• Emma Fontvieille, Vivian Viallon, Martina Recalde, Reynalda Cordova, Anna Jansana, Laia Peruchet-Noray, Hannah Lennon, Alicia K Heath, Dagfinn Aune, Sofia Christakoudi, Verena Katzke, Rudolf Kaaks, Elif Inan-Eroglu, Matthias B Schulze, Lene Mellemkjær, Anne Tjønneland, Kim Overvad, Marta Farràs, Dafina Petrova, Pilar Amiano, María-Dolores Chirlaque, Conchi Moreno-Iribas, Sandar Tin Tin, Giovanna Masala, Sabina Sieri, Fulvio Ricceri, Salvatore Panico, Anne M May, Evelyn M Monninkhof, Elisabete Weiderpass, Marc J Gunter, Pietro Ferrari, and Heinz Freisling.
• Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), 25 Avenue Tony Garnier, CS 90627, 69366, Lyon, CEDEX 07, France.
• Bmc Med. 2023 Nov 23; 21 (1): 418418.

BackgroundWhether cancer risk associated with a higher body mass index (BMI), a surrogate measure of adiposity, differs among adults with and without cardiovascular diseases (CVD) and/or type 2 diabetes (T2D) is unclear. The primary aim of this study was to evaluate separate and joint associations of BMI and CVD/T2D with the risk of cancer.MethodsThis is an individual participant data meta-analysis of two prospective cohort studies, the UK Biobank (UKB) and the European Prospective Investigation into Cancer and nutrition (EPIC), with a total of 577,343 adults, free of cancer, T2D, and CVD at recruitment. We used Cox proportional hazard regressions to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between BMI and incidence of obesity-related cancer and in turn overall cancer with a multiplicative interaction between BMI and the two cardiometabolic diseases (CMD). HRs and 95% CIs for separate and joint associations for categories of overweight/obesity and CMD status were estimated, and additive interaction was quantified through relative excess risk due to interaction (RERI).ResultsIn the meta-analysis of both cohorts, BMI (per ~ 5 kg/m2) was positively associated with the risk of obesity-related cancer among participants without a CMD (HR: 1.11, 95%CI: 1.07,1.16), among participants with T2D (HR: 1.11, 95% CI: 1.05,1.18), among participants with CVD (HR: 1.17, 95% CI: 1.11,1.24), and suggestively positive among those with both T2D and CVD (HR: 1.09, 95% CI: 0.94,1.25). An additive interaction between obesity (BMI ≥ 30 kg/m2) and CVD with the risk of overall cancer translated into a meta-analytical RERI of 0.28 (95% CI: 0.09-0.47).ConclusionsIrrespective of CMD status, higher BMI increased the risk of obesity-related cancer among European adults. The additive interaction between obesity and CVD suggests that obesity prevention would translate into a greater cancer risk reduction among population groups with CVD than among the general population.© 2023. The Author(s).

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