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000179919 041__ $$aEnglish
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000179919 1001_ $$aKohls, Mirjam$$b0
000179919 245__ $$aImpact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study.
000179919 260__ $$aHeidelberg$$bSpringer$$c2022
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000179919 520__ $$aBody mass index (BMI) and cardiometabolic comorbidities such as cardiovascular disease and type 2 diabetes have been studied as negative prognostic factors in cancer survival, but possible dependencies in the mechanisms underlying these associations remain largely unexplored. We analysed these associations in colorectal and breast cancer patients.Based on repeated BMI assessments of cancer-free participants from four European countries in the European Prospective Investigation into Cancer and nutrition (EPIC) study, individual BMI-trajectories reflecting predicted mean BMI between ages 20 to 50 years were estimated using a growth curve model. Participants with incident colorectal or breast cancer after the age of 50 years were included in the survival analysis to study the prognostic effect of mean BMI and cardiometabolic diseases (CMD) prior to cancer. CMD were defined as one or more chronic conditions among stroke, myocardial infarction, and type 2 diabetes. Hazard ratios (HRs) and confidence intervals (CIs) of mean BMI and CMD were derived using multivariable-adjusted Cox proportional hazard regression for mean BMI and CMD separately and both exposures combined, in subgroups of localised and advanced disease.In the total cohort of 159,045 participants, there were 1,045 and 1,620 eligible patients of colorectal and breast cancer. In colorectal cancer patients, a higher BMI (by 1 kg/m2) was associated with a 6% increase in risk of death (95% CI of HR: 1.02-1.10). The HR for CMD was 1.25 (95% CI: 0.97-1.61). The associations for both exposures were stronger in patients with localised colorectal cancer. In breast cancer patients, a higher BMI was associated with a 4% increase in risk of death (95% CI: 1.00-1.08). CMDs were associated with a 46% increase in risk of death (95% CI: 1.01-2.09). The estimates and CIs for BMI remained similar after adjustment for CMD and vice versa.Our results suggest that cumulative exposure to higher BMI during early to mid-adulthood was associated with poorer survival in patients with breast and colorectal cancer, independent of CMD prior to cancer diagnosis. The association between a CMD diagnosis prior to cancer and survival in patients with breast and colorectal cancer was independent of BMI.
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000179919 650_7 $$2Other$$aBody mass index
000179919 650_7 $$2Other$$aBreast cancer
000179919 650_7 $$2Other$$aCardiovascular disease
000179919 650_7 $$2Other$$aCohort study
000179919 650_7 $$2Other$$aColorectal cancer
000179919 650_7 $$2Other$$aComorbidity
000179919 650_7 $$2Other$$aCumulative exposure
000179919 650_7 $$2Other$$aDiabetes
000179919 650_7 $$2Other$$aSurvival
000179919 7001_ $$aFreisling, Heinz$$b1
000179919 7001_ $$aCharvat, Hadrien$$b2
000179919 7001_ $$aSoerjomataram, Isabelle$$b3
000179919 7001_ $$aViallon, Vivian$$b4
000179919 7001_ $$aDavila-Batista, Veronica$$b5
000179919 7001_ $$0P:(DE-He78)4b2dc91c9d1ac33a1c0e0777d0c1697a$$aKaaks, Rudolf$$b6$$udkfz
000179919 7001_ $$0P:(DE-He78)74a6af8347ec5cbd4b77e562e10ca1f2$$aTurzanski-Fortner, Renée$$b7$$udkfz
000179919 7001_ $$aAleksandrova, Krasimira$$b8
000179919 7001_ $$aSchulze, Matthias B$$b9
000179919 7001_ $$aDahm, Christina C$$b10
000179919 7001_ $$aTilma Vistisen, Helene$$b11
000179919 7001_ $$aRostgaard-Hansen, Agnetha Linn$$b12
000179919 7001_ $$aTjønneland, Anne$$b13
000179919 7001_ $$aBonet, Catalina$$b14
000179919 7001_ $$aSánchez, Maria-Jose$$b15
000179919 7001_ $$aColorado-Yohar, Sandra$$b16
000179919 7001_ $$aMasala, Giovanna$$b17
000179919 7001_ $$aPalli, Domenico$$b18
000179919 7001_ $$aKrogh, Vittorio$$b19
000179919 7001_ $$aRicceri, Fulvio$$b20
000179919 7001_ $$aRolandsson, Olov$$b21
000179919 7001_ $$aLu, Sai San Moon$$b22
000179919 7001_ $$aTsilidis, Konstantinos K$$b23
000179919 7001_ $$aWeiderpass, Elisabete$$b24
000179919 7001_ $$aGunter, Marc J$$b25
000179919 7001_ $$aFerrari, Pietro$$b26
000179919 7001_ $$aBerger, Ursula$$b27
000179919 7001_ $$aArnold, Melina$$b28
000179919 773__ $$0PERI:(DE-600)2041352-X$$a10.1186/s12885-022-09589-y$$gVol. 22, no. 1, p. 546$$n1$$p546$$tBMC cancer$$v22$$x1471-2407$$y2022
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