Search

Background: We investigated the association between body mass index (BMI) and obesity‐related cancer risk among individuals with/without incident hypertension (HTN), type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) and the joint associations of overweight/obesity (BMI ≥25 kg/m2) and each cardiometabolic condition with obesity‐related cancer risk Methods: We conducted a population‐based cohort (n = 1,774,904 individuals aged ≥40 years and free of cancer and cardiometabolic conditions at baseline) study between 2010 and 2018 with electronic health records from Spain. Our main outcome measures were hazard ratios (HRs) for incident obesity‐related cancers and relative excess risk due to interaction (RERI). Results: A total of 38,082 individuals developed obesity‐related cancers after a median of 8 years of follow‐up. The positive association between BMI and obesity‐related cancer risk was similar among individuals free of cardiometabolic conditions (hazard ratio, HR per 5 kg/m2: 1.08, 95% confidence interval, CI: 1.06–1.10) and with incident HTN (1.05, 1.01–1.08). The association among those with incident T2DM was null (0.98, 0.93–1.03). There was a positive additive interaction between overweight/obesity and CVD (relative excess risk due to interaction [RERI]: 0.19 [0.09, 0.30]), meaning that the combined association was 0.19 more than the sum of the individual associations. In contrast, a RERI of −0.24 (−0.28, −0.20) was observed for the combined association between overweight/obesity and T2DM. Conclusions: Public health strategies to reduce overweight can help prevent cancer cases among the general population and individuals with incident HTN/CVD. Further, weight‐loss interventions seem to lead to a greater cancer risk reduction among individuals with CVD. [ABSTRACT FROM AUTHOR]

Key Features The Information System for Research in Primary Care (SIDIAP) is a database of population-wide primary care electronic health records that was created to provide a useful tool for healthcare research. Data resource basics Primary care in Catalonia, Spain Spain has a universal taxpayer-funded health system that is decentralized to its 17 autonomous communities (the country's first level of political and administrative division).[1] Primary care is free of charge and is the main entry point for accessing public non-emergency health-related services that are delivered through primary care. The growth in the recording of information in SIDIAP over time is shown in Figure 3a and b. For example, in 2019, ~80% of the SIDIAP population had at least one visit to primary care and >60% had one clinical diagnosis and/or a prescription/dispensation for a medication (Figure 3a). The Information System for Research in Primary Care The Information System for Research in Primary Care (SIDIAP; www.sidiap.org) database includes routinely collected data by >30 000 professionals from the ICS. [Extracted from the article]

Background: A high body mass index (BMI) has been associated with increased risk of several cancers; however, whether BMI is related to a larger number of cancers than currently recognized is unclear. Moreover, whether waist circumference (WC) is more strongly associated with specific cancers than BMI is not well established. We aimed to investigate the associations between BMI and 26 cancers accounting for non-linearity and residual confounding by smoking status as well as to compare cancer risk estimates between BMI and WC.Methods: Prospective cohort study with population-based electronic health records from Catalonia, Spain. We included 3,658,417 adults aged ≥ 18 years and free of cancer at baseline between 2006 and 2017. Our main outcome measures were cause-specific hazard ratios (HRs) with 99% confidence intervals (CIs) for incident cancer at 26 anatomical sites.Results: After a median follow-up time of 8.3 years, 202,837 participants were diagnosed with cancer. A higher BMI was positively associated with risk of nine cancers (corpus uteri, kidney, gallbladder, thyroid, colorectal, breast post-menopausal, multiple myeloma, leukemia, non-Hodgkin lymphoma) and was positively associated with three additional cancers among never smokers (head and neck, brain and central nervous system, Hodgkin lymphoma). The respective HRs (per 5 kg/m2 increment) ranged from 1.04 (99%CI 1.01 to 1.08) for non-Hodgkin lymphoma to 1.49 (1.45 to 1.53) for corpus uteri cancer. While BMI was negatively associated to five cancer types in the linear analyses of the overall population, accounting for non-linearity revealed that BMI was associated to prostate cancer in a U-shaped manner and to head and neck, esophagus, larynx, and trachea, bronchus and lung cancers in an L-shaped fashion, suggesting that low BMIs are an approximation of heavy smoking. Of the 291,305 participants with a WC measurement, 27,837 were diagnosed with cancer. The 99%CIs of the BMI and WC point estimates (per 1 standard deviation increment) overlapped for all cancers.Conclusions: In this large Southern European study, a higher BMI was associated with increased risk of twelve cancers, including four hematological and head and neck (only among never smokers) cancers. Furthermore, BMI and WC showed comparable estimates of cancer risk associated with adiposity. [ABSTRACT FROM AUTHOR]

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/m2) 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/m2) 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. [ABSTRACT FROM AUTHOR]

