Central body fatness is a stronger predictor of cancer risk than overall body size

Asalah Alareeki,Amanda M. Barberio,Darren R. Brenner,Paul Arora,Christine M. Friedenreich,Joy Pader,Jennifer E. Vena,Benjamin Viner

doi:10.1038/s41467-018-08159-w

Asalah Alareeki, Amanda M. Barberio

Open Access

https://doi.org/10.1038/s41467-018-08159-w

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Abstract

The importance of body size versus weight distribution for cancer risk is unclear. We investigated associations between measures of body size and shape and the risk of developing cancer. The study population consisted of 26,607 participants from the Alberta’s Tomorrow Project cohort. Two main measures of body shape and size were examined: i) body mass index (BMI) and ii) waist circumference (WC). Incident cancers were identified via linkage to the Alberta Cancer Registry. Cox proportional hazards models were used. Males and females classified as obese (BMI ≥ 30 kg /m−2) have a 33% and 22% increased risk of all-cancer, respectively, than their normal weight counterparts. Similar all-cancer risk increases are observed for those above sex-specific WC guidelines. Mutual adjustment for WC attenuates the association between BMI and all-cancer risk, especially among females. Central adiposity appears to be a stronger predictor of all-cancer risk than body size.

Highlights

The importance of body size versus weight distribution for cancer risk is unclear
A recent systematic review and meta-analysis by Aune et al (2015) examining anthropometric factors and endometrial cancer risk, as part of the World Cancer Research Fund (WCRF) Continuous Update Project, noted that a limited number of studies reported on waist circumference (WC) (4 out of 30) and waist-to-hip ratio (WHR) (5 out of 30), and few studies performed mutual adjustments for BMI and WC to elucidate their independent role in endometrial cancer risk[18]
The analytic study population consisted of 26,607 participants who completed the Health and Lifestyle Questionnaire (HLQ), Canadian Diet History Questionnaire (CDHQ), and Past Year Total Physical Activity Questionnaire (PYTPAQ), consented to data linkage, and had no previous cancer diagnosis in the Alberta Cancer Registry (ACR)

Summary

Introduction

The importance of body size versus weight distribution for cancer risk is unclear. We investigated associations between measures of body size and shape and the risk of developing cancer. In 2012, we estimated in Alberta, Canada the proportion of cancer cases attributable to excess body weight and found positive associations of overweight/obesity with risk of seven cancer sites (colorectal, breast, endometrial, esophageal, gallbladder, pancreatic, and kidney cancers); overall, we concluded that 17% and 12% cancers among males and females, respectively, could be attributed to excess body weight[17]. We utilized data from Alberta’s Tomorrow Project (ATP), a prospective cohort study that included three measures of body size and shape available for participants enrolled at baseline: (i) BMI, (ii) WC, and (iii) WHR. Our two main objectives were: (i) to examine the associations between various measures of body shape and size and the risk of all-cancer and site-specific cancers, and; (ii) to examine which is the stronger predictor of cancer risk—total body mass or central body fatness

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