adjusted for sex, study, smoking status and physical activity (Model 2). Restricted cubic splines very fitted with knots at 0, 1, 5 and 10 years for overweight duration and at 0, 1, 13 and 65 for OWY. P-values are for non-linearity.

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