TY - JOUR

T1 - Body mass index and cancer risk among adults with and without cardiometabolic diseases

T2 - evidence from the EPIC and UK Biobank prospective cohort studies

AU - Fontvieille, Emma

AU - Viallon, Vivian

AU - Recalde, Martina

AU - Cordova, Reynalda

AU - Jansana, Anna

AU - Peruchet-Noray, Laia

AU - Lennon, Hannah

AU - Heath, Alicia K.

AU - Aune, Dagfinn

AU - Christakoudi, Sofia

AU - Katzke, Verena

AU - Kaaks, Rudolf

AU - Inan-Eroglu, Elif

AU - Schulze, Matthias B.

AU - Mellemkjær, Lene

AU - Tjønneland, Anne

AU - Overvad, Kim

AU - Farràs, Marta

AU - Petrova, Dafina

AU - Amiano, Pilar

AU - Chirlaque, María Dolores

AU - Moreno-Iribas, Conchi

AU - Tin Tin, Sandar

AU - Masala, Giovanna

AU - Sieri, Sabina

AU - Ricceri, Fulvio

AU - Panico, Salvatore

AU - May, Anne M.

AU - Monninkhof, Evelyn M.

AU - Weiderpass, Elisabete

AU - Gunter, Marc J.

AU - Ferrari, Pietro

AU - Freisling, Heinz

N1 - Publisher Copyright: © 2023, The Author(s).

PY - 2023

Y1 - 2023

N2 - 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/m2) 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/m2) 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.

AB - 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/m2) 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/m2) 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.

KW - Cardiovascular diseases

KW - Comorbidities

KW - Multimorbidity

KW - Obesity

KW - Obesity-related cancers

KW - Type 2 diabetes

U2 - 10.1186/s12916-023-03114-z

DO - 10.1186/s12916-023-03114-z

M3 - Journal article

C2 - 37993940

AN - SCOPUS:85177669887

VL - 21

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

IS - 1

M1 - 418

ER -