The association between body fatness and mortality among breast cancer survivors: results from a prospective cohort study.
Body fatness
Breast cancer survivors
Breast cancer-specific mortality
Mortality
Prospective study
Weight change
Journal
European journal of epidemiology
ISSN: 1573-7284
Titre abrégé: Eur J Epidemiol
Pays: Netherlands
ID NLM: 8508062
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
09
09
2022
accepted:
24
02
2023
medline:
8
5
2023
pubmed:
30
3
2023
entrez:
29
3
2023
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 36988840
doi: 10.1007/s10654-023-00979-5
pii: 10.1007/s10654-023-00979-5
pmc: PMC10163997
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
545-557Subventions
Organisme : AECC Scientific Foundation
ID : PRYES211366AGUD
Informations de copyright
© 2023. The Author(s).
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