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@ARTICLE{Kohls:179919,
author = {M. Kohls and H. Freisling and H. Charvat and I.
Soerjomataram and V. Viallon and V. Davila-Batