BMI and lifetime changes in BMI and cancer mortality risk.

Niloofar Taghizadeh,H Marike Boezen,Carolien P Schröder,E G Elisabeth De Vries,Jan P Schouten,Judith M Vonk,C Mary Schooling

doi:10.1371/journal.pone.0125261

Niloofar Taghizadeh, H Marike Boezen + Show 5 more

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https://doi.org/10.1371/journal.pone.0125261

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Abstract

Body Mass Index (BMI) is known to be associated with cancer mortality, but little is known about the link between lifetime changes in BMI and cancer mortality in both males and females. We studied the association of BMI measurements (at baseline, highest and lowest BMI during the study-period) and lifetime changes in BMI (calculated over different time periods (i.e. short time period: annual change in BMI between successive surveys, long time period: annual change in BMI over the entire study period) with mortality from any cancer, and lung, colorectal, prostate and breast cancer in a large cohort study (n=8,645. Vlagtwedde-Vlaardingen, 1965-1990) with a follow-up on mortality status on December 31st 2008. We used multivariate Cox regression models with adjustments for age, smoking, sex, and place of residence. Being overweight at baseline was associated with a higher risk of prostate cancer mortality (hazard ratio (HR) =2.22; 95% CI 1.19-4.17). Obesity at baseline was associated with a higher risk of any cancer mortality [all subjects (1.23 (1.01-1.50)), and females (1.40 (1.07-1.84))]. Chronically obese females (females who were obese during the entire study-period) had a higher risk of mortality from any cancer (2.16 (1.47-3.18), lung (3.22 (1.06-9.76)), colorectal (4.32 (1.53-12.20)), and breast cancer (2.52 (1.15-5.54)). We found no significant association between long-term annual change in BMI and cancer mortality risk. Both short-term annual increase and decrease in BMI were associated with a lower mortality risk from any cancer [all subjects: (0.67 (0.47-0.94)) and (0.73 (0.55-0.97)), respectively]. In conclusion, a higher BMI is associated with a higher cancer mortality risk. This study is the first to show that short-term annual changes in BMI were associated with lower mortality from any type of cancer.

Highlights

Overweight and obesity are major public health problems in both developed and developing countries [1]
We found no significant association between long-term annual change in Body mass index (BMI) and cancer mortality risk
Additional adjustment for baseline BMI did not change the results. This is the first large cohort study in a general population investigating the association of BMI levels and long-term and short-term annual changes in BMI with any cancer mortality and four common types of cancer mortality

Summary

Introduction

Overweight and obesity are major public health problems in both developed and developing countries [1]. In the Netherlands, overweight and obesity rates have reached epidemic proportions, they are still lower than in countries like the United States and UK. BMI and Cancer Mortality Risk among Dutch adults increased from about 5% in the early 1980s to nearly 12% in 2011, while 41% was classified as overweight [2]. Several studies investigating the association between BMI and cancer suggest that a higher BMI can increase cancer incidence [3,4,5]. In the United States, the proportion of all cancer deaths that can be attributed to overweight or obesity in adults older than 50 years was found to be 14% in males and 20% in females [6]. Maintaining a healthy weight has been proposed in cancer prevention strategies [3], suggesting a possible role of changes in BMI as well as baseline BMI regarding cancer risk

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