Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study.
Long-term weight gain (i.e., weight gain since age 20) has been related to higher risk of postmenopausal breast cancer, but a lower risk of premenopausal breast cancer. The effect of weight change in middle adulthood is unclear. We investigated the association between weight change in middle adulthood (i.e., women aged 40-50 years) and the risk of breast cancer before and after the age of 50. We included female participants of the European Prospective Investigation into Cancer and Nutrition cohort, with information on anthropometric measures at recruitment and after a median follow-up of 4.3 years. Annual weight change was categorized using quintiles taking quintile 2 and 3 as the reference category (-0.44 to 0.36 kg/year). Multivariable Cox proportional hazards regression analysis was used to examine the association. 205,723 women were included and 4,663 incident breast cancer cases were diagnosed during a median follow-up of 7.5 years (from second weight assessment onward). High weight gain (Q5: 0.83-4.98 kg/year) was related to a slightly, but significantly higher breast cancer risk (HRQ5_versus_Q2/3 : 1.09, 95% CI: 1.01-1.18). The association was more pronounced for breast cancer diagnosed before or at age 50 (HRQ5_versus_Q2/3 : 1.37, 95% CI: 1.02-1.85). Weight loss was not associated with breast cancer risk. There was no evidence for heterogeneity by hormone receptor status. In conclusion, high weight gain in middle adulthood increases the risk of breast cancer. The association seems to be more pronounced for breast cancer diagnosed before or at age 50. Our results illustrate the importance of avoiding weight gain in middle adulthood.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Marleen J
MJ
Emaus
Carla H
CH
van Gils
Marije F
MF
Bakker
Charlotte N Steins
CN
Bisschop
Evelyn M
EM
Monninkhof
H B
HB
Bueno-de-Mesquita
Noémie
N
Travier
Tina Landsvig
TL
Berentzen
Kim
K
Overvad
Anne
A
Tjønneland
Isabelle
I
Romieu
Sabina
S
Rinaldi
Veronique
V
Chajes
Marc J
MJ
Gunter
Françoise
F
Clavel-Chapelon
Guy
G
Fagherazzi
Sylvie
S
Mesrine
Jenny
J
Chang-Claude
Rudolf
R
Kaaks
Heiner
H
Boeing
Krasimira
K
Aleksandrova
Antonia
A
Trichopoulou
Androniki
A
Naska
Philippos
P
Orfanos
Domenico
D
Palli
Claudia
C
Agnoli
Rosario
R
Tumino
Paolo
P
Vineis
Amalia
A
Mattiello
Tonje
T
Braaten
Kristin Benjaminsen
KB
Borch
Eiliv
E
Lund
Virginia
V
Menéndez
María-José
MJ
Sánchez
Carmen
C
Navarro
Aurelio
A
Barricarte
Pilar
P
Amiano
Malin
M
Sund
Anne
A
Andersson
Signe
S
Borgquist
Asa
A
Olsson
Kay-Tee
KT
Khaw
Nick
N
Wareham
Ruth C
RC
Travis
Elio
E
Riboli
Petra H M
PH
Peeters
Anne M
AM
May
D000328:Adult; D001835:Body Weight; D001943:Breast Neoplasms / Q000150:complications / Q000453:epidemiology*; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D017697:Premenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D015430:Weight Gain
adult weight gain; breast cancer; estrogen receptor; menopausal status; progesterone receptor