Waist circumference, body mass index, and postmenopausal breast cancer incidence in the Cancer Prevention Study-II Nutrition Cohort
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High body mass index (BMI) is an established risk factor for postmenopausal breast cancer. However, less is known about associations with waist circumference. In particular, it is unclear whether a larger waist circumference is associated with risk more than would be expected based solely on its contribution to BMI.
We examined the associations of BMI and waist circumference with risk of postmenopausal breast cancer, with and without mutual adjustment, in the Cancer Prevention Study-II Nutrition Cohort. Analyses included 28,965 postmenopausal women who reported weight and waist circumference on a questionnaire in 1997 and were not taking menopausal hormones.
During a median follow-up of 11.58 years, 1,088 invasive breast cancer cases were identified. Hazard ratios (HR) and 95 % confidence intervals (CI) were estimated from multivariable-adjusted Cox proportional hazard regression models. Without adjustment for BMI, a larger waist circumference was associated with higher risk of breast cancer (per 10 cm increase in waist circumference, HR = 1.13, 95 % CI 1.08–1.19). However, adjustment for BMI eliminated the association with waist circumference (per 10 cm HR = 1.00, 95 % CI 0.92–1.08). BMI was associated with risk unadjusted for waist circumference (per 1 kg/m2 HR = 1.04, 95 % CI 1.03–1.05) and adjusted for waist circumference (per 1 kg/m2 HR = 1.04, 95 % CI 1.02–1.06).
Our study of predominantly white women provides evidence that a larger waist circumference is associated with higher risk of postmenopausal breast cancer, but not beyond its contribution to BMI.
KeywordsBreast cancer Obesity Waist circumference
The American Cancer Society (ACS) funds the creation, maintenance, and updating of the Cancer Prevention Study-II (CPS-II) cohort. The authors thank the CPS-II participants and Study Management Group for their invaluable contributions to this research. The authors would also like to acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention National Program of Cancer Registries, and cancer registries supported by the National Cancer Institute Surveillance Epidemiology and End Results program.
Conflict of interest
The author(s) declare that they have no competing interests.
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