Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States
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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.
KeywordsCHANCES Ageing Cohort Obesity Cancer Prevention
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.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
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