Journal Article

Body mass index and cancer risk among adults with and without cardiometabolic diseases: evidence from the EPIC and UK Biobank prospective cohort studies

Peruchet-Noray, Laia, Ferrari, Pietro, Farràs, Marta, Monninkhof, Evelyn M., Viallon, Vivian, Christakoudi, Sofia, Weiderpass, Elisabete, Schulze, Matthias B., Mellemkjær, Lene, May, Anne M., Freisling, Heinz, Moreno-Iribas, Conchi, Cordova, Reynalda, Overvad, Kim, Inan-Eroglu, Elif, Heath, Alicia K., Chirlaque, María-Dolores, Tjønneland, Anne, Petrova, Dafina, Ricceri, Fulvio, Lennon, Hannah, Tin Tin, Sandar, Aune, Dagfinn, Fontvieille, Emma, Katzke, Verena, Amiano, Pilar, Recalde, Martina, Sieri, Sabina, Jansana, Anna, Kaaks, Rudolf, Masala, Giovanna, Panico, Salvatore, Gunter, Marc J.

2023

Overview

Background Whether cancer risk associated with a higher body mass index (BMI), a surrogate measure of adiposity, differs among adults with and without cardiovascular diseases (CVD) and/or type 2 diabetes (T2D) is unclear. The primary aim of this study was to evaluate separate and joint associations of BMI and CVD/T2D with the risk of cancer. Methods This is an individual participant data meta-analysis of two prospective cohort studies, the UK Biobank (UKB) and the European Prospective Investigation into Cancer and nutrition (EPIC), with a total of 577,343 adults, free of cancer, T2D, and CVD at recruitment. We used Cox proportional hazard regressions to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between BMI and incidence of obesity-related cancer and in turn overall cancer with a multiplicative interaction between BMI and the two cardiometabolic diseases (CMD). HRs and 95% CIs for separate and joint associations for categories of overweight/obesity and CMD status were estimated, and additive interaction was quantified through relative excess risk due to interaction (RERI). Results In the meta-analysis of both cohorts, BMI (per ~ 5 kg/m 2 ) was positively associated with the risk of obesity-related cancer among participants without a CMD (HR: 1.11, 95%CI: 1.07,1.16), among participants with T2D (HR: 1.11, 95% CI: 1.05,1.18), among participants with CVD (HR: 1.17, 95% CI: 1.11,1.24), and suggestively positive among those with both T2D and CVD (HR: 1.09, 95% CI: 0.94,1.25). An additive interaction between obesity (BMI ≥ 30 kg/m 2 ) and CVD with the risk of overall cancer translated into a meta-analytical RERI of 0.28 (95% CI: 0.09–0.47). Conclusions Irrespective of CMD status, higher BMI increased the risk of obesity-related cancer among European adults. The additive interaction between obesity and CVD suggests that obesity prevention would translate into a greater cancer risk reduction among population groups with CVD than among the general population.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adipose tissue / Adult / Adults / Biobanks / Biological Specimen Banks / Biomedicine / Body mass / Body Mass Index / Body size / Cancer / Cardiovascular diseases / Cardiovascular Diseases - etiology / Care and treatment / Cohort analysis / Comorbidities / Comorbidity / Complications and side effects / Diabetes / Diabetes mellitus / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - epidemiology / Gallbladder / Health aspects / Health hazards / Health risks / Hospitals / Humans / Investigations / Lifestyles / Medical records / Medical screening / Medicine / Medicine & Public Health / Meta-analysis / Multimorbidity / Multiple myeloma / Neoplasms - complications / Neoplasms - epidemiology / Nutrition research / Obesity / Obesity - complications / Obesity - epidemiology / Obesity-related cancers / Oncology, Experimental / Overweight / Pancreas / Patient admissions / Population / Prevention / Prospective Studies / Questionnaires / Research Article / Risk Factors / Risk management / Skin cancer / Sociodemographics / Thyroid gland / Type 2 diabetes / United Kingdom - epidemiology / Womens health