| Title: | Body Mass Index and Breast Cancer Risk Among Postmenopausal Women with and without Cardiometabolic Diseases: Findings from the Epic and UK Biobank Cohorts |
| Journal: | - |
| Published: | 1 Sep 2024 |
| DOI: | https://doi.org/10.2139/ssrn.4958839 |
Publication 13542
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
Background: Adiposity, measured by BMI, is a known risk factor for postmenopausal breast cancer. However, whether the association of BMI with breast cancer risk differs among women with and without cardiovascular diseases (CVD) or type 2 diabetes (T2D) is uncertain.Methods: We used individual participant data from the European Prospective Investigation into Cancer and nutrition (EPIC) and UK Biobank (UKB) that included 168,547 postmenopausal women, free of cancer, T2D, and CVD at recruitment. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with multivariable-adjusted Cox regression for associations between BMI and incident breast cancer by T2D and CVD status. Incidence rates per 1000 person-years and rate differences between observed and expected joint associations of adiposity and CVD or T2D for breast cancer were estimated. Study-specific estimates were meta-analyzed.Results: After a median follow-up of 10.7 years in EPIC and 10.9 years in UKB, 6,793 postmenopausal women developed breast cancer. In the meta-analysis of both cohorts, BMI (per 1-SD increment, 5 kg/m2) was more strongly associated with breast cancer risk in women with CVD (HR: 1.31, 95% CI: 1.16, 1.47) than in women without CVD (HR: 1.13, 95% CI: 1.10, 1.16) (p-interaction=0.02). T2D did not modify breast cancer risk (p-interaction=0.33). The meta-analyzed joint association of overweight (BMI≥25 kg/m2) and CVD led to 1.53 (95% CI 0.35, 2.71) more cases of breast cancer per 1000 person-years than expected, but no such joint association was observed with T2D.Interpretations: These findings may inform precision prevention strategies for women at higher risk of breast cancer.Funding: Funding [grant number: IIG_2019_1978] was obtained from World Cancer Research Fund (UK), as part of the World Cancer Research Fund International grant program. The coordination of EPIC-Europe is financially supported by International Agency for Research on Cancer (IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by: Danish Cancer Society (Denmark); Ligue Nationale Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale (MGEN), Institut National de la Santé et de la Recherche Médicale (INSERM), French National Research Agency (ANR, reference ANR-10-COHO-0006), French Ministry for Higher Education (subsidy 2102918823, 2103236497, and 2103586016) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC- Italy, Italian Ministry of Health, Italian Ministry of University and Research (MUR), Compagnia di San Paolo (Italy); "Europe against Cancer" Programme of the European Commission (DG SANCO); Dutch Ministry of Public Health, Welfare and Sports (VWS), the Netherlands Organisation for Health Research and Development (ZonMW), World Cancer Research Fund (WCRF), (The Netherlands); UiT The Arctic University of Norway; Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (C864/A14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (MR/N003284/1, MC-UU_12.Declaration of Interest: The authors declare that they have no competing interests.Ethical Approval: All participants from EPIC and UKB have provided written informed consent to participate in the respective cohorts. UKB has ethical approval from the Northwest Multi-Centre Research Ethics Committee. The EPIC study was approved by the Cancer Ethical Review Committee of IARC and by local ethical committees at the participating centers. The current study was approved by the IARC's Ethics Committee (No. 21-47).</p>
27 Authors
- Heinz Freisling
- Anna Jansana
- Laia Peruchet-Noray
- Reynalda Cordova
- Quan Gan
- Sabina Rinaldi
- Laure Dossus
- Yahya Mahamat-Saleh
- Marc J. Gunter
- Alicia K. Heath
- Dagfinn Aune
- Elif Inan-Eroglu
- Matthias Schulze
- Niels Bock
- Christina C. Dahm
- Carlota Castro-Espin
- Maria José Sánchez Pérez
- Aurora Perez-Cornago
- Sandar TinTin
- Sabina Sieri
- Vittorio Simeon
- Ricceri Fulvio
- Rosario Tumino
- N. Charlotte Onland-Moret
- Yvonne Koop
- Pietro Ferrari
- Emma Fontvieille
1 Application
| Application ID | Title |
|---|---|
| 55870 | Obesity and cancer risk and overall and cancer specific mortality: the role of metabolic health and comorbidities |
Enabling scientific discoveries that improve human health