Waist circumference and risk of 23 site-specific cancers: a population-based cohort study of Korean adults

Abstract

Background Large waist circumference (WC) is a risk factor for several site-specific cancers, but a large-scale systematic investigation across all common cancers adjusted for potential confounders has not been conducted. This study aimed to evaluate the possible links between WC and common cancers. Methods We prospectively examined the association between WC and the risk of cancers in a 7-year cohort study of nearly 22.9 million Korean adults. Using the claims database merged with the national health check-up data, we fitted proportional hazard models to investigate associations between WC and 23 of the most common cancers, with adjustment for potential confounders, including body mass index (BMI). We also evaluated the modification of BMI on the relationships between WC and the incidence of cancer. Results A total of 769,871 cancer cases were identified. WC was positively associated with 18 of 23 cancers, and the effects varied substantially by site in each sex. The modification of BMI on the WC-cancer association also varied across the cancer site; in most cases it mitigated the association. For cancers of the oral cavity, larynx, oesophagus, lung, and premenopausal breast, the BMI adjustment reversed the association toward being positive (all P trend < 0.001). Conclusions Central obesity, independent of general obesity, was associated with the risk of several cancers. The heterogeneity in the mediating effects of BMI suggests that different mechanisms are associated with different cancer sites. Based upon these findings, active strategies to monitor and prevent central obesity should be implemented.

Metabolic syndrome and risk of pancreatic cancer: A population‐based prospective cohort study

“…40 A population-based cohort study of Korean adults demonstrated that the risk of pancreatic cancer increased with increasing WC in both genders, and the effect was not affected by the presence of type 2 diabetes mellitus. 41 Another study conducted in 29 133 Finnish male smokers followed for almost two decades angiogenesis and were implicated in tumorigenesis of pancreatic cancer. [47][48][49][50][51] Obesity by itself might promote pancreatic cancer development through up-regulating sex steroid hormones, since the pancreas contains various sex hormone receptors and the antiestrogen inhibited pancreatic tumors proliferation.…”

Developing a preventive psycho‐oncology for a global context. The International Psycho‐Oncology Society 2018 Sutherland Award Lecture

“…For cancers of the oral cavity, larynx, esophagus, lung, and premenopausal breast, BMI adjustment reversed these positive associations (all P trend < .001). 3 How do we help people control weight in obesogenic environments? Do people understand the risks associated with certain lifestyle factors?…”

“…A recent 7‐year cohort study of 769 861 Korean cancer cases found 18 of 23 different cancers were consistently positively linked to higher waist circumference. For cancers of the oral cavity, larynx, esophagus, lung, and premenopausal breast, BMI adjustment reversed these positive associations (all P trend < .001) . How do we help people control weight in obesogenic environments?…”

Body size, body composition and endometrial cancer risk among postmenopausal women in UK Biobank

“…The distribution of body fat, in particular central adiposity, is linked to several metabolic abnormalities including insulin resistance and inflammation that are associated with endometrial cancer development 10,11 . Although several studies have evaluated central adiposity, typically assessed by waist circumference, waist to hip ratio or waist to height ratio, in relation to risk of endometrial cancer, 12‐21 it remains unclear whether central adiposity contributes to risk independently of overall adiposity.…”