title: Body Mass Index, Waist Circumference, Diabetes, and Risk of Liver Cancer for U.S. Adults.
abstract: Incidence rates for liver cancer have increased 3-fold since the mid-1970s in the United States in parallel with increasing trends for obesity and type II diabetes mellitus. We conducted an analysis of baseline body mass index (BMI), waist circumference (WC), and type II diabetes mellitus with risk of liver cancer. The Liver Cancer Pooling Project maintains harmonized data from 1.57 million adults enrolled in 14 U.S.-based prospective studies. Cox regression estimated HRs and 95% confidence intervals (CI) adjusted for age, sex, study center, alcohol, smoking, race, and BMI (for WC and type II diabetes mellitus). Stratified analyses assessed whether the BMI-liver cancer associations differed by hepatitis sera-positivity in nested analyses for a subset of cases (n = 220) and controls (n = 547). After enrollment, 2,162 incident liver cancer diagnoses were identified. BMI, per 5 kg/m2, was associated with higher risks of liver cancer, more so for men (HR = 1.38; 95% CI, 1.30-1.46) than women (HR = 1.25; 95% CI, 1.17-1.35; Pinteraction= 0.02). WC, per 5 cm, was associated with higher risks of liver cancer, approximately equally by sex (overall, HR = 1.08; 95% CI, 1.04-1.13). Type II diabetes mellitus was associated with higher risk of liver cancer (HR = 2.61; 95% CI, 2.34-2.91). In stratified analyses, there was a null association between BMI and liver cancer risk for participants who were sera-positive for hepatitis. This study suggests that high BMI, high WC, and type II diabetes mellitus are associated with higher risks of liver cancer and that the association may differ by status of viral hepatitis infection. Cancer Res; 76(20); 6076-83. ©2016 AACR.
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, Georgia. peter.campbell@cancer.org.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Campbell
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
authors.forename: Christina C
authors.initials: CC
authors.lastname: Newton
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Neal D
authors.initials: ND
authors.lastname: Freedman
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Jill
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authors.lastname: Koshiol
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Alavanja
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Beane Freeman
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Chan
authors.affiliation: Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
authors.forename: Dawn Q
authors.initials: DQ
authors.lastname: Chong
authors.affiliation: Department of Nutrition Science, Purdue University, West Lafayette, Indiana.
authors.forename: Mridul
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authors.lastname: Datta
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
authors.forename: Mia M
authors.initials: MM
authors.lastname: Gaudet
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. VA Boston Healthcare System, Boston, Massachusetts.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.affiliation: Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.affiliation: AARP, Washington, DC (retired).
authors.forename: Albert R
authors.initials: AR
authors.lastname: Hollenbeck
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Lindsey
authors.initials: L
authors.lastname: King
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts.
authors.forename: I-Min
authors.initials: IM
authors.lastname: Lee
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, Massachusetts.
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Petrick
authors.affiliation: Division of Pediatric Epidemiology and Clinical Research and Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Jenny N
authors.initials: JN
authors.lastname: Poynter
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Purdue
authors.affiliation: Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Kim
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authors.lastname: Robien
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, Massachusetts.
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Vikrant V
authors.initials: VV
authors.lastname: Sahasrabuddhe
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Schairer
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts.
authors.forename: Howard D
authors.initials: HD
authors.lastname: Sesso
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Sigurdson
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Stevens
authors.affiliation: Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York.
authors.forename: Jean
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authors.lastname: Wactawski-Wende
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, New York.
authors.forename: Anne
authors.initials: A
authors.lastname: Zeleniuch-Jacquotte
authors.affiliation: Faculty Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Renehan
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: McGlynn
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D055105:Waist Circumference