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Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States

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Abstract

Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing different forms of cancer. Study participants from seven European and one US cohort study with two or more weight assessments during follow-up were included (n = 329,576). Trajectories of body mass index (BMI) across ages were estimated using a quadratic growth model; overweight duration (BMI ≥ 25) and cumulative weighted overweight years were calculated. In multivariate Cox models and random effects analyses, a longer duration of overweight was significantly associated with the incidence of obesity-related cancer [overall hazard ratio (HR) per 10-year increment: 1.36; 95 % CI 1.12–1.60], but also increased the risk of postmenopausal breast and colorectal cancer. Additionally accounting for the degree of overweight further increased the risk of obesity-related cancer. Risks associated with a longer overweight duration were higher in men than in women and were attenuated by smoking. For postmenopausal breast cancer, increased risks were confined to women who never used hormone therapy. Overall, 8.4 % of all obesity-related cancers could be attributed to overweight at any age. These findings provide further insights into the role of overweight duration in the etiology of cancer and indicate that weight control is relevant at all ages. This knowledge is vital for the development of effective and targeted cancer prevention strategies.

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Acknowledgments

Data used throughout the present study are derived from the CHANCES project. The project is coordinated by the Hellenic Health Foundation, Greece. The project received funding by the FP7 framework programme of DG-RESEARCH in the European Commission (Grant Agreement No. HEALTH-F3-2010-242244). EPIC Greece: funded by the Hellenic Health Foundation. EPIC Netherlands: funded by European Commission (DG SANCO); Dutch Ministry of Public Health, Welfare and Sports (VWS); The National Institute for Public Health and the Environment; the Dutch Cancer Society, the Netherlands Organisation for Health Research and Development (ZONMW); World Cancer Research Fund (WCRF). EPIC Spain: supported by Health Research Fund (FIS) of the Spanish Ministry of Health RTICC ‘Red Temática de Investigación Cooperativa en Cáncer (Grant Numbers: Rd06/0020/0091 and Rd12/0036/0018), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (Project 6236), and Navarra, Instituto de Salud Carlos III, Redes de Investigacion Cooperativa (RD06/0020). ESTHER: funded by the Baden-Württemberg state Ministry of Science, Research and Arts (Stuttgart, Germany), the Federal Ministry of Education and Research (Berlin, Germany), and the Federal Ministry of Family Affairs, Senior Citizens, Women and Youth (Berlin, Germany). PRIME Belfast: supported by grants from the Institut National de la Santé et de la Recherche Médicale (INSERM), the Merck, Sharp and Dohme-Chibret Laboratory and the Northern Ireland Health and Social Care Research and Development Office. NIH-AARP: support for the National Institutes of Health (NIH)-AARP Diet and Health Study was provided by the Intramural Research Program of the National Cancer Institute (NCI), NIH. Tromsø: funded by: UiT The Arctic University of Norway, the National Screening Service, and the Research Council of Norway. MA and IS were additionally supported by the World Cancer Research Fund International (Grant Number SG 2012/619).

Collaborators on behalf of the CHANCES consortium

Migle Baceviciene, Jolanda M A Boer, Wojciech Drygas, Sture Eriksson, Edith Feskens, Valeriy Gafarov, Julian Gardiner, Niclas Hakansson, Jan-Hakan Jansson, Pekka Jousilahti, Ellen Kampman, Jukka Kontto, Ruzena Kubinova, Max Leenders, Allan Linneberg, Maja-Lisa Lochen, Roberto Lorbeer, Sofia Malyutina, Ellisiv B Mathiesen, Hakan Melhus, Karl Michaëlsson, Inger Njolstad, Nicola Orsini, Andrzej Pająk, Hynek Pikhart, Charlotta Pisinger, Veikko Salomaa, María-José Sánchez, Susana Sans, Barbara Schaan, Andrea Schneider, Galatios Siganos, Stefan Söderberg, Martinette Streppel, Abdonas Tamošiūnas, Giovanni Veronesi, Eveline Waterham, Patrik Wennberg.

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Authors and Affiliations

  1. Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France

    Melina Arnold, Freddie Bray & Isabelle Soerjomataram

  2. Section of Nutrition and Metabolism, Dietary Exposure Assessment Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France

    Heinz Freisling

  3. Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, National Cancer Institute (NCI/DCEG), 9609 Medical Center Drive, Bethesda, MD, 20892, USA

    Rachael Stolzenberg-Solomon

  4. UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, University Road, Belfast, BT7 1NN, Northern Ireland, UK

    Frank Kee & Mark George O’Doherty

  5. Network Aging Research (NAR), Heidelberg University, Bergheimer Straße 20, 69115, Heidelberg, Germany

    José Manuel Ordóñez-Mena

  6. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany

    José Manuel Ordóñez-Mena

  7. Department of Community Medicine, The Arctic University of Norway, 9037, Tromsø, Norway

    Tom Wilsgaard

  8. Juliu Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands

    Anne Maria May

  9. Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands

    Hendrik Bas Bueno-de-Mesquita

  10. Department of Gastroenterology and Hepatology, University Medical Centre, Huispost Str. 6.131, 3508 GA, Utrecht, The Netherlands

    Hendrik Bas Bueno-de-Mesquita

  11. Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK

    Hendrik Bas Bueno-de-Mesquita

  12. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    Hendrik Bas Bueno-de-Mesquita

  13. Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark

    Anne Tjønneland

  14. Hellenic Health Foundation, 13 Kaisareias & Alexandroupoleos, 115 27, Athens, Greece

    Philippos Orfanos, Antonia Trichopoulou & Paolo Boffetta

  15. Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Mikras Asias 75, 115 27, Athens, Greece

    Antonia Trichopoulou

  16. Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1128, New York, NY, 10029-6574, USA

    Paolo Boffetta

  17. Section of Nutrition and Metabolism, Nutritional Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France

    Mazda Jenab

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  1. Melina Arnold
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  2. Heinz Freisling
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  8. Anne Maria May
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Consortia

on behalf of the CHANCES consortium

  • Migle Baceviciene
  • , Jolanda M. A. Boer
  • , Wojciech Drygas
  • , Sture Eriksson
  • , Edith Feskens
  • , Valeriy Gafarov
  • , Julian Gardiner
  • , Niclas Hakansson
  • , Jan-Hakan Jansson
  • , Pekka Jousilahti
  • , Ellen Kampman
  • , Jukka Kontto
  • , Ruzena Kubinova
  • , Max Leenders
  • , Allan Linneberg
  • , Maja-Lisa Lochen
  • , Roberto Lorbeer
  • , Sofia Malyutina
  • , Ellisiv B. Mathiesen
  • , Hakan Melhus
  • , Karl Michaëlsson
  • , Inger Njolstad
  • , Nicola Orsini
  • , Andrzej Pająk
  • , Hynek Pikhart
  • , Charlotta Pisinger
  • , Veikko Salomaa
  • , María-José Sánchez
  • , Susana Sans
  • , Barbara Schaan
  • , Andrea Schneider
  • , Galatios Siganos
  • , Stefan Söderberg
  • , Martinette Streppel
  • , Abdonas Tamošiūnas
  • , Giovanni Veronesi
  • , Giovanni Veronesi
  •  & Patrik Wennberg

Corresponding author

Correspondence to Melina Arnold.

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Arnold, M., Freisling, H., Stolzenberg-Solomon, R. et al. Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States. Eur J Epidemiol 31, 893–904 (2016). https://doi.org/10.1007/s10654-016-0169-z

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