Abstract
Early-adulthood body size is strongly inversely associated with risk of premenopausal breast cancer. It is unclear whether subsequent changes in weight affect risk. We pooled individual-level data from 17 prospective studies to investigate the association of weight change with premenopausal breast cancer risk, considering strata of initial weight, timing of weight change, other breast cancer risk factors and breast cancer subtype. Hazard ratios (HR) and 95% confidence intervals (CI) were obtained using Cox regression. Among 628,463 women, 10,886 were diagnosed with breast cancer before menopause. Models adjusted for initial weight at ages 18–24 years and other breast cancer risk factors showed that weight gain from ages 18–24 to 35–44 or to 45–54 years was inversely associated with breast cancer overall (e.g., HR per 5 kg to ages 45–54: 0.96, 95% CI: 0.95–0.98) and with oestrogen-receptor(ER)-positive breast cancer (HR per 5 kg to ages 45–54: 0.96, 95% CI: 0.94–0.98). Weight gain from ages 25–34 was inversely associated with ER-positive breast cancer only and weight gain from ages 35–44 was not associated with risk. None of these weight gains were associated with ER-negative breast cancer. Weight loss was not consistently associated with overall or ER-specific risk after adjusting for initial weight. Weight increase from early-adulthood to ages 45–54 years is associated with a reduced premenopausal breast cancer risk independently of early-adulthood weight. Biological explanations are needed to account for these two separate factors.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1306-1314 |
| Number of pages | 9 |
| Journal | International Journal of Cancer |
| Volume | 147 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 1 2020 |
Keywords
- body weight changes
- breast neoplasms
- cohort studies
- premenopause
- risk factors
ASJC Scopus subject areas
- Oncology
- Cancer Research
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In: International Journal of Cancer, Vol. 147, No. 5, 01.09.2020, p. 1306-1314.
Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Adult weight change and premenopausal breast cancer risk
T2 - A prospective pooled analysis of data from 628,463 women
AU - Schoemaker, Minouk J.
AU - Nichols, Hazel B.
AU - Wright, Lauren B.
AU - Brook, Mark N.
AU - Jones, Michael E.
AU - O'Brien, Katie M.
AU - Adami, Hans Olov
AU - Baglietto, Laura
AU - Bernstein, Leslie
AU - Bertrand, Kimberly A.
AU - Boutron-Ruault, Marie Christine
AU - Chen, Yu
AU - Connor, Avonne E.
AU - Dossus, Laure
AU - Eliassen, A. Heather
AU - Giles, Graham G.
AU - Gram, Inger T.
AU - Hankinson, Susan E.
AU - Kaaks, Rudolf
AU - Key, Timothy J.
AU - Kirsh, Victoria A.
AU - Kitahara, Cari M.
AU - Larsson, Susanna C.
AU - Linet, Martha
AU - Ma, Huiyan
AU - Milne, Roger L.
AU - Ozasa, Kotaro
AU - Palmer, Julie R.
AU - Riboli, Elio
AU - Rohan, Thomas E.
AU - Sacerdote, Carlotta
AU - Sadakane, Atsuko
AU - Sund, Malin
AU - Tamimi, Rulla M.
AU - Trichopoulou, Antonia
AU - Ursin, Giske
AU - Visvanathan, Kala
AU - Weiderpass, Elisabete
AU - Willett, Walter C.
AU - Wolk, Alicja
AU - Zeleniuch-Jacquotte, Anne
AU - Sandler, Dale P.
AU - Swerdlow, Anthony J.
