Publication:
Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study.

Loading...
Thumbnail Image

Date

2022-04-11

Authors

Kohls, Mirjam
Freisling, Heinz
Charvat, Hadrien
Soerjomataram, Isabelle
Viallon, Vivian
Davila-Batista, Veronica
Kaaks, Rudolf
Turzanski-Fortner, Renee
Aleksandrova, Krasimira
Schulze, Matthias B

Advisors

Journal Title

Journal ISSN

Volume Title

Publisher

BioMed Central Ltd.
Metrics
Google Scholar
Export

Research Projects

Organizational Units

Journal Issue

Abstract

Body mass index (BMI) and cardiometabolic comorbidities such as cardiovascular disease and type 2 diabetes have been studied as negative prognostic factors in cancer survival, but possible dependencies in the mechanisms underlying these associations remain largely unexplored. We analysed these associations in colorectal and breast cancer patients. Based on repeated BMI assessments of cancer-free participants from four European countries in the European Prospective Investigation into Cancer and nutrition (EPIC) study, individual BMI-trajectories reflecting predicted mean BMI between ages 20 to 50 years were estimated using a growth curve model. Participants with incident colorectal or breast cancer after the age of 50 years were included in the survival analysis to study the prognostic effect of mean BMI and cardiometabolic diseases (CMD) prior to cancer. CMD were defined as one or more chronic conditions among stroke, myocardial infarction, and type 2 diabetes. Hazard ratios (HRs) and confidence intervals (CIs) of mean BMI and CMD were derived using multivariable-adjusted Cox proportional hazard regression for mean BMI and CMD separately and both exposures combined, in subgroups of localised and advanced disease. In the total cohort of 159,045 participants, there were 1,045 and 1,620 eligible patients of colorectal and breast cancer. In colorectal cancer patients, a higher BMI (by 1 kg/m2) was associated with a 6% increase in risk of death (95% CI of HR: 1.02-1.10). The HR for CMD was 1.25 (95% CI: 0.97-1.61). The associations for both exposures were stronger in patients with localised colorectal cancer. In breast cancer patients, a higher BMI was associated with a 4% increase in risk of death (95% CI: 1.00-1.08). CMDs were associated with a 46% increase in risk of death (95% CI: 1.01-2.09). The estimates and CIs for BMI remained similar after adjustment for CMD and vice versa. Our results suggest that cumulative exposure to higher BMI during early to mid-adulthood was associated with poorer survival in patients with breast and colorectal cancer, independent of CMD prior to cancer diagnosis. The association between a CMD diagnosis prior to cancer and survival in patients with breast and colorectal cancer was independent of BMI.

Description

MeSH Terms

Adult
Body Mass Index
Breast Neoplasms
Cardiovascular Diseases
Cohort Studies
Colorectal Neoplasms
Diabetes Mellitus, Type 2
Female
Humans
Middle Aged
Proportional Hazards Models
Prospective Studies
Risk Factors
Young Adult

DeCS Terms

Adulto
Diabetes Mellitus tipo 2
Enfermedades cardiovasculares
Estudios prospectivos
Estudios de cohortes
Factores de riesgo
Femenino
Modelos de riesgos proporcionales
Neoplasias colorrectales
Neoplasias de la mama
Índice de Masa Corporal

CIE Terms

Keywords

Body mass index, Breast cancer, Cardiovascular disease, Cohort study, Colorectal cancer, Comorbidity, Cumulative exposure, Diabetes, Survival

Citation

Kohls M, Freisling H, Charvat H, Soerjomataram I, Viallon V, Davila-Batista V, et al. Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study. BMC Cancer. 2022 May 14;22(1):546.