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Abdominal and gluteofemoral size and risk of liver cancer: The liver cancer pooling project
Author(s) -
Florio Andrea A.,
Campbell Peter T.,
Zhang Xuehong,
ZeleniuchJacquotte Anne,
WactawskiWende Jean,
SmithWarner Stephanie A.,
Sinha Rashmi,
Simon Tracey G.,
Sesso Howard D.,
Schairer Catherine,
Rosenberg Lynn,
Rohan Thomas E.,
Robien Kim,
Renehan Andrew G.,
Purdue Mark P.,
Poynter Jenny N.,
Palmer Julie R.,
Newton Christina C.,
Lu Yunxia,
Linet Martha S.,
Liao Linda M.,
Lee IMin,
Koshiol Jill,
Kitahara Cari M.,
Kirsh Victoria A.,
Hofmann Jonathan N.,
Graubard Barry I.,
Giovannucci Edward,
Gaziano John M.,
Gapstur Susan M.,
Freedman Neal D.,
Demuth Jane,
Chong Dawn Q.,
Chan Andrew T.,
Buring Julie E.,
Bradshaw Patrick T.,
Beane Freeman Laura E.,
McGlynn Katherine A.,
Petrick Jessica L.
Publication year - 2019
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.32760
Subject(s) - medicine , waist , hazard ratio , body mass index , hepatocellular carcinoma , prospective cohort study , confidence interval , liver cancer , abdominal obesity , proportional hazards model , cancer , gastroenterology , circumference , cohort , cohort study , surgery , geometry , mathematics
Obesity is known to be associated with primary liver cancer (PLC), but the separate effects of excess abdominal and gluteofemoral size are unclear. Thus, we examined the association between waist and hip circumference with risk of PLC overall and by histologic type—hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). The Liver Cancer Pooling Project is a consortium of prospective cohort studies that include data from 1,167,244 individuals (PLC n = 2,208, HCC n = 1,154, ICC n = 335). Multivariable‐adjusted hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using proportional hazards regression. Waist circumference, per 5 cm increase, was associated with an 11% increased PLC risk (HR = 1.11, 95%CI: 1.09–1.14), including when adjusted for hip circumference (HR = 1.12, 95%CI: 1.08–1.17) and also when restricted to individuals in a normal body mass index (BMI) range (18.5 to <25 kg/m 2 ; HR = 1.14, 95%CI: 1.07–1.21). Hip circumference, per 5 cm increase, was associated with a 9% increased PLC risk (HR = 1.09, 95%CI: 1.06–1.12), but no association remained after adjustment for waist circumference (HR = 0.99, 95%CI: 0.94–1.03). HCC and ICC results were similar. These findings suggest that excess abdominal size is associated with an increased risk of liver cancer, even among individuals considered to have a normal BMI. However, excess gluteofemoral size alone confers no increased risk. Our findings extend prior analyses, which found an association between excess adiposity and risk of liver cancer, by disentangling the separate effects of excess abdominal and gluteofemoral size through utilization of both waist and hip circumference measurements.