Weight change in middle adulthood and risk of cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

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  • Sofia Christakoudi, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, MRC Centre for Transplantation, King's College London, Great Maze Pond, London SE1 9RT, United Kingdom., Storbritannien
  • Panagiota Pagoni, University of Ioannina School of Medicine, MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom., Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Grækenland
  • Pietro Ferrari, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Amanda J Cross, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Storbritannien
  • Ioanna Tzoulaki, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece, Storbritannien
  • David C Muller, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Storbritannien
  • Elisabete Weiderpass, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Heinz Freisling, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Neil Murphy, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Laure Dossus, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Renee Turzanski Fortner, German Cancer Research Center (DKFZ), Tyskland
  • Antonio Agudo, Unit of Nutrition and Cancer. Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Spanien
  • Kim Overvad
  • Aurora Perez-Cornago, Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, United Kingdom., Storbritannien
  • Timothy J Key, Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, United Kingdom., Storbritannien
  • Paul Brennan, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Mattias Johansson, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Anne Tjønneland, Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen, Danmark
  • Jytte Halkjaer, Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen, Danmark
  • Marie-Christine Boutron-Ruault, Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe "Exposome, Hérédité, Cancer et Santé", CESP, Villejuif, Frankrig
  • Fanny Artaud, Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe "Exposome, Hérédité, Cancer et Santé", CESP, Villejuif, Frankrig
  • Gianluca Severi, University of Florence, Florence, Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe "Exposome, Hérédité, Cancer et Santé", CESP, Villejuif, Italien
  • Rudolf Kaaks, German Cancer Research Center (DKFZ), Tyskland
  • Matthias B Schulze, German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany., Institute of Nutrition Science, University of Potsdam, Nuthetal, Germany., Tyskland
  • Manuela M Bergmann, Department of Epidemiology, German Institute of Human Nutrition (DIfE) 14558 Potsdam-Rehbrücke, Nuthetal, Germany., Tyskland
  • Giovanna Masala, Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy., Italien
  • Sara Grioni, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy., Italien
  • Vittorio Simeon, Physical Health and Preventive Medicine University "L.Vanvitelli", Italien
  • Rosario Tumino, Cancer Registry and Histopathology Department , Provincial Health Authority (ASP), Ragusa, Italy., Italien
  • Carlotta Sacerdote, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Italien
  • Guri Skeie, Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway., Norge
  • Charlotta Rylander, Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway., Norge
  • Kristin Benjaminsen Borch, Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway., Norge
  • J Ramón Quirós, Public Health Directorate, Spanien
  • Miguel Rodriguez-Barranco, Escuela Andaluza de Salud Pública (EASP), Granada, Instituto de Investigación Biosanitaria (ibs.GRANADA), Consorcio Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Spanien
  • Maria-Dolores Chirlaque, Universidad de Murcía, Consorcio Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain., Spanien
  • Eva Ardanaz, Navarra Public Health Institute, Consorcio Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., IdiSNA, Navarra Institute for Health Research, Pamplona, Spain., Spanien
  • Pilar Amiano, BioDonostia Researach Institute, Consorcio Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Spanien
  • Isabel Drake, Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital, Malmö, Lund University, Lund, Sweden., Sverige
  • Tanja Stocks, Department of Clinical Sciences Lund, Lund University, Lund, Sverige
  • Christel Häggström, University of Umeå, Umeå, Sweden., Department of Surgical Science, Uppsala University, Uppsala, Sweden., Sverige
  • Sophia Harlid, University of Umeå, Umeå, Sweden., Sverige
  • Merete Ellingjord-Dale, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Storbritannien
  • Elio Riboli, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Storbritannien
  • Konstantinos K Tsilidis, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece, Storbritannien

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), post-menopausal 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 Organization 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 post-menopausal 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.

OriginalsprogEngelsk
TidsskriftInternational Journal of Cancer
Vol/bind148
Nummer7
Sider (fra-til)1637-1651
Antal sider15
ISSN0020-7136
DOI
StatusUdgivet - 1 apr. 2021

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