Josefine De Ridder1, Cristina Julián-Almárcegui2,3, Amy Mullee3, Sabina Rinaldi4, Koen Van Herck1, German Vicente-Rodríguez2,5, Inge Huybrechts6,7. 1. Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. 2. GENUD "Growth, Exercise, Nutrition and Development" Research Group, University of Zaragoza, Zaragoza, Spain. 3. Dietary Exposure Assessment Group (DEX), International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France. 4. Biomarkers Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France. 5. Department of Physiatrist and Nursing, Faculty of Health and Sport Sciences, University of Zaragoza, Huesca, Spain. 6. Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. huybrechtsi@iarc.fr. 7. Dietary Exposure Assessment Group (DEX), International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France. huybrechtsi@iarc.fr.
Abstract
PURPOSE: In epidemiology, the relationship between increased adiposity and cancer risk has long been recognized. However, whether the association is the same for measures of abdominal or whole body adiposity is unclear. The aim of this systematic review is to compare cancer risk, associated with body mass index (BMI), an indicator of whole body adiposity, with indicators of abdominal adiposity in studies in which these indicators have been directly measured. METHODS: We conducted a systematic search from 1974 (EMBASE) and 1988 (PubMed) to September 2015 with keywords related to adiposity and cancer. Included studies were limited to cohort studies reporting directly measured anthropometry and performing mutually adjusted analyses. RESULTS: Thirteen articles were identified, with two reporting on breast cancer, three on colorectal cancer, three on endometrial cancer, two on gastro-oesophageal cancer, two on renal cancer, one on ovarian cancer, one on bladder cancer, one on liver and biliary tract cancer and one on leukaemia. Evidence suggests that abdominal adiposity is a stronger predictor than whole body adiposity for gastro-oesophageal, leukaemia and liver and biliary tract cancer in men and women and for renal cancer in women. Abdominal adiposity was a stronger predictor for bladder and colorectal cancer in women, while only BMI was a predictor in men. In contrast, BMI appears to be a stronger predictor for ovarian cancer. For breast and endometrial cancer, both measures were predictors for cancer risk in postmenopausal women. CONCLUSIONS: Only few studies used mutually adjusted and measured anthropometric indicators when studying adiposity-cancer associations. Further research investigating cancer risk and adiposity should include more accurate non-invasive indicators of body fat deposition and focus on the understudied cancer types, namely leukaemia, ovarian, bladder and liver and biliary tract cancer.
PURPOSE: In epidemiology, the relationship between increased adiposity and cancer risk has long been recognized. However, whether the association is the same for measures of abdominal or whole body adiposity is unclear. The aim of this systematic review is to compare cancer risk, associated with body mass index (BMI), an indicator of whole body adiposity, with indicators of abdominal adiposity in studies in which these indicators have been directly measured. METHODS: We conducted a systematic search from 1974 (EMBASE) and 1988 (PubMed) to September 2015 with keywords related to adiposity and cancer. Included studies were limited to cohort studies reporting directly measured anthropometry and performing mutually adjusted analyses. RESULTS: Thirteen articles were identified, with two reporting on breast cancer, three on colorectal cancer, three on endometrial cancer, two on gastro-oesophageal cancer, two on renal cancer, one on ovarian cancer, one on bladder cancer, one on liver and biliary tract cancer and one on leukaemia. Evidence suggests that abdominal adiposity is a stronger predictor than whole body adiposity for gastro-oesophageal, leukaemia and liver and biliary tract cancer in men and women and for renal cancer in women. Abdominal adiposity was a stronger predictor for bladder and colorectal cancer in women, while only BMI was a predictor in men. In contrast, BMI appears to be a stronger predictor for ovarian cancer. For breast and endometrial cancer, both measures were predictors for cancer risk in postmenopausal women. CONCLUSIONS: Only few studies used mutually adjusted and measured anthropometric indicators when studying adiposity-cancer associations. Further research investigating cancer risk and adiposity should include more accurate non-invasive indicators of body fat deposition and focus on the understudied cancer types, namely leukaemia, ovarian, bladder and liver and biliary tract cancer.
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