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Tytuł:
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Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study.
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Autorzy:
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Kohls M; Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany.; Pettenkofer School of Public Health, Munich, Germany.; Cancer Surveillance Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France.
Freisling H; Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France. .
Charvat H; Cancer Surveillance Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France.
Soerjomataram I; Cancer Surveillance Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France.
Viallon V; Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France.
Davila-Batista V; Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France.
Kaaks R; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Turzanski-Fortner R; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Aleksandrova K; Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany.; Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
Schulze MB; Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Dahm CC; Department of Public Health, Aarhus University, Aarhus, Denmark.
Tilma Vistisen H; Department of Public Health, Aarhus University, Aarhus, Denmark.
Rostgaard-Hansen AL; Danish Cancer Society Research Centre, Diet, Genes and Environment, Copenhagen, Denmark.
Tjønneland A; Danish Cancer Society Research Centre, Diet, Genes and Environment, Copenhagen, Denmark.; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Bonet C; Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia, Barcelona, Spain.
Sánchez MJ; Escuela Andaluza de Salud Pública (EASP), Granada, Spain.; Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain.; CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain.; Universidad de Granada, Granada, Spain.
Colorado-Yohar S; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.; CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.; Research Group On Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia.
Masala G; Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy.
Palli D; Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy.
Krogh V; Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Milan, Italy.
Ricceri F; Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
Rolandsson O; Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
Lu SSM; Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
Tsilidis KK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Weiderpass E; International Agency for Research on Cancer - IARC/WHO, Lyon, France.
Gunter MJ; Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France.
Ferrari P; Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France.
Berger U; Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany.; Pettenkofer School of Public Health, Munich, Germany.
Arnold M; Cancer Surveillance Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France. .
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Źródło:
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BMC cancer [BMC Cancer] 2022 May 14; Vol. 22 (1), pp. 546. Date of Electronic Publication: 2022 May 14.
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Typ publikacji:
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Journal Article; Multicenter Study
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BioMed Central, [2001-
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MeSH Terms:
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Breast Neoplasms*/complications
Cardiovascular Diseases*/epidemiology
Colorectal Neoplasms*
Diabetes Mellitus, Type 2*/complications
Adult ; Body Mass Index ; Cohort Studies ; Female ; Humans ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Young Adult
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Grant Information:
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001 International WHO_ World Health Organization
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Contributed Indexing:
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Keywords: Body mass index; Breast cancer; Cardiovascular disease; Cohort study; Colorectal cancer; Comorbidity; Cumulative exposure; Diabetes; Survival
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Entry Date(s):
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Date Created: 20220515 Date Completed: 20220518 Latest Revision: 20240324
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Update Code:
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20240324
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PubMed Central ID:
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PMC9107127
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DOI:
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10.1186/s12885-022-09589-y
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PMID:
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35568802
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Background: Body mass index (BMI) and cardiometabolic comorbidities such as cardiovascular disease and type 2 diabetes have been studied as negative prognostic factors in cancer survival, but possible dependencies in the mechanisms underlying these associations remain largely unexplored. We analysed these associations in colorectal and breast cancer patients.
Methods: Based on repeated BMI assessments of cancer-free participants from four European countries in the European Prospective Investigation into Cancer and nutrition (EPIC) study, individual BMI-trajectories reflecting predicted mean BMI between ages 20 to 50 years were estimated using a growth curve model. Participants with incident colorectal or breast cancer after the age of 50 years were included in the survival analysis to study the prognostic effect of mean BMI and cardiometabolic diseases (CMD) prior to cancer. CMD were defined as one or more chronic conditions among stroke, myocardial infarction, and type 2 diabetes. Hazard ratios (HRs) and confidence intervals (CIs) of mean BMI and CMD were derived using multivariable-adjusted Cox proportional hazard regression for mean BMI and CMD separately and both exposures combined, in subgroups of localised and advanced disease.
Results: In the total cohort of 159,045 participants, there were 1,045 and 1,620 eligible patients of colorectal and breast cancer. In colorectal cancer patients, a higher BMI (by 1 kg/m2) was associated with a 6% increase in risk of death (95% CI of HR: 1.02-1.10). The HR for CMD was 1.25 (95% CI: 0.97-1.61). The associations for both exposures were stronger in patients with localised colorectal cancer. In breast cancer patients, a higher BMI was associated with a 4% increase in risk of death (95% CI: 1.00-1.08). CMDs were associated with a 46% increase in risk of death (95% CI: 1.01-2.09). The estimates and CIs for BMI remained similar after adjustment for CMD and vice versa.
Conclusions: Our results suggest that cumulative exposure to higher BMI during early to mid-adulthood was associated with poorer survival in patients with breast and colorectal cancer, independent of CMD prior to cancer diagnosis. The association between a CMD diagnosis prior to cancer and survival in patients with breast and colorectal cancer was independent of BMI.
(© 2022. The Author(s).)
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