title: Metabolic risk score and cancer risk: pooled analysis of seven cohorts.
abstract: BACKGROUND
  There are few data on the joint influence of metabolic factors on risk of separate cancers.
  
  
  METHODS
  We analysed data on body mass index, blood pressure and plasma levels of glucose, total cholesterol and triglycerides from seven European cohorts comprising 564 596 men and women with a mean age of 44 years. We weighted those factors equally into a standardized metabolic risk score [MRS, mean = 0, standard deviation (SD) = 1], with an individual's level indicated as SDs from the sex- and cohort-specific means. Cancer hazard ratios were calculated by Cox regression with age as timescale and with relevant adjustments including smoking status. All statistical tests were two-sided.
  
  
  RESULTS
  During a mean follow-up of 12 years, 21 593 men and 14 348 women were diagnosed with cancer. MRS was linearly and positively associated with incident cancer in total and at sites (P < 0.05). In men, risk per SD MRS was increased by 43% (95% confidence interval: 27-61) for renal cell cancer, 43% (16-76) for liver cancer, 29% (20-38) for colon cancer, 27% (5-54) for oesophageal cancer, 20% (9-31) for rectal cancer, 19% (4-37) for leukaemias, 15% (1-30) for oral cancer and 10% (2-19) for bladder cancer. In women, risk increases per SD MRS were 56% (42-70) for endometrial cancer, 53% (29-81) for pancreatic cancer, 40% (16-67) for renal cell cancer, 27% (9-47) for cervical cancer and 17% (3-32) for rectal cancer.
  
  
  CONCLUSIONS
  This largest study to date on the joint influence of metabolic factors on risk of separate cancers showed increased risks for several cancers, in particular renal cell and liver cancer in men and endometrial and pancreatic cancer in women.
authors: Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden, Department of Clinical Sciences in Malmö, Diabetes and Cardiovascular Diseases, Genetic Epidemiology, Lund University, Lund, Sweden, tanja.stocks@med.lu.se.
authors: Tanja
authors: T
authors: Stocks
authors: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway, Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway.
authors: Tone
authors: T
authors: Bjørge
authors: Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria.
authors: Hanno
authors: H
authors: Ulmer
authors: Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden.
authors: Jonas
authors: J
authors: Manjer
authors: Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
authors: Christel
authors: C
authors: Häggström
authors: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany, Agency for Preventive and Social Medicine, Bregenz, Austria.
authors: Gabriele
authors: G
authors: Nagel
authors: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway, Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors: Anders
authors: A
authors: Engeland
authors: Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden.
authors: Dorthe
authors: D
authors: Johansen
authors: Department of Public Health and Clinical Medicine, Nutritional Research, and.
authors: Göran
authors: G
authors: Hallmans
authors: Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors: Randi
authors: R
authors: Selmer
authors: Agency for Preventive and Social Medicine, Bregenz, Austria.
authors: Hans
authors: H
authors: Concin
authors: Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway.
authors: Steinar
authors: S
authors: Tretli
authors: Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
authors: Håkan
authors: H
authors: Jonsson
authors: Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
authors: Pär
authors: P
authors: Stattin
mesh_terms: D000328:Adult; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000473:pathology*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol
keywords: cohort studies; metabolic syndrome x; neoplasms
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