Comparison of anthropometric measures as predictors of cancer incidence: A pooled collaborative analysis of 11 Australian cohorts
Corresponding Author
Jessica L. Harding
Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
Correspondence to: Jessica L. Harding Level 4, 99 Commercial Road Melbourne, VIC, Australia 3004, Tel.: +61 (3) 8532 1582, Fax: +61 (3) 8532 1100, E-mail: [email protected]Search for more papers by this authorJonathan E. Shaw
Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorKaarin J. Anstey
Research School of Population Health, The Australian National University, Canberra, Australia
Search for more papers by this authorRobert Adams
The Health Observatory Discipline of Medicine, The University of Adelaide, Adelaide, Australia
Search for more papers by this authorBeverley Balkau
Centre for Research in Epidemiology and Population Health, INSERM, U018 France
Search for more papers by this authorSharon L. Brennan-Olsen
IMPACT Strategic Research Centre School of Medicine, Deakin University, Geelong, Australia
Department of Medicine, NorthWest Academic Centre, The University of Melbourne, St Albans, Australia
Search for more papers by this authorTom Briffa
School of Population Health, The University of Western Australia, Crawley, Australia
Search for more papers by this authorTimothy M.E. Davis
School of Medicine and Pharmacology, The University of Western Australia, Crawley, Australia
Search for more papers by this authorWendy A. Davis
School of Medicine and Pharmacology, The University of Western Australia, Crawley, Australia
Search for more papers by this authorAnnette Dobson
School of Population Health, The University of Queensland, Brisbane, Australia
Search for more papers by this authorLeon Flicker
Centre for Medical Research, The University of Western Australia, Crawley, Australia
Search for more papers by this authorGraham Giles
Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
Search for more papers by this authorJanet Grant
Population Research & Outcome Studies, The University of Adelaide, Adelaide, Australia
Search for more papers by this authorRachel Huxley
School of Population Health, The University of Queensland, Brisbane, Australia
Search for more papers by this authorMatthew Knuiman
School of Population Health, The University of Western Australia, Crawley, Australia
Search for more papers by this authorMary Luszcz
Flinders Centre for Ageing Studies, Flinders University, Adelaide, Australia
Search for more papers by this authorRobert J. MacInnis
School of Population and Global Health, The University of Melbourne, Melbourne, Australia
Search for more papers by this authorPaul Mitchell
Westmead Millennium Institute, The University of Sydney, Sydney, Australia
Search for more papers by this authorJulie A. Pasco
IMPACT Strategic Research Centre School of Medicine, Deakin University, Geelong, Australia
Department of Medicine, NorthWest Academic Centre, The University of Melbourne, St Albans, Australia
Search for more papers by this authorChristopher Reid
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorDavid Simmons
Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
Department of Rural Health, The University of Melbourne, Shepparton, Australia
Search for more papers by this authorLeon Simons
UNSW Australia Lipid Research Dept, St Vincent's Hospital, Sydney, Australia
Search for more papers by this authorAndrew Tonkin
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorMark Woodward
The George Institute for Global Health, The University of Sydney, Sydney, Australia
The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, United Kingdom
Search for more papers by this authorAnna Peeters
Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
A.P. and D.J.M. Joint senior authorship
Search for more papers by this authorDianna J. Magliano
Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
A.P. and D.J.M. Joint senior authorship
Search for more papers by this authorCorresponding Author
Jessica L. Harding
Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
Correspondence to: Jessica L. Harding Level 4, 99 Commercial Road Melbourne, VIC, Australia 3004, Tel.: +61 (3) 8532 1582, Fax: +61 (3) 8532 1100, E-mail: [email protected]Search for more papers by this authorJonathan E. Shaw
Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorKaarin J. Anstey
Research School of Population Health, The Australian National University, Canberra, Australia
Search for more papers by this authorRobert Adams
The Health Observatory Discipline of Medicine, The University of Adelaide, Adelaide, Australia
Search for more papers by this authorBeverley Balkau
Centre for Research in Epidemiology and Population Health, INSERM, U018 France
Search for more papers by this authorSharon L. Brennan-Olsen
IMPACT Strategic Research Centre School of Medicine, Deakin University, Geelong, Australia
Department of Medicine, NorthWest Academic Centre, The University of Melbourne, St Albans, Australia
Search for more papers by this authorTom Briffa
School of Population Health, The University of Western Australia, Crawley, Australia
