Combined association of general and central obesity with incidence and mortality of cancers in 22 sites

Parra Soto, S. L., Petermann-Rocha, F., Boonpor, J., Gray, S. R. , Pell, J. P. , Celis-Morales, C. and Ho, F. K. (2021) Combined association of general and central obesity with incidence and mortality of cancers in 22 sites. American Journal of Clinical Nutrition, 113(2), pp. 401-409. (doi: 10.1093/ajcn/nqaa335) (PMID:33381801)

Abstract

Background Body mass index (BMI) and waist circumference (WC) are measures of general and central obesity, respectively, and both have been shown to be associated with cancer. However, there is insufficient evidence of their combined association with the risk of cancer. Objectives This study aimed to investigate the associations of combinations of BMI and WC with cancer at 22 sites. Methods A total of 386,101 (54.5% women) UK Biobank participants aged from 37 to 73 y were included. The outcomes were incidence of and mortality from cancer at 22 sites. Participants were categorized as normal weight (BMI 18.5–24.9) or overweight (including obese, BMI ≥ 25) and as normal WC or centrally obese (WC ≥ 94 cm for men and ≥80 cm for women). Four mutually exclusive groups were derived: 1) normal weight without central obesity, 2) normal weight with central obesity, 3) overweight without central obesity, and 4) overweight with central obesity. We used Cox proportional hazards models to estimate HRs and 95% CIs. Results The mean follow-up period was 8.8 y. Compared with participants with normal weight and WC, men who were overweight and centrally obese had higher cancer incidence risk at 3 sites [stomach (HR: 1.75; 95% CI: 1.33, 2.32; Padj = 0.002), kidney (HR: 1.45; 95% CI: 1.17, 1.81; Padj = 0.016), and colorectal (HR: 1.31; 95% CI: 1.17, 1.47; Padj < 0.001) cancer]. Similar associations were found at 4 sites in women [endometrial (HR: 2.48; 95% CI: 2.06, 2.98; Padj < 0.001), uterine (HR: 2.23; 95% CI: 1.89, 2.64; Padj < 0.001), kidney (HR: 1.84; 95% CI: 1.37, 2.46; Padj = 0.001), and breast (HR: 1.24; 95% CI: 1.16, 1.32; Padj < 0.001) cancer] and for all-cause cancer (HR: 1.07; 95% CI: 1.03, 1.10; Padj = 0.003). Only endometrial cancer mortality (HR: 3.28; 95% CI: 1.77, 6.07; Padj = 0.004) was significantly associated with being overweight and centrally obese. Conclusions The combination of general and central obesity was associated with a higher risk at several cancer sites and some associations were sex-specific.

• Item Type: Articles
• Additional Information: Funding: SPS and FPR were funded by the Chilean Government PhD scholarship program JB were funded by the Thai Government PhD scholarship program. No other funding’s have been received for conducting this study.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ho, Dr Frederick and Parra, Solange and Celis, Dr Carlos and Gray, Professor Stuart and Pell, Professor Jill and Petermann-Rocha, Mrs Fanny and Boonpor, Jirapitcha
• Authors: Parra Soto, S. L., Petermann-Rocha, F., Boonpor, J., Gray, S. R., Pell, J. P., Celis-Morales, C., and Ho, F. K.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: American Journal of Clinical Nutrition
• Publisher: Oxford University Press
• ISSN: 0002-9165
• ISSN (Online): 1938-3207
• Published Online: 31 December 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in American Journal of Clinical Nutrition 113(2): 401-409
• Publisher Policy: Reproduced in accordance with the publisher copyright policy