Overweight-years and cancer risk: A prospective study of the association and comparison of predictive performance with body mass index (Atherosclerosis Risk in Communities Study)

被引:4
作者
Hawwash, Nadin K. [1 ,2 ]
Sperrin, Matthew [3 ]
Martin, Glen P. [3 ]
Joshu, Corinne E. [4 ,5 ]
Florido, Roberta [6 ]
Platz, Elizabeth A. [4 ,5 ]
Renehan, Andrew G. [1 ,7 ]
机构
[1] Univ Manchester, Fac Biol Med & Hlth, Sch Med Sci, Div Canc Sci, Manchester, England
[2] Manchester Canc Res Ctr, Canc Res UK, Manchester, England
[3] Univ Manchester, Ctr Hlth Informat, Div Informat Imaging & Data Sci, Div Informat Imaging & Data Sci,Sch Hlth Sci, Manchester, England
[4] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[5] Sidney Kimmel Comprehens Canc Ctr Johns Hopkins, Baltimore, MD USA
[6] Johns Hopkins Univ, Div Cardiol, Baltimore, MD USA
[7] Manchester Biomed Res Ctr, Natl Inst Hlth Res NIHR, Manchester, England
关键词
BMI; cancer; life-course; obesity; overweight; DURATION; ADULTS;
D O I
10.1002/ijc.34821
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Excess body mass index (BMI) is associated with a higher risk of at least 13 cancers, but it is usually measured at a single time point. We tested whether the overweight-years metric, which incorporates exposure time to BMI >= 25 kg/m2, is associated with cancer risk and compared this with a single BMI measure. We used adulthood BMI readings in the Atherosclerosis Risk in Communities (ARIC) study to derive the overweight-years metric. We calculated associations between the metric and BMI and the risk of cancers using Cox proportional hazards models. Models that either included the metric or BMI were compared using Harrell's C-statistic. We included 13,463 participants, with 3,876 first primary cancers over a mean of 19 years (SD 7) of cancer follow-up. Hazard ratios for obesity-related cancers per standard deviation overweight-years were 1.15 (95% CI: 1.05-1.25) in men and 1.14 (95% CI: 1.08-1.20) in women. The difference in the C-statistic between models that incorporated BMI, or the overweight-years metric was non-significant in men and women. Overweight-years was associated with the risk of obesity-related cancers but did not outperform a single BMI measure in association performance characteristics. While obesity is associated with multiple cancer types, little is known about whether the duration of exposure to excess adipose impacts the development of obesity-related cancers. Here, the authors derived body mass index (BMI) cumulative exposure taking into account duration and degree of excess BMI. Comparison of the overweight-years metric to single BMI measures showed that cancer incidence is related to the cumulative degree and duration of overweight. Single BMI measures, however, were generally superior to the overweight-years metric in association performance characteristics. Nonetheless, the findings suggest that duration and degree of overweight should be considered in cancer prevention.image
引用
收藏
页码:1556 / 1568
页数:13
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