Search for more papers by this authorTimothy M.E. Davis
School of Medicine and Pharmacology, The University of Western Australia, Crawley, Australia
Search for more papers by this authorWendy A. Davis
School of Medicine and Pharmacology, The University of Western Australia, Crawley, Australia
Search for more papers by this authorAnnette Dobson
School of Population Health, The University of Queensland, Brisbane, Australia
Search for more papers by this authorLeon Flicker
Centre for Medical Research, The University of Western Australia, Crawley, Australia
Search for more papers by this authorGraham Giles
Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
Search for more papers by this authorJanet Grant
Population Research & Outcome Studies, The University of Adelaide, Adelaide, Australia
Search for more papers by this authorRachel Huxley
School of Population Health, The University of Queensland, Brisbane, Australia
Search for more papers by this authorMatthew Knuiman
School of Population Health, The University of Western Australia, Crawley, Australia
Search for more papers by this authorMary Luszcz
Flinders Centre for Ageing Studies, Flinders University, Adelaide, Australia
Search for more papers by this authorRobert J. MacInnis
School of Population and Global Health, The University of Melbourne, Melbourne, Australia
Search for more papers by this authorPaul Mitchell
Westmead Millennium Institute, The University of Sydney, Sydney, Australia
Search for more papers by this authorJulie A. Pasco
IMPACT Strategic Research Centre School of Medicine, Deakin University, Geelong, Australia
Department of Medicine, NorthWest Academic Centre, The University of Melbourne, St Albans, Australia
Search for more papers by this authorChristopher Reid
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorDavid Simmons
Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
Department of Rural Health, The University of Melbourne, Shepparton, Australia
Search for more papers by this authorLeon Simons
UNSW Australia Lipid Research Dept, St Vincent's Hospital, Sydney, Australia
Search for more papers by this authorAndrew Tonkin
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorMark Woodward
The George Institute for Global Health, The University of Sydney, Sydney, Australia
The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, United Kingdom
Search for more papers by this authorAnna Peeters
Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
A.P. and D.J.M. Joint senior authorship
Search for more papers by this authorDianna J. Magliano
Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
A.P. and D.J.M. Joint senior authorship
Search for more papers by this authorAbstract
Obesity is a risk factor for cancer. However, it is not known if general adiposity, as measured by body mass index (BMI) or central adiposity [e.g., waist circumference (WC)] have stronger associations with cancer, or which anthropometric measure best predicts cancer risk. We included 79,458 men and women from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on anthropometry [BMI, WC, Hip Circumference (HC), WHR, waist to height ratio (WtHR), A Body Shape Index (ABSI)], linked to the Australian Cancer Database. Cox proportional hazards models assessed the association between each anthropometric marker, per standard deviation and the risk of overall, colorectal, post-menopausal (PM) breast, prostate and obesity-related cancers. We assessed the discriminative ability of models using Harrell's c-statistic. All anthropometric markers were associated with overall, colorectal and obesity-related cancers. BMI, WC and HC were associated with PM breast cancer and no significant associations were seen for prostate cancer. Strongest associations were observed for WC across all outcomes, excluding PM breast cancer for which HC was strongest. WC had greater discrimination compared to BMI for overall and colorectal cancer in men and women with c-statistics ranging from 0.70 to 0.71. We show all anthropometric measures are associated with the overall, colorectal, PM breast and obesity-related cancer in men and women, but not prostate cancer. WC discriminated marginally better than BMI. However, all anthropometric measures were similarly moderately predictive of cancer risk. We do not recommend one anthropometric marker over another for assessing an individuals' risk of cancer.
Abstract
What's New?
The accumulation of excess fat around the abdomen is a well-known risk factor for cardiovascular and metabolic diseases and is associated with a variety of cancers. While measures that reflect central adiposity, namely waist circumference (WC) and waist-to-hip ratio (WHR), are strongly associated with cardiometabolic disease risk, their ability to predict cancer risk is unclear. In this study, overall cancer risk and risk of colorectal and obesity-related cancers were associated with multiple anthropometric measures—not only WC or WHR. An exception was prostate cancer, which was not significantly associated with any anthropometric marker.
Supporting Information
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