Abstract
BackgroundOverweight and diabetes are known cancer risk factors. This study examines independent and combined effects of weight gain and metabolic dysfunction during middle-adult years on obesity-related cancer risk.MethodsSubjects (n = 3850) aged 45–69 years at exams 3–5 in the Framingham Offspring Study were classified according to current and prior (~14 years earlier) weight status, interim weight change and prevalent metabolic dysfunction. Cancer risk among subjects who were overweight at baseline and remained overweight, as well as those who became overweight during follow-up, was compared with risk among normal-weight individuals.ResultsGaining ≥0.45 kg (≥1.0 pound)/year (vs. maintaining stable weight) over ~14 years increased cancer risk by 38% (95% confidence interval (CI), 1.09, 1.76); combined with metabolic dysfunction, weight gain increased cancer risk by 77% (95% CI, 1.21, 2.59). Compared with non-overweight adults, men and women who became overweight during midlife had 2.18-fold and 1.60-fold increased cancer risks; those who were overweight from baseline had non-statistically significant 28 and 33% increased cancer risks, respectively, despite having a midlife body mass index that was 3.4 kg/m2 higher than those who gained weight later.ConclusionMidlife weight gain was a strong cancer risk factor. This excess risk was somewhat stronger among those with concurrent metabolic dysfunction.
Highlights
A number of studies have identified excess body fat as a modifiable risk factor for certain cancers;[1] fewer studies have examined the effect of change in body weight on obesity-related cancer risk
Study population The Framingham Offspring Study includes the offspring of subjects participating in the original Framingham Heart Study, as well as their spouses
After controlling for confounding by age, height, education level, cigarettes/day, alcohol intake, physical activity, BMI at the start of the weight change period and age at the start of the weight change period, men and women who gained at least a pound per year had a higher risk of obesity-related cancer than those who had stable weight (hazard ratio (HR) 1.32; 95% confidence interval (CI), 0.88, 2.00 for men; HR 1.39; 95% CI, 1.03, 1.87 for women)
Summary
A number of studies have identified excess body fat as a modifiable risk factor for certain cancers;[1] fewer studies have examined the effect of change in body weight (loss or gain) on obesity-related cancer risk. This study examines independent and combined effects of weight gain and metabolic dysfunction during middle-adult years on obesity-related cancer risk. Compared with non-overweight adults, men and women who became overweight during midlife had 2.18-fold and 1.60-fold increased cancer risks; those who were overweight from baseline had non-statistically significant 28 and 33% increased cancer risks, respectively, despite having a midlife body mass index that was 3.4 kg/m2 higher than those who gained weight later. CONCLUSION: Midlife weight gain was a strong cancer risk factor This excess risk was somewhat stronger among those with concurrent metabolic dysfunction
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