Obesity and elevated central adiposity were associated with increased risk for future cancers, including gastrointestinal and gynecologic cancer, researchers reported.
In addition, elevated circulating C-reactive protein levels were associated with increased risk for future overall, colorectal and lung cancer, according to data published in JACC: CardioOncology.
“Obesity is increasing globally, with more than 40% of adults and 20% of children in the United States currently categorized as obese (BMI 30 kg/m2) and 6.9% of incident cancers attributed to excess body weight. Increased adiposity creates a chronic proinflammatory state, which may be a shared mechanism underlying the development of many comorbidities, including cancer,” Elizabeth E. Liu, BS, of the CardioVascular Institute at Beth Israel Deaconess Medical Center, and colleagues wrote. “We sought to leverage two large prospective longitudinal community-based inception cohorts to examine the association of obesity with future development of histologically confirmed cancer.”
Researchers included 20,667 participants (mean age, 50 years; 53% women) in the Framingham Heart and PREVEND studies without cancer at baseline and evaluated the association between obesity, waist circumference, visceral and subcutaneous adipose tissue and CRP with future cancer.
Obesity, adiposity and future cancer risk
During a median follow-up of 15 years, 2,619 cancer events occurred.
Researchers observed that obesity was associated with elevated risk for gastrointestinal cancer (HR = 1.3; 95% CI, 1.05-1.6), gynecologic cancer (HR = 1.62; 95% CI, 1.08-2.45) and breast cancer (HR = 1.32; 95% CI, 1.05-1.66) and reduced risk for lung cancer (HR = 0.62; 95% CI, 0.44-0.87).
High waist circumference was associated with increased risk for future overall cancer (HR = 1.07; 95% CI, 1.01-1.13; P = .02), as well as gastrointestinal and gynecologic cancer, but not lung cancer.
Visceral, but not subcutaneous, adipose tissue was associated with elevated for overall cancer (HR = 1.22; 95% CI, 1.05-1.43), lung cancer (HR = 1.92; 95% CI, 1.01-3.66) and melanoma (HR = 1.56; 95% CI, 1.02-2.38), regardless of BMI, according to the study.
Researchers also observed that pericardial adipose tissue was associated with future risk for overall cancer (HR = 1.14; 95% CI, 1.02-1.27; P = .018), melanoma (HR = 1.4; 95% CI, 1.07-1.82; P = .013) and lung cancer (HR = 1.51; 95% CI, 1.01-2.26; P = .044).
Moreover, elevated circulating CRP levels were associated with risk for overall, colorectal and lung cancer (P for all < .05).
Targeted interventions needed
“Of particular interest is the observed heterogeneity in risk for site-specific cancers, underscoring the argument that not all cancers are the same and that targeted interventions need to be personalized,” Kerryn W. Reding, PhD, MPH, RN, adjunct associate professor of epidemiology, associate professor of biobehavioral nursing and health informatics at University of Washington School of Public Health and assistant member in the public health sciences division at Fred Hutchinson Cancer Research Center, and colleagues wrote in a related editorial. “Not all cancer sites were associated with obesity or central adiposity, and some differed in directionality of association.
“Cancer control has been historically focused on tobacco cessation and limits to alcohol intake, as well as access to screening and genetic testing,” the editorial authors wrote. “Proper nutrition, reduction of obesity and adiposity are universal concerns and require equal attention from all aspects of society, not only from health care providers, but also in collaboration with the food industry, government and public health researchers.”
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