Higher BMI linked to increased cancer risk in those with cardiovascular disease
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Key takeaways:
- Higher BMI increased the risk for obesity-associated cancer among European adults.
- Researchers observed an interaction between obesity and cardiovascular disease with risk for overall cancer.
Higher BMI increased the risk for obesity-related cancer among a cohort of European adults, irrespective of cardiometabolic disease status, according to study results.
The findings, published in BMC Medicine, suggest that obesity prevention could translate into further reduction in cancer risk among populations with cardiovascular disease, researchers concluded.
Methods
“For so long, research has focused solely on how BMI affects cancer risk for the general population. However, a growing proportion of the population is living with chronic conditions, which we thought may render these people more susceptible to develop cancer at the same level of overweight or obesity,” Heinz Freisling, PhD, cancer epidemiologist at International Agency for Research on Cancer, in Lyon, France, told Healio. “This is why we separated the risks into specific groups of people with cardiovascular diseases and cardiometabolic diseases, further showing the risk that living with overweight and obesity can have on cancer.”
Freisling and colleagues sought to examine separate and joint associations of BMI and cardiovascular disease/type 2 diabetes with cancer risk among 577,343 adults included in the UK Biobank and the European Prospective Investigation into Cancer and Nutrition (EPIC). All adults were free of cancer, cardiovascular disease and type 2 diabetes at baseline.
Investigators used Cox proportional hazard regressions to estimate multivariable-adjusted hazard ratios and 95% confidence intervals to assess associations between BMI and incidence of obesity-related cancer. They also assessed the association between overall cancer and multiplicative interaction between BMI and cardiometabolic diseases.
Researchers further assessed HRs and 95% CIs for separate and combined associations for categories of overweight/obesity and cardiometabolic disease status and additionally quantified through relative excess risk due to interaction (RERI).
Findings
Results showed a positive association between BMI and obesity-associated cancer risk among adults without cardiometabolic disease (HR = 1.11; 95% CI, 1.07-1.16).
Additional results revealed a positive association between BMI and obesity-associated cancer risk among adults with type 2 diabetes (HR = 1.11; 95% CI, 1.05-1.18), those with cardiovascular disease (HR = 1.17; 95% CI, 1.11-1.24) and a trend toward a positive association among those with type 2 diabetes and cardiovascular disease (HR = 1.09; 95% CI, 0.94-1.25).
Researchers additionally observed an additive interaction between obesity and cardiovascular disease with risk for overall cancer, which translated into a meta-analytical RERI of 0.28 (95% CI, 0.09–0.47).
“We found that unhealthy weight increased the risk for cancer among people living with diabetes or a cardiovascular disease to the same degree as the general population,” Freisling said. “Among people with a cardiovascular disease, unhealthy weight has what we call a risk additivity, which means that unhealthy weight is more detrimental in terms of cancer risk among people with cardiovascular disease than among those without cardiovascular disease.”
Implications
Obesity prevention strategies should be particularly beneficial to people living with cardiovascular diseases, Freisling told Healio.
“One should also consider targeting this population group for obesity prevention to mitigate cancer risk,” he said. “Our findings apply to overall cancer and to obesity-related cancers combined, which is very relevant for public health. However, we are next investigating which specific types of cancers are of particular concern, because such knowledge could be used to risk-stratify the population for screening.”
For more information:
Heinz Freisling, PhD, can be reached at freislingh@iarc.who.int.
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