Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States.
Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing different forms of cancer. Study participants from seven European and one US cohort study with two or more weight assessments during follow-up were included (n = 329,576). Trajectories of body mass index (BMI) across ages were estimated using a quadratic growth model; overweight duration (BMI ≥ 25) and cumulative weighted overweight years were calculated. In multivariate Cox models and random effects analyses, a longer duration of overweight was significantly associated with the incidence of obesity-related cancer [overall hazard ratio (HR) per 10-year increment: 1.36; 95 % CI 1.12-1.60], but also increased the risk of postmenopausal breast and colorectal cancer. Additionally accounting for the degree of overweight further increased the risk of obesity-related cancer. Risks associated with a longer overweight duration were higher in men than in women and were attenuated by smoking. For postmenopausal breast cancer, increased risks were confined to women who never used hormone therapy. Overall, 8.4 % of all obesity-related cancers could be attributed to overweight at any age. These findings provide further insights into the role of overweight duration in the etiology of cancer and indicate that weight control is relevant at all ages. This knowledge is vital for the development of effective and targeted cancer prevention strategies.
Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France. arnoldm@iarc.fr.
Melina
M
Arnold
Section of Nutrition and Metabolism, Dietary Exposure Assessment Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France.
Heinz
H
Freisling
Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, National Cancer Institute (NCI/DCEG), 9609 Medical Center Drive, Bethesda, MD, 20892, USA.
Rachael
R
Stolzenberg-Solomon
UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, University Road, Belfast, BT7 1NN, Northern Ireland, UK.
Frank
F
Kee
UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, University Road, Belfast, BT7 1NN, Northern Ireland, UK.
Mark George
MG
O'Doherty
Network Aging Research (NAR), Heidelberg University, Bergheimer Straße 20, 69115, Heidelberg, Germany.|Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
José Manuel
JM
Ordóñez-Mena
Department of Community Medicine, The Arctic University of Norway, 9037, Tromsø, Norway.
Tom
T
Wilsgaard
Juliu Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Anne Maria
AM
May
Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands.|Department of Gastroenterology and Hepatology, University Medical Centre, Huispost Str. 6.131, 3508 GA, Utrecht, The Netherlands.|Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.|Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Hendrik Bas
HB
Bueno-de-Mesquita
Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark.
Anne
A
Tjønneland
Hellenic Health Foundation, 13 Kaisareias & Alexandroupoleos, 115 27, Athens, Greece.
Philippos
P
Orfanos
Hellenic Health Foundation, 13 Kaisareias & Alexandroupoleos, 115 27, Athens, Greece.|Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Mikras Asias 75, 115 27, Athens, Greece.
Antonia
A
Trichopoulou
Hellenic Health Foundation, 13 Kaisareias & Alexandroupoleos, 115 27, Athens, Greece.|Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1128, New York, NY, 10029-6574, USA.
Paolo
P
Boffetta
Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France.
Freddie
F
Bray
Section of Nutrition and Metabolism, Nutritional Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France.
Mazda
M
Jenab
Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France.
Isabelle
I
Soerjomataram
D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D048909:Diabetes Complications; D005060:Europe; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology*; D050177:Overweight / Q000150:complications*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D014481:United States
Ageing; CHANCES; Cancer; Cohort; Obesity; Prevention