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Body mass index and cancer risk among adults with and without cardiometabolic diseases: evidence from the EPIC and UK Biobank prospective cohort studies

Abstract:
Abstract Background Whether cancer risk associated with a higher body mass index (BMI), a surrogate measure of adiposity, differs among adults with and without cardiovascular diseases (CVD) and/or type 2 diabetes (T2D) is unclear. The primary aim of this study was to evaluate separate and joint associations of BMI and CVD/T2D with the risk of cancer. Methods This is an individual participant data meta-analysis of two prospective cohort studies, the UK Biobank (UKB) and the European Prospective Investigation into Cancer and nutrition (EPIC), with a total of 577,343 adults, free of cancer, T2D, and CVD at recruitment. We used Cox proportional hazard regressions to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between BMI and incidence of obesity-related cancer and in turn overall cancer with a multiplicative interaction between BMI and the two cardiometabolic diseases (CMD). HRs and 95% CIs for separate and joint associations for categories of overweight/obesity and CMD status were estimated, and additive interaction was quantified through relative excess risk due to interaction (RERI). Results In the meta-analysis of both cohorts, BMI (per ~ 5 kg/m 2 ) was positively associated with the risk of obesity-related cancer among participants without a CMD (HR: 1.11, 95%CI: 1.07,1.16), among participants with T2D (HR: 1.11, 95% CI: 1.05,1.18), among participants with CVD (HR: 1.17, 95% CI: 1.11,1.24), and suggestively positive among those with both T2D and CVD (HR: 1.09, 95% CI: 0.94,1.25). An additive interaction between obesity (BMI ≥ 30 kg/m 2 ) and CVD with the risk of overall cancer translated into a meta-analytical RERI of 0.28 (95% CI: 0.09–0.47). Conclusions Irrespective of CMD status, higher BMI increased the risk of obesity-related cancer among European adults. The additive interaction between obesity and CVD suggests that obesity prevention would translate into a greater cancer risk reduction among population groups with CVD than among the general population.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/s12916-023-03114-z
Publication website:
https://iris.unito.it/bitstream/2318/1947716/1/s12916-023-03114-z.pdf

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ORCID:
0000-0001-5488-9317
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ORCID:
0000-0002-9799-4421
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ORCID:
0000-0003-2256-618X
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ORCID:
0000-0002-7781-6433
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Author
ORCID:
0000-0001-8504-1618


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Funder identifier:
10.13039/501100000321
Grant:
IIG_2019_1978


Publisher:
BioMed Central
Journal:
BMC Medicine More from this journal
Volume:
21
Issue:
1
Pages:
418-418
Article number:
418
Publication date:
2023-11-23
DOI:
EISSN:
1741-7015
ISSN:
1741-7015


Language:
English
Keywords:
Pubs id:
1570548
Local pid:
pubs:1570548
Source identifiers:
W4388924457
Deposit date:
2026-06-04
ARK identifier:
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