Comparison of anthropometric measures as predictors of cancer incidence: A pooled collaborative analysis of 11 Australian cohorts

Abstract

Obesity is a risk factor for cancer. However, it is not known if general adiposity, as measured by body mass index (BMI) or central adiposity [e.g., waist circumference (WC)] have stronger associations with cancer, or which anthropometric measure best predicts cancer risk. We included 79,458 men and women from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on anthropometry [BMI, WC, Hip Circumference (HC), WHR, waist to height ratio (WtHR), A Body Shape Index (ABSI)], linked to the Australian Cancer Database. Cox proportional hazards models assessed the association between each anthropometric marker, per standard deviation and the risk of overall, colorectal, post-menopausal (PM) breast, prostate and obesity-related cancers. We assessed the discriminative ability of models using Harrell's c-statistic. All anthropometric markers were associated with overall, colorectal and obesity-related cancers. BMI, WC and HC were associated with PM breast cancer and no significant associations were seen for prostate cancer. Strongest associations were observed for WC across all outcomes, excluding PM breast cancer for which HC was strongest. WC had greater discrimination compared to BMI for overall and colorectal cancer in men and women with c-statistics ranging from 0.70 to 0.71. We show all anthropometric

Lifetime body size and estrogen-receptor-positive breast cancer risk in the California Teachers Study cohort

“…In fact, among short postmenopausal women who became overweight or obese due to adult weight gain after age 18 years but prior to baseline, risk associated with gluteal adiposity was substantially greater than that due to abdominal adiposity. This finding is consistent with the recent report by Harding et al [18] suggesting that hip circumference may be a better predictor of postmenopausal breast cancer than waist circumference.…”

World Cancer Research Fund International: Continuous Update Project—systematic literature review and meta-analysis of observational cohort studies on physical activity, sedentary behavior, adiposity, and weight change and breast cancer risk

“…The positive association was stronger in European [46,79,97,145] and North American studies [41,56,76,82,94,98,101,136] than Australian and New Zealand studies (10 studies, 1 publication [135]) (p for meta-regression = 0.04) (Table S13); and was more evident among never or former users [41,56,79,82,130,136] than current or ever users [41,56,79,130,177] of postmenopausal hormones (p-values for meta-regression ≥ 0.06) ( Figs. 4 and S47-S48).…”

“…for meta-regression < 0.001). Asian studies[59, 86,112,158,174] showed an average stronger positive association than studies from Europe[46,47,49,63, 66, 72, 79, 88, 91, 96, 97,115,120,125,143,153,168,169,171,172], North America[44,51,56,57, 75, 80, 81, 98,100,101,136,152,159,167,171,178], and Australia and New Zealand[68,135] …”

The association between DXA‐derived body fat measures and breast cancer risk among postmenopausal women in the Women's Health Initiative

“…[3][4][5][6][7][8] These studies have provided consistent evidence to support a role for excess adiposity, as defined by having a BMI >25.0 kg/m 2 (overweight/obesity), in the development of breast cancer among postmenopausal women. [3][4][5][6][7][8] As a measure of adiposity, BMI is limited, in that it does not truly reflect one's body fat distribution, 9 and, therefore, may not precisely estimate breast cancer risk among persons with excess adiposity. In an attempt to better capture the influence of body fat distribution on risk of breast cancer, several epidemiological studies have investigated the associations of waist circumference (WC) and waist-to-hip-ratio (WHR), 4,8,10,11 indicators of central adiposity, with risk of postmenopausal breast cancer.…”