Premium
Weight change in middle adulthood and risk of cancer in the European Prospective Investigation into Cancer and Nutrition ( EPIC ) cohort
Author(s) -
Christakoudi Sofia,
Pagoni Panagiota,
Ferrari Pietro,
Cross Amanda J.,
Tzoulaki Ioanna,
Muller David C.,
Weiderpass Elisabete,
Freisling Heinz,
Murphy Neil,
Dossus Laure,
Turzanski Fortner Renee,
Agudo Antonio,
Overvad Kim,
PerezCornago Aurora,
Key Timothy J.,
Brennan Paul,
Johansson Mattias,
Tjønneland Anne,
Halkjær Jytte,
BoutronRuault MarieChristine,
Artaud Fanny,
Severi Gianluca,
Kaaks Rudolf,
Schulze Matthias B.,
Bergmann Manuela M.,
Masala Giovanna,
Grioni Sara,
Simeon Vittorio,
Tumino Rosario,
Sacerdote Carlotta,
Skeie Guri,
Rylander Charlotta,
Borch Kristin Benjaminsen,
Quirós J. Ramón,
RodriguezBarranco Miguel,
Chirlaque MariaDolores,
Ardanaz Eva,
Amiano Pilar,
Drake Isabel,
Stocks Tanja,
Häggström Christel,
Harlid Sophia,
EllingjordDale Merete,
Riboli Elio,
Tsilidis Konstantinos K.
Publication year - 2020
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.33339
Subject(s) - medicine , european prospective investigation into cancer and nutrition , hazard ratio , weight gain , weight change , cancer , prospective cohort study , body mass index , overweight , cohort , breast cancer , proportional hazards model , cohort study , risk factor , obesity , confidence interval , gynecology , weight loss , body weight
Obesity is a risk factor for several major cancers. Associations of weight change in middle adulthood with cancer risk, however, are less clear. We examined the association of change in weight and body mass index (BMI) category during middle adulthood with 42 cancers, using multivariable Cox proportional hazards models in the European Prospective Investigation into Cancer and Nutrition cohort. Of 241 323 participants (31% men), 20% lost and 32% gained weight (>0.4 to 5.0 kg/year) during 6.9 years (average). During 8.0 years of follow‐up after the second weight assessment, 20 960 incident cancers were ascertained. Independent of baseline BMI, weight gain (per one kg/year increment) was positively associated with cancer of the corpus uteri (hazard ratio [HR] = 1.14; 95% confidence interval: 1.05‐1.23). Compared to stable weight (±0.4 kg/year), weight gain (>0.4 to 5.0 kg/year) was positively associated with cancers of the gallbladder and bile ducts (HR = 1.41; 1.01‐1.96), postmenopausal breast (HR = 1.08; 1.00‐1.16) and thyroid (HR = 1.40; 1.04‐1.90). Compared to maintaining normal weight, maintaining overweight or obese BMI (World Health Organisation categories) was positively associated with most obesity‐related cancers. Compared to maintaining the baseline BMI category, weight gain to a higher BMI category was positively associated with cancers of the postmenopausal breast (HR = 1.19; 1.06‐1.33), ovary (HR = 1.40; 1.04‐1.91), corpus uteri (HR = 1.42; 1.06‐1.91), kidney (HR = 1.80; 1.20‐2.68) and pancreas in men (HR = 1.81; 1.11‐2.95). Losing weight to a lower BMI category, however, was inversely associated with cancers of the corpus uteri (HR = 0.40; 0.23‐0.69) and colon (HR = 0.69; 0.52‐0.92). Our findings support avoiding weight gain and encouraging weight loss in middle adulthood.