title: Comparison of anthropometric measures as predictors of cancer incidence: A pooled collaborative analysis of 11 Australian cohorts.
abstract: Obesity is a risk factor for cancer. However, it is not known if general adiposity, as measured by body mass index (BMI) or central adiposity [e.g., waist circumference (WC)] have stronger associations with cancer, or which anthropometric measure best predicts cancer risk. We included 79,458 men and women from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on anthropometry [BMI, WC, Hip Circumference (HC), WHR, waist to height ratio (WtHR), A Body Shape Index (ABSI)], linked to the Australian Cancer Database. Cox proportional hazards models assessed the association between each anthropometric marker, per standard deviation and the risk of overall, colorectal, post-menopausal (PM) breast, prostate and obesity-related cancers. We assessed the discriminative ability of models using Harrell's c-statistic. All anthropometric markers were associated with overall, colorectal and obesity-related cancers. BMI, WC and HC were associated with PM breast cancer and no significant associations were seen for prostate cancer. Strongest associations were observed for WC across all outcomes, excluding PM breast cancer for which HC was strongest. WC had greater discrimination compared to BMI for overall and colorectal cancer in men and women with c-statistics ranging from 0.70 to 0.71. We show all anthropometric measures are associated with the overall, colorectal, PM breast and obesity-related cancer in men and women, but not prostate cancer. WC discriminated marginally better than BMI. However, all anthropometric measures were similarly moderately predictive of cancer risk. We do not recommend one anthropometric marker over another for assessing an individuals' risk of cancer.
authors: Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors: Jessica L
authors: JL
authors: Harding
authors: Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors: Jonathan E
authors: JE
authors: Shaw
authors: Research School of Population Health, The Australian National University, Canberra, Australia.
authors: Kaarin J
authors: KJ
authors: Anstey
authors: The Health Observatory Discipline of Medicine, The University of Adelaide, Adelaide, Australia.
authors: Robert
authors: R
authors: Adams
authors: Centre for Research in Epidemiology and Population Health, INSERM, U018, France.
authors: Beverley
authors: B
authors: Balkau
authors: IMPACT Strategic Research Centre School of Medicine, Deakin University, Geelong, Australia.|Department of Medicine, NorthWest Academic Centre, The University of Melbourne, St Albans, Australia.
authors: Sharon L
authors: SL
authors: Brennan-Olsen
authors: School of Population Health, The University of Western Australia, Crawley, Australia.
authors: Tom
authors: T
authors: Briffa
authors: School of Medicine and Pharmacology, The University of Western Australia, Crawley, Australia.
authors: Timothy M E
authors: TM
authors: Davis
authors: School of Medicine and Pharmacology, The University of Western Australia, Crawley, Australia.
authors: Wendy A
authors: WA
authors: Davis
authors: School of Population Health, The University of Queensland, Brisbane, Australia.
authors: Annette
authors: A
authors: Dobson
authors: Centre for Medical Research, The University of Western Australia, Crawley, Australia.
authors: Leon
authors: L
authors: Flicker
authors: Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia.
authors: Graham
authors: G
authors: Giles
authors: Population Research & Outcome Studies, The University of Adelaide, Adelaide, Australia.
authors: Janet
authors: J
authors: Grant
authors: School of Population Health, The University of Queensland, Brisbane, Australia.
authors: Rachel
authors: R
authors: Huxley
authors: School of Population Health, The University of Western Australia, Crawley, Australia.
authors: Matthew
authors: M
authors: Knuiman
authors: Flinders Centre for Ageing Studies, Flinders University, Adelaide, Australia.
authors: Mary
authors: M
authors: Luszcz
authors: School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
authors: Robert J
authors: RJ
authors: MacInnis
authors: Westmead Millennium Institute, The University of Sydney, Sydney, Australia.
authors: Paul
authors: P
authors: Mitchell
authors: IMPACT Strategic Research Centre School of Medicine, Deakin University, Geelong, Australia.|Department of Medicine, NorthWest Academic Centre, The University of Melbourne, St Albans, Australia.
authors: Julie A
authors: JA
authors: Pasco
authors: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors: Christopher
authors: C
authors: Reid
authors: Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England.|Department of Rural Health, The University of Melbourne, Shepparton, Australia.
authors: David
authors: D
authors: Simmons
authors: UNSW Australia Lipid Research Dept, St Vincent's Hospital, Sydney, Australia.
authors: Leon
authors: L
authors: Simons
authors: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors: Andrew
authors: A
authors: Tonkin
authors: The George Institute for Global Health, The University of Sydney, Sydney, Australia.|The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, United Kingdom.
authors: Mark
authors: M
authors: Woodward
authors: Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors: Anna
authors: A
authors: Peeters
authors: Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors: Dianna J
authors: DJ
authors: Magliano
mesh_terms: D050154:Adiposity; D000368:Aged; D000886:Anthropometry; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D009520:New Zealand / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology