A body shape index (ABSI) is associated inversely with post-menopausal progesterone-receptor-negative breast cancer risk in a large European cohort

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  • Sofia Christakoudi
  • Konstantinos K. Tsilidis
  • Laure Dossus
  • Sabina Rinaldi
  • Elisabete Weiderpass
  • Christian S. Antoniussen
  • Christina C. Dahm
  • Lene Mellemkjær
  • Verena Katzke
  • Rudolf Kaaks
  • Matthias B. Schulze
  • Giovanna Masala
  • Sara Grioni
  • Salvatore Panico
  • Rosario Tumino
  • Carlotta Sacerdote
  • Anne M. May
  • Evelyn M. Monninkhof
  • J. Ramón Quirós
  • Catalina Bonet
  • Maria Jose Sánchez
  • Pilar Amiano
  • María Dolores Chirlaque
  • Marcela Guevara
  • Ann H. Rosendahl
  • Tanja Stocks
  • Aurora Perez-Cornago
  • Sandar Tin Tin
  • Alicia K. Heath
  • Elom K. Aglago
  • Laia Peruchet-Noray
  • Heinz Freisling
  • Elio Riboli
Background
Associations of body shape with breast cancer risk, independent of body size, are unclear because waist and hip circumferences are correlated strongly positively with body mass index (BMI).

Methods
We evaluated body shape with the allometric “a body shape index” (ABSI) and hip index (HI), which compare waist and hip circumferences, correspondingly, among individuals with the same weight and height. We examined associations of ABSI, HI, and BMI (per one standard deviation increment) with breast cancer overall, and according to menopausal status at baseline, age at diagnosis, and oestrogen and progesterone receptor status (ER+/-PR+/-) in multivariable Cox proportional hazards models using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Results
During a mean follow-up of 14.0 years, 9011 incident breast cancers were diagnosed among 218,276 women. Although there was little evidence for association of ABSI with breast cancer overall (hazard ratio HR = 0.984; 95% confidence interval: 0.961–1.007), we found borderline inverse associations for post-menopausal women (HR = 0.971; 0.942-1.000; n = 5268 cases) and breast cancers diagnosed at age ≥ 55 years (HR = 0.976; 0.951–1.002; n = 7043) and clear inverse associations for ER + PR- subtypes (HR = 0.894; 0.822–0.971; n = 726) and ER-PR- subtypes (HR = 0.906; 0.835–0.983 n = 759). There were no material associations with HI. BMI was associated strongly positively with breast cancer overall (HR = 1.074; 1.049–1.098), for post-menopausal women (HR = 1.117; 1.085–1.150), for cancers diagnosed at age ≥ 55 years (HR = 1.104; 1.076–1.132), and for ER + PR + subtypes (HR = 1.122; 1.080–1.165; n = 3101), but not for PR- subtypes.

Conclusions
In the EPIC cohort, abdominal obesity evaluated with ABSI was not associated with breast cancer risk overall but was associated inversely with the risk of post-menopausal PR- breast cancer. Our findings require validation in other cohorts and with a larger number of PR- breast cancer cases.
OriginalsprogEngelsk
Artikelnummer562
TidsskriftBMC Cancer
Vol/bind23
Udgave nummer1
Antal sider12
ISSN1471-2407
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
The authors thank the National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands, for their contribution and ongoing support to the EPIC study. The authors acknowledge the use of data from the EPIC-France cohort (principal investigators (PIs) Dr Gianluca Severi and Dr Marie-Christine Boutron-Ruault); EPIC-Bilthoven cohort (PI Prof Monique Verschuren); and EPIC-Cambridge cohort (PI Prof Nicholas J Wareham).

Funding Information:
The coordination of EPIC is financially supported by the International Agency for Research on Cancer (IARC) and by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by: Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia, and Navarra, and the Catalan Institute of Oncology - ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (United Kingdom).

Publisher Copyright:
© 2023, The Author(s).

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