The association between air pollution and green spaces with breast cancer risk stratified by menopausal status has not been frequently investigated despite its importance given the different impact of risk factors on breast cancer risk depending on menopausal status. To study the association between air pollution, green spaces and pre and postmenopausal breast cancer risk. We conducted a population-based cohort study using electronic primary care records in Catalonia. We included women aged 17–85 years free of cancer at study entry between 2009 and 2017. Our exposures were particulate matter <2.5 μm (PM 2.5) & <10 μm (PM 10), nitrogen dioxide (NO 2), normalized difference vegetation index (NDVI), and percentage of green spaces estimated at the census tract level. Breast cancer was identified with ICD-10 code C50. We estimated cause-specific hazard ratios (HR) for the relationship between each individual exposure and pre and postmenopausal breast cancer risk, using linear and non-linear models. Of the 1,054,180 pre and 744,658 postmenopausal women followed for a median of 10 years, 6,126 and 17,858 developed breast cancer, respectively. Among premenopausal women, only very high levels of PM 10 (≥46 μg/m3) were associated with increased cancer risk (compared to lower levels) in non-linear models. Among postmenopausal women, an interquartile range increase in PM 2.5 (HR:1.03; 95%CI:1.01–1.04), PM 10 (1.03; 1.01–1.05), and NO 2 (1.05; 1.02–1.08) were associated with higher cancer risk. NDVI was negatively associated with decreased cancer risk only among postmenopausal women who did not change residence during follow-up (0.84; 0.71–0.99) or who were followed for at least three years (0.82; 0.69–0.98). Living in areas with high concentrations of PM 2.5 , PM 10 , and NO 2 increases breast cancer risk in postmenopausal women while long-term exposure to green spaces may decrease this risk. Only very high concentrations of PM 10 increase breast cancer risk in premenopausal women. • High levels of PM and NO 2 increase breast cancer risk in postmenopausal women. • Very high concentrations of PM 10 increase breast cancer risk in premenopausal women. • Long-term exposure to green spaces may decrease breast cancer risk in older women. • We used survival models with restricted cubic splines to investigate associations. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MS) has emerged as a significant global health concern. The relationship between MS and the risk of cancer doesn't seem clear, whether examining by components or in combination. The objective of this study is to examine the relationship between MS, its components, and the overall risk of cancer, including the risk of 13 specific cancer types. Methods: We included 3,918,781 individuals aged 40 years or older sourced from the SIDIAP database between 2008 and 2017. Cox models were employed with MS components and their combinations. A subsample was created using a matched cohort (by age and sex). Incidence curves were computed to determine the time elapsed between the date of having 1–5 MS components and cancer incidence, compared to matched participants with no MS components, which showed that individuals who had one MS component experienced a greater incidence of cancer over 5 and 10 years than individuals with no MS, and the incidence rose with an increase in the number of MS components. Results: Individuals exposed to MS components were diagnosed with cancer earlier than those who were not exposed to them. In the Cox model, HDL (HR 1.46, 95% CI: 1.41–1.52) and Glycemia (HR 1.40, 95% CI: 1.37–1.44) were the individual combinations with the highest risk of overall cancer. In combinations with two components, the highest HR was HDL+Glycemia (HR 1.52, 95% CI: 1.45–1.59) and Glycemia+HBP (HR 1.48, 95% CI: 1.45–1.50). In combinations with three components, the highest HR was HDL+Glycemia+HBP (HR 1.58, 95% CI: 1.55–1.62). Conclusion: In summary, having one or more MS components raises the risk of developing at least 11 cancer types and these risk differ according to type of component included. Some sex differences are also observed. Our findings suggest that implementing prevention measures aimed at specific MS components may lower the risk of various cancer types. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MS) is the simultaneous occurrence of a cluster of predefined cardiovascular risk factors. Although individual MS components are associated with increased risk of cancer, it is still unclear whether the association between MS and cancer differs from the association between individual MS components and cancer. The aim of this matched case-control study was to estimate the association of 13 types of cancer with (1) MS and (2) the diagnosis of 0, 1 or 2 individual MS components. Methods: Cases included 183,248 patients ≥40 years from the SIDIAP database with incident cancer diagnosed between January 2008-December 2017. Each case was matched to four controls by inclusion date, sex and age. Adjusted conditional logistic regression models were used to evaluate the association between MS and cancer risk, comparing the effect of global MS versus having one or two individual components of MS. Results: MS was associated with an increased risk of the following cancers: colorectal (OR: 1.28, 95%CI: 1.23–1.32), liver (OR: 1.93, 95%CI: 1.74–2.14), pancreas (OR: 1.79, 95%CI: 1.63–1.98), post-menopausal breast (OR: 1.10, 95%CI: 1.06–1.15), pre-menopausal endometrial (OR: 2.14, 95%CI: 1.74–2.65), post-menopausal endometrial (OR: 2.46, 95%CI: 2.20–2.74), bladder (OR: 1.41, 95%CI: 1.34–1.48), kidney (OR: 1.84, 95%CI: 1.69–2.00), non-Hodgkin lymphoma (OR: 1.23, 95%CI: 1.10–1.38), leukaemia (OR: 1.42, 95%CI: 1.31–1.54), lung (OR: 1.11, 95%CI: 1.05–1.16) and thyroid (OR: 1.71, 95%CI: 1.50–1.95). Except for prostate, pre-menopause breast cancer and Hodgkin and non-Hodgkin lymphoma, MS is associated with a higher risk of cancer than 1 or 2 individual MS components. Estimates were significantly higher in men than in women for colorectal and lung cancer, and in smokers than in non-smokers for lung cancer. Conclusion: MS is associated with a higher risk of developing 11 types of common cancer, with a positive correlation between number of MS components and risk of cancer. [ABSTRACT FROM AUTHOR]