N1 - Funding Information: We thank the National Cancer Institute Cohort Consortium for facilitating this collaboration. We thank Melissa House MS (WestStat Inc, MD); Mustapha Abubakar MBBS PhD (National Cancer Institute, MD); Niclas Håkansson PhD (Karolinska Institute, Stockholm, Sweden); Jane Sullivan-Halley BS (Beckman Research Institute of City of Hope, Duarte, CA); Allison Iwan BS, Diane Kampa BS (University of Minnesota, MN); Jerry Reid PHD (American Registry of Radiologic Technologists, MN); Jeffrey Yu MPH (Slone Epidemiology Center at Boston University, Boston, MA) for contributions to acquisition, analysis or interpretation of data. They received no compensation for their contributions other than their salaries. We wish to acknowledge all study participants, staff, and participating cancer registries. The Nurses' Health Study (NHS) and Nurses' Health Study 2 (NHS2) would like to thank the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. The study protocol was approved by the institutional review boards of the Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, and those of participating registries as required. Support for this research comes, in part, from Breast Cancer Now; The Institute of Cancer Research, London; the Avon Foundation (02-2014-080); the United States National Center for Advancing Translational Sciences (KL2-TR001109); Karolinska Institutet Distinguished Professor Award Dnr: 2368/10-221; the United States National Institutes of Health, National Institute of Environmental Health Sciences (Z01 ES044005, P30 ES000260, P30 CA016087), National Cancer Institute (UM1 CA176726, UM1 CA186107, UM1 CA182876, UM1 CA182934, UM1 CA164974, R01 CA058420, R01 CA092447, CA144034), the National Program of Cancer Registries of the Centers for Disease Control and Prevention, and the Department of Energy; The Dahod Breast Cancer Research Program at Boston University School of Medicine; the State of Maryland, the Maryland Cigarette Restitution Fund; VicHealth, Cancer Council Victoria and the Australian National Health and Medical Research Council (209057, 396414 and 1074383); the Breast Cancer Research Foundation (BCRF-17-138); the Swedish Research Council and Swedish Cancer Foundation; the Japanese Ministry of Health, Labor and Welfare; the Hellenic Health Foundation. The California Teachers Study is supported by R01 CA77398 and U01 CA199277. The coordination of the European Prospective Investigation in Cancer is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Swedish Cancer Society, Swedish Research Council and County Councils of Skane and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford; United Kingdom). The Institute of Cancer Research, London, acknowledges National Health Service funding to the Royal Marsden/ICR NIHR Biomedical Research Centre. Funding Information: We thank the National Cancer Institute Cohort Consortium for facilitating this collaboration. We thank Melissa House MS (WestStat Inc, MD); Mustapha Abubakar MBBS PhD (National Cancer Institute, MD); Niclas Håkansson PhD (Karolinska Institute, Stockholm, Sweden); Jane Sullivan‐Halley BS (Beckman Research Institute of City of Hope, Duarte, CA); Allison Iwan BS, Diane Kampa BS (University of Minnesota, MN); Jerry Reid PHD (American Registry of Radiologic Technologists, MN); Jeffrey Yu MPH (Slone Epidemiology Center at Boston University, Boston, MA) for contributions to acquisition, analysis or interpretation of data. They received no compensation for their contributions other than their salaries. We wish to acknowledge all study participants, staff, and participating cancer registries. The Nurses' Health Study (NHS) and Nurses' Health Study 2 (NHS2) would like to thank the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. The study protocol was approved by the institutional review boards of the Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, and those of participating registries as required. Support for this research comes, in part, from Breast Cancer Now; The Institute of Cancer Research, London; the Avon Foundation (02‐2014‐080); the United States National Center for Advancing Translational Sciences (KL2‐TR001109); Karolinska Institutet Distinguished Professor Award Dnr: 2368/10‐221; the United States National Institutes of Health, National Institute of Environmental Health Sciences (Z01 ES044005, P30 ES000260, P30 CA016087), National Cancer Institute (UM1 CA176726, UM1 CA186107, UM1 CA182876, UM1 CA182934, UM1 CA164974, R01 CA058420, R01 CA092447, CA144034), the National Program of Cancer Registries of the Centers for Disease Control and Prevention, and the Department of Energy; The Dahod Breast Cancer Research Program at Boston University School of Medicine; the State of Maryland, the Maryland Cigarette Restitution Fund; VicHealth, Cancer Council Victoria and the Australian National Health and Medical Research Council (209057, 396414 and 1074383); the Breast Cancer Research Foundation (BCRF‐17‐138); the Swedish Research Council and Swedish Cancer Foundation; the Japanese Ministry of Health, Labor and Welfare; the Hellenic Health Foundation. The California Teachers Study is supported by R01 CA77398 and U01 CA199277. The coordination of the European Prospective Investigation in Cancer is financially supported by the European Commission (DG‐SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro‐AIRC‐Italy and National Research Council (Italy); Swedish Cancer Society, Swedish Research Council and County Councils of Skane and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC‐Norfolk; C570/A16491 and C8221/A19170 to EPIC‐Oxford), Medical Research Council (1000143 to EPIC‐Norfolk, MR/M012190/1 to EPIC‐Oxford; United Kingdom). The Institute of Cancer Research, London, acknowledges National Health Service funding to the Royal Marsden/ICR NIHR Biomedical Research Centre. Publisher Copyright: © 2020 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Early-adulthood body size is strongly inversely associated with risk of premenopausal breast cancer. It is unclear whether subsequent changes in weight affect risk. We pooled individual-level data from 17 prospective studies to investigate the association of weight change with premenopausal breast cancer risk, considering strata of initial weight, timing of weight change, other breast cancer risk factors and breast cancer subtype. Hazard ratios (HR) and 95% confidence intervals (CI) were obtained using Cox regression. Among 628,463 women, 10,886 were diagnosed with breast cancer before menopause. Models adjusted for initial weight at ages 18–24 years and other breast cancer risk factors showed that weight gain from ages 18–24 to 35–44 or to 45–54 years was inversely associated with breast cancer overall (e.g., HR per 5 kg to ages 45–54: 0.96, 95% CI: 0.95–0.98) and with oestrogen-receptor(ER)-positive breast cancer (HR per 5 kg to ages 45–54: 0.96, 95% CI: 0.94–0.98). Weight gain from ages 25–34 was inversely associated with ER-positive breast cancer only and weight gain from ages 35–44 was not associated with risk. None of these weight gains were associated with ER-negative breast cancer. Weight loss was not consistently associated with overall or ER-specific risk after adjusting for initial weight. Weight increase from early-adulthood to ages 45–54 years is associated with a reduced premenopausal breast cancer risk independently of early-adulthood weight. Biological explanations are needed to account for these two separate factors.
AB - Early-adulthood body size is strongly inversely associated with risk of premenopausal breast cancer. It is unclear whether subsequent changes in weight affect risk. We pooled individual-level data from 17 prospective studies to investigate the association of weight change with premenopausal breast cancer risk, considering strata of initial weight, timing of weight change, other breast cancer risk factors and breast cancer subtype. Hazard ratios (HR) and 95% confidence intervals (CI) were obtained using Cox regression. Among 628,463 women, 10,886 were diagnosed with breast cancer before menopause. Models adjusted for initial weight at ages 18–24 years and other breast cancer risk factors showed that weight gain from ages 18–24 to 35–44 or to 45–54 years was inversely associated with breast cancer overall (e.g., HR per 5 kg to ages 45–54: 0.96, 95% CI: 0.95–0.98) and with oestrogen-receptor(ER)-positive breast cancer (HR per 5 kg to ages 45–54: 0.96, 95% CI: 0.94–0.98). Weight gain from ages 25–34 was inversely associated with ER-positive breast cancer only and weight gain from ages 35–44 was not associated with risk. None of these weight gains were associated with ER-negative breast cancer. Weight loss was not consistently associated with overall or ER-specific risk after adjusting for initial weight. Weight increase from early-adulthood to ages 45–54 years is associated with a reduced premenopausal breast cancer risk independently of early-adulthood weight. Biological explanations are needed to account for these two separate factors.
KW - body weight changes
KW - breast neoplasms
KW - cohort studies
KW - premenopause
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85079732237&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85079732237&partnerID=8YFLogxK
U2 - 10.1002/ijc.32892
DO - 10.1002/ijc.32892
M3 - Article
C2 - 32012248
AN - SCOPUS:85079732237
SN - 0020-7136
VL - 147
SP - 1306
EP - 1314
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 5
ER -