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The association between body fatness and mortality among breast cancer survivors:results from a prospective cohort study

Authors :
Catalina Bonet
Marta Crous-Bou
Konstantinos K. Tsilidis
Marc J. Gunter
Rudolf Kaaks
Matthias B. Schulze
Renée T. Fortner
Christian S. Antoniussen
Christina C. Dahm
Lene Mellemkjær
Anne Tjønneland
Pilar Amiano
Eva Ardanaz
Sandra M. Colorado-Yohar
Miguel Rodriguez-Barranco
Sandar Tin Tin
Claudia Agnoli
Giovanna Masala
Salvatore Panico
Carlotta Sacerdote
Anne M. May
Kristin Benjaminsen Borch
Charlotta Rylander
Guri Skeie
Sofia Christakoudi
Dagfinn Aune
Elisabete Weiderpass
Laure Dossus
Elio Riboli
Antonio Agudo
Source :
Bonet, C, Crous-Bou, M, Tsilidis, K K, Gunter, M J, Kaaks, R, Schulze, M B, Fortner, R T, Antoniussen, C S, Dahm, C C, Mellemkjær, L, Tjønneland, A, Amiano, P, Ardanaz, E, Colorado-Yohar, S M, Rodriguez-Barranco, M, Tin Tin, S, Agnoli, C, Masala, G, Panico, S, Sacerdote, C, May, A M, Borch, K B, Rylander, C, Skeie, G, Christakoudi, S, Aune, D, Weiderpass, E, Dossus, L, Riboli, E & Agudo, A 2023, ' The association between body fatness and mortality among breast cancer survivors : results from a prospective cohort study ', European Journal of Epidemiology, vol. 38, no. 5, pp. 545-557 . https://doi.org/10.1007/s10654-023-00979-5
Publication Year :
2023

Abstract

Evidence linking body fatness to breast cancer (BC) prognosis is limited. While it seems that excess adiposity is associated with poorer BC survival, there is uncertainty over whether weight changes reduce mortality. This study aimed to assess the association between body fatness and weight changes pre- and postdiagnosis and overall mortality and BC-specific mortality among BC survivors. Our study included 13,624 BC survivors from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, with a mean follow-up of 8.6 years after diagnosis. Anthropometric data were obtained at recruitment for all cases and at a second assessment during follow-up for a subsample. We measured general obesity using the body mass index (BMI), whereas waist circumference and A Body Shape Index were used as measures of abdominal obesity. The annual weight change was calculated for cases with two weight assessments. The association with overall mortality and BC-specific mortality were based on a multivariable Cox and Fine and Gray models, respectively. We performed Mendelian randomization (MR) analysis to investigate the potential causal association. Five-unit higher BMI prediagnosis was associated with a 10% (95% confidence interval: 5–15%) increase in overall mortality and 7% (0–15%) increase in dying from BC. Women with abdominal obesity demonstrated a 23% (11–37%) increase in overall mortality, independent of the association of BMI. Results related to weight change postdiagnosis suggested a U-shaped relationship with BC-specific mortality, with higher risk associated with losing weight or gaining > 2% of the weight annually. MR analyses were consistent with the identified associations. Our results support the detrimental association of excess body fatness on the survival of women with BC. Substantial weight changes postdiagnosis may be associated with poorer survival.

Subjects

Subjects :
Epidemiology

Details

Language :
English
Database :
OpenAIRE
Journal :
Bonet, C, Crous-Bou, M, Tsilidis, K K, Gunter, M J, Kaaks, R, Schulze, M B, Fortner, R T, Antoniussen, C S, Dahm, C C, Mellemkjær, L, Tjønneland, A, Amiano, P, Ardanaz, E, Colorado-Yohar, S M, Rodriguez-Barranco, M, Tin Tin, S, Agnoli, C, Masala, G, Panico, S, Sacerdote, C, May, A M, Borch, K B, Rylander, C, Skeie, G, Christakoudi, S, Aune, D, Weiderpass, E, Dossus, L, Riboli, E & Agudo, A 2023, ' The association between body fatness and mortality among breast cancer survivors : results from a prospective cohort study ', European Journal of Epidemiology, vol. 38, no. 5, pp. 545-557 . https://doi.org/10.1007/s10654-023-00979-5
Accession number :
edsair.doi.dedup.....344c219a73b9f3cb70e1216b8df979b4