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Weight Gain After Breast Cancer Diagnosis and All-Cause Mortality: Systematic Review and Meta-Analysis.
- Source :
- JNCI: Journal of the National Cancer Institute; Dec2015, Vol. 107 Issue 12, p1-15, 15p, 1 Diagram, 7 Charts
- Publication Year :
- 2015
-
Abstract
- <bold>Background: </bold>Overweight and obesity are associated with breast cancer mortality. However, the relationship between postdiagnosis weight gain and mortality is unclear. We conducted a systematic review and meta-analysis of weight gain after breast cancer diagnosis and breast cancer-specific, all-cause mortality and recurrence outcomes.<bold>Methods: </bold>Electronic databases identified articles up through December 2014, including: PubMed (1966-present), EMBASE (1974-present), CINAHL (1982-present), and Web of Science. Language and publication status were unrestricted. Cohort studies and clinical trials measuring weight change after diagnosis and all-cause/breast cancer-specific mortality or recurrence were considered. Participants were women age 18 years or older with stage I-IIIC breast cancer. Fixed effects analysis summarized the association between weight gain (≥5.0% body weight) and all-cause mortality; all tests were two-sided.<bold>Results: </bold>Twelve studies (n = 23 832) were included. Weight gain (≥5.0%) compared with maintenance (<±5.0%) was associated with increased all-cause mortality (hazard ratio [HR] = 1.12, 95% confidence interval [CI] = 1.03 to 1.22, P = .01, I(2) = 55.0%). Higher risk of mortality was apparent for weight gain ≥10.0% (HR = 1.23, 95% CI = 1.09 to 1.39, P < .001); 5% to 10.0% weight gain was not associated with all-cause mortality (P = .40). The association was not statistically significant for those with a prediagnosis body mass index (BMI) of less than 25 kg/m(2) (HR = 1.14, 95% CI = 0.99 to 1.31, P = .07) or with a BMI of 25 kg/m(2) or higher (HR = 1.00, 95% CI = 0.86 to 1.16, P = .19). Weight gain of 10.0% or more was not associated with hazard of breast cancer-specific mortality (HR = 1.17, 95% CI = 1.00 to 1.38, P = .05).<bold>Conclusions: </bold>Weight gain after diagnosis of breast cancer is associated with higher all-cause mortality rates compared with maintaining body weight. Adverse effects are greater for weight gains of 10.0% or higher. [ABSTRACT FROM AUTHOR]
- Subjects :
- REGULATION of body weight
BREAST tumors
CANCER relapse
CINAHL database
CONFIDENCE intervals
MEDICAL information storage & retrieval systems
MEDLINE
META-analysis
MORTALITY
ONLINE information services
PROBABILITY theory
RESEARCH funding
STATISTICAL hypothesis testing
TUMOR classification
WOMEN'S health
WEIGHT gain
SYSTEMATIC reviews
EVIDENCE-based medicine
BODY mass index
DESCRIPTIVE statistics
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 00278874
- Volume :
- 107
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- JNCI: Journal of the National Cancer Institute
- Publication Type :
- Academic Journal
- Accession number :
- 111875465
- Full Text :
- https://doi.org/10.1093/jnci/djv275