Body Size Indicators and Risk of Gallbladder Cancer: Pooled Analysis of Individual-Level Data from 19 Prospective Cohort Studies.
Background:There are few established risk factors for gallbladder cancer beyond gallstones. Recent studies suggest a higher risk with high body mass index (BMI), an indicator of general heaviness, but evidence from other body size measures is lacking.Methods:Associations of adult BMI, young adult BMI, height, adult weight gain, waist circumference (WC), waist-height ratio (WHtR), hip circumference (HC), and waist-hip ratio (WHR) with gallbladder cancer risk were evaluated. Individual-level data from 1,878,801 participants in 19 prospective cohort studies (14 studies had circumference measures) were harmonized and included in this analysis. Multivariable Cox proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI).Results:After enrollment, 567 gallbladder cancer cases were identified during 20.1 million person-years of observation, including 361 cases with WC measures. Higher adult BMI (per 5 kg/m2, HR: 1.24; 95% CI, 1.13-1.35), young adult BMI (per 5 kg/m2, HR: 1.12; 95% CI, 1.00-1.26), adult weight gain (per 5 kg, HR: 1.07; 95% CI, 1.02-1.12), height (per 5 cm, HR: 1.10; 95% CI, 1.03-1.17), WC (per 5 cm, HR: 1.09; 95% CI, 1.02-1.17), WHtR (per 0.1 unit, HR: 1.24; 95% CI, 1.00-1.54), and HC (per 5 cm, HR: 1.13; 95% CI, 1.04-1.22), but not WHR (per 0.1 unit, HR: 1.03; 95% CI, 0.87-1.22), were associated with higher risks of gallbladder cancer, and results did not differ meaningfully by sex or other demographic/lifestyle factors.Conclusions:These findings indicate that measures of overall and central excess body weight are associated with higher gallbladder cancer risks.Impact:Excess body weight is an important, and potentially preventable, gallbladder cancer risk factor.Cancer Epidemiol Biomarkers Prev; 26(4); 597-606. ©2017 AACR.
Epidemiology Research Program, American Cancer Society, Atlanta, Georgia. peter.campbell@cancer.org.
Peter T
PT
Campbell
Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
Christina C
CC
Newton
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Cari M
CM
Kitahara
Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
Alpa V
AV
Patel
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Patricia
P
Hartge
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Jill
J
Koshiol
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Katherine A
KA
McGlynn
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.|Department of Medical Epidemiology and Biostatistics, Karolinska Insitutet, Stockholm, Sweden.
Hans-Olov
HO
Adami
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Amy
A
Berrington de González
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Laura E
LE
Beane Freeman
Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, California.
Leslie
L
Bernstein
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.|Divisions of Preventive Medicine and Aging, Brigham and Women's Hospital, Boston, Massachusetts.
Julie E
JE
Buring
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Neal D
ND
Freedman
Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
Yu-Tang
YT
Gao
Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
Graham G
GG
Giles
Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France.
Marc J
MJ
Gunter
Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France.
Mazda
M
Jenab
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Linda M
LM
Liao
Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
Roger L
RL
Milne
Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC.
Kim
K
Robien
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health/Department of Health and Human Services, Research Triangle Park, North Carolina.
Dale P
DP
Sandler
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Catherine
C
Schairer
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.|Divisions of Preventive Medicine and Aging, Brigham and Women's Hospital, Boston, Massachusetts.
Howard D
HD
Sesso
Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee.
Xiao-Ou
XO
Shu
Department of Medical Epidemiology and Biostatistics, Karolinska Insitutet, Stockholm, Sweden.|Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.|Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.|Genetic Epidemiology Group, Samfundet Folkhälsan, Research Center Helsinki, Finland.
Elisabete
E
Weiderpass
Department of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Alicja
A
Wolk
Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
Yong-Bing
YB
Xiang
Department of Population Health, New York University School of Medicine, New York, New York.
Anne
A
Zeleniuch-Jacquotte
Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee.
Wei
W
Zheng
Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
Susan M
SM
Gapstur
D000328:Adult; D015992:Body Mass Index; D049628:Body Size; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000145:classification / Q000150:complications; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D055105:Waist Circumference; D065927:Waist-Height Ratio; D049629:Waist-Hip Ratio; D015430:Weight Gain; D055815:Young Adult