Volume 147, Issue 3 pp. 793-802
Cancer Epidemiology

Cumulative exposure to premenopausal obesity and risk of postmenopausal cancer: A population-based study in Icelandic women

Hwayoung Noh

Corresponding Author

Hwayoung Noh

Nutritional Methodology and Biostatistics Group, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France

Correspondence to: Hwayoung Noh, E-mail: [email protected]Search for more papers by this author
Hadrien Charvat

Hadrien Charvat

Section of Cancer Surveillance, International Agency for Research on Cancer (IARC-WHO), Lyon, France

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Heinz Freisling

Heinz Freisling

Nutritional Methodology and Biostatistics Group, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France

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Guðríður H. Ólafsdóttir

Guðríður H. Ólafsdóttir

Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland

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Elínborg J. Ólafsdóttir

Elínborg J. Ólafsdóttir

Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland

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Laufey Tryggvadóttir

Laufey Tryggvadóttir

Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland

Faculty of Medicine, Laeknagardur, University of Iceland, Reykjavik, Iceland

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Melina Arnold

Melina Arnold

Section of Cancer Surveillance, International Agency for Research on Cancer (IARC-WHO), Lyon, France

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Isabelle Soerjomataram

Isabelle Soerjomataram

Section of Cancer Surveillance, International Agency for Research on Cancer (IARC-WHO), Lyon, France

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First published: 21 November 2019
Citations: 15

Abstract

Obesity, often assessed at one point in time, is an established risk factor of several types of cancer, however, associations with cumulative exposure to obesity across the life course are not well understood. We investigated the relationship between combined measures of duration and intensity of premenopausal overweight and obesity and the incidence of postmenopausal breast, endometrial, and colorectal cancers in Icelandic women. Body mass index (BMI) trajectories between ages 20 and 50 of 88,809 women from the Cancer Detection Clinic Cohort were predicted using growth curve models. Indicators of overweight and obesity duration and intensity were computed and their association with risk of postmenopausal breast, endometrial, and colorectal cancers was examined using multivariate Cox models for subjects followed-up beyond the age of 50 (n = 67,488). During a mean follow-up of 17 years, incident events of 3,016 postmenopausal breast, 410 endometrial and 987 colorectal cancers were ascertained. Each 0.1 kg/m2 per year increase in BMI between ages 20 and 50 was positively associated with risks of postmenopausal breast, endometrium and colorectal cancers with hazard ratios equal to 1.09 (95% Confidence Interval (CI):1.04–1.13), 1.31 (95% CI: 1.18–1.44) and 1.10 (95% CI: 1.00–1.21), respectively. Compared to women who were never obese, cumulative BMI × years of obesity were linearly positively associated with risk of endometrial cancer, whereas the association with breast cancer was initially positive, but leveled off with increasing cumulative BMI × years. Cumulative exposure to obesity may provide additional insights into the etiology of cancer and should be considered in future studies that assess obesity–cancer relationships.

Abstract

What's new?

When investigating the risk of cancer associated with obesity, it can be challenging to summarize obesity in a metric that is most relevant to risk. Here the authors found that cumulative exposure – taking into consideration exposure duration and intensity – to premenopausal obesity was positively associated with risks of postmenopausal cancers, most prominently endometrial cancer but also breast and colorectal cancer. The authors propose that assessing the cumulative exposure to obesity may provide additional insights into the etiology of cancer.

Conflict of interest

The authors declare that they have no conflict of interest.

Data availability

The data that support the findings of our study are available from Dr Laufey Tryggvadóttir ([email protected]) with the permission of Dr Laufey Tryggvadóttir. Restrictions apply to the availability of these data, which were used under license for our study.

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