Body mass index and cancer risk among adults with and without cardiometabolic diseases: evidence from the EPIC and UK Biobank prospective cohort studies
Emma Fontvieille,
Vivian Viallon,
Martina Recalde,
Reynalda Cordova,
Anna Jansana,
Laia Peruchet-Noray,
Hannah Lennon,
Alicia K. Heath,
Dagfinn Aune,
Sofia Christakoudi,
Verena Katzke,
Rudolf Kaaks,
Elif Inan-Eroglu,
Matthias B. Schulze,
Lene Mellemkjær,
Anne Tjønneland,
Kim Overvad,
Marta Farràs,
Dafina Petrova,
Pilar Amiano,
María-Dolores Chirlaque,
Conchi Moreno-Iribas,
Sandar Tin Tin,
Giovanna Masala,
Sabina Sieri,
Fulvio Ricceri,
Salvatore Panico,
Anne M. May,
Evelyn M. Monninkhof,
Elisabete Weiderpass,
Marc J. Gunter,
Pietro Ferrari,
Heinz Freisling
Affiliations
Emma Fontvieille
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Vivian Viallon
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Martina Recalde
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Reynalda Cordova
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Anna Jansana
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Laia Peruchet-Noray
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Hannah Lennon
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Alicia K. Heath
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London
Dagfinn Aune
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London
Sofia Christakoudi
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London
Verena Katzke
Department of Cancer Epidemiology, German Cancer Research Center (DKFZ)
Rudolf Kaaks
Department of Cancer Epidemiology, German Cancer Research Center (DKFZ)
Elif Inan-Eroglu
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke
Matthias B. Schulze
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke
Lene Mellemkjær
Danish Cancer Society Research Center
Anne Tjønneland
Danish Cancer Society Research Center
Kim Overvad
Department of Public Health, Aarhus University
Marta Farràs
Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Institut Català d’Oncologia, Bellvitge Biomedical Research Institute (IDIBELL)
Dafina Petrova
Escuela Andaluza de Salud Pública (EASP)
Pilar Amiano
Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa
María-Dolores Chirlaque
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
Conchi Moreno-Iribas
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
Sandar Tin Tin
Cancer Epidemiology Unit, Oxford Population Health, University of Oxford
Giovanna Masala
Institute for Cancer Research, Prevention and Clinical Network (ISPRO)
Sabina Sieri
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano
Fulvio Ricceri
Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health, University of Turin
Salvatore Panico
Department of Clinical Medicine and Surgery, Federico II University
Anne M. May
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University
Evelyn M. Monninkhof
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University
Elisabete Weiderpass
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Marc J. Gunter
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Pietro Ferrari
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Heinz Freisling
Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO)
Abstract Background Whether cancer risk associated with a higher body mass index (BMI), a surrogate measure of adiposity, differs among adults with and without cardiovascular diseases (CVD) and/or type 2 diabetes (T2D) is unclear. The primary aim of this study was to evaluate separate and joint associations of BMI and CVD/T2D with the risk of cancer. Methods This is an individual participant data meta-analysis of two prospective cohort studies, the UK Biobank (UKB) and the European Prospective Investigation into Cancer and nutrition (EPIC), with a total of 577,343 adults, free of cancer, T2D, and CVD at recruitment. We used Cox proportional hazard regressions to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between BMI and incidence of obesity-related cancer and in turn overall cancer with a multiplicative interaction between BMI and the two cardiometabolic diseases (CMD). HRs and 95% CIs for separate and joint associations for categories of overweight/obesity and CMD status were estimated, and additive interaction was quantified through relative excess risk due to interaction (RERI). Results In the meta-analysis of both cohorts, BMI (per ~ 5 kg/m2) was positively associated with the risk of obesity-related cancer among participants without a CMD (HR: 1.11, 95%CI: 1.07,1.16), among participants with T2D (HR: 1.11, 95% CI: 1.05,1.18), among participants with CVD (HR: 1.17, 95% CI: 1.11,1.24), and suggestively positive among those with both T2D and CVD (HR: 1.09, 95% CI: 0.94,1.25). An additive interaction between obesity (BMI ≥ 30 kg/m2) and CVD with the risk of overall cancer translated into a meta-analytical RERI of 0.28 (95% CI: 0.09–0.47). Conclusions Irrespective of CMD status, higher BMI increased the risk of obesity-related cancer among European adults. The additive interaction between obesity and CVD suggests that obesity prevention would translate into a greater cancer risk reduction among population groups with CVD than among the general population.
