Adult weight gain and adiposity-related cancers: a dose-response meta-analysis of prospective observational studies

NaNa Keum; Darren C Greenwood; Dong Hoon Lee; Rockli Kim; Dagfinn Aune; Woong Ju; Frank B Hu; Edward L Giovannucci

doi:10.1093/jnci/djv088

Adult weight gain and adiposity-related cancers: a dose-response meta-analysis of prospective observational studies

J Natl Cancer Inst. 2015 Mar 10;107(2):djv088. doi: 10.1093/jnci/djv088. Print 2015 Feb.

Authors

NaNa Keum¹, Darren C Greenwood², Dong Hoon Lee², Rockli Kim², Dagfinn Aune², Woong Ju², Frank B Hu², Edward L Giovannucci²

Affiliations

¹ Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG). nak212@mail.harvard.edu.
² Departments of Nutrition and Epidemiology (NK, DHL, FBH, ELG) and Department of Social and Behavioral Sciences (RK), Harvard School of Public Health, Boston, MA; Division of Biostatistics, University of Leeds, Leeds, UK (DCG); Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway (DA); Department of Epidemiology and Biostatistics, Imperial College London, London, UK (DA); Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, Republic of Korea (WJ); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (FBH, ELG).

PMID: 25757865
DOI: 10.1093/jnci/djv088

Abstract

Background: Adiposity, measured by body mass index, is implicated in carcinogenesis. While adult weight gain has diverse advantages over body mass index in measuring adiposity, systematic reviews on adult weight gain in relation to adiposity-related cancers are lacking.

Methods: PubMed and Embase were searched through September 2014 for prospective observational studies investigating the relationship between adult weight gain and the risk of 10 adiposity-related cancers. Dose-response meta-analyses were performed using a random-effects model to estimate summary relative risk (RR) and 95% confidence interval (CI) for each cancer type. All statistical tests were two-sided.

Results: A total of 50 studies were included. For each 5 kg increase in adult weight gain, the summary relative risk was 1.11 (95% CI = 1.08 to 1.13) for postmenopausal breast cancer among no- or low-hormone replacement therapy (HRT) users, 1.39 (95% CI = 1.29 to 1.49) and 1.09 (95% CI = 1.02 to 1.16) for postmenopausal endometrial cancer among HRT nonusers and users, respectively, 1.13 (95% CI = 1.03 to 1.23) for postmenopausal ovarian cancer among no or low HRT users, 1.09 (95% CI = 1.04 to 1.13) for colon cancer in men. The relative risk of kidney cancer comparing highest and lowest level of adult weight gain was 1.42 (95% CI = 1.11 to 1.81). Adult weight gain was unrelated to cancers of the breast (premenopausal women, postmenopausal HRT users), prostate, colon (women), pancreas, and thyroid. An increase in risk associated with adult weight gain for breast cancer was statistically significantly greater among postmenopausal women (P(heterogeneity) = .001) and HRT nonusers (P(heterogeneity) = .001); that for endometrial cancer was alike among HRT nonusers (P(heterogeneity) = .04).

Conclusions: Avoiding adult weight gain itself may confer protection against certain types of cancers, particularly among HRT nonusers.

Publication types

Meta-Analysis
Review

MeSH terms

Adiposity*
Adult
Aged
Body Mass Index*
Breast Neoplasms / epidemiology
Breast Neoplasms / etiology
Colonic Neoplasms / epidemiology
Colonic Neoplasms / etiology
Endometrial Neoplasms / epidemiology
Endometrial Neoplasms / etiology
Estrogen Replacement Therapy
Female
Humans
Male
Middle Aged
Models, Statistical
Neoplasms / epidemiology*
Neoplasms / etiology*
Obesity / complications*
Observational Studies as Topic
Ovarian Neoplasms / epidemiology
Ovarian Neoplasms / etiology
Pancreatic Neoplasms / epidemiology
Pancreatic Neoplasms / etiology
Postmenopause*
Prospective Studies
Prostatic Neoplasms / epidemiology
Prostatic Neoplasms / etiology
Risk
Weight Gain*