Obesity increases risk for cancer death for white but not Black adults
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White adults with obesity have an increased risk for cancer death, whereas Black women with obesity have no increased risk and Black men with obesity have a lower risk for death from cancer, according to a presenter at ObesityWeek 2021.
“Cancer causes one of every five deaths in the United States,” Justin C. Brown, PhD, director of the cancer metabolism program at Pennington Biomedical Research Center at Louisiana State University, told Healio. “It is often assumed that because Black adults experience a disproportionate burden of obesity, this would predict risk of death from cancer. We tested if this common assumption was valid.”
Researchers analyzed data from the Pennington Center Longitudinal Study, a prospective cohort study of 18,296 adults (35% men; 34.3% Black adults) who participated in clinical trials at the Pennington Biomedical Research Center since 1992. BMI and waist circumference were obtained for each participant. Data from the Louisiana Tumor Registry were collected to identify deaths attributable to cancer.
During a median follow-up of 14.1 years, 346 participants died of cancer. Race modified the association between BMI and cancer death for men (P = .045). White men with a BMI of 35 kg/m2 had a significantly increased risk for cancer death compared with those with a BMI of 22 kg/m2 (HR = 1.74; 95% CI, 1.38-2.21). Conversely, Black men with a BMI of 35 kg/m2 had a significantly lower risk for cancer death compared with those with a BMI of 22 kg/m2 (HR = 0.64; 95% CI, 0.45-0.9).
Race did not modify the association between BMI and cancer death in women. White women with a BMI of 35 kg/m2 had a significantly increased risk for cancer death compared with those with a BMI of 22 kg/m2 (HR = 1.42; 95% CI, 1.18-1.7). The risk for cancer death did not significantly change by BMI for Black women.
Brown said there were several limitations to the data, including the cohort being participants in other clinical trials and not necessarily representative of the general public, residual confounding, lack of BMI measurements at multiple timepoints and an insufficient sample size to conduct cancer site-specific analysis.
“Race is a social and not a biological construct,” Brown said during the presentation about another limitation. “We have ongoing analyses that will allow us to integrate genetic ancestry into our analysis, and this may offer some additional insight into why these differences may exist.”
Additional research is needed to measure body composition through DXA or MRI to determine how specific tissues may predict cancer death, according to Brown.
“In addition, understanding the location of fat may be relevant to more accurately predicting death from cancer,” Brown told Healio.
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Brown JC, et al. Obesity and cancer death in white and Black adults: A prospective cohort study. Presented at: ObesityWeek 2021; Nov. 1-5, 2021 (virtual meeting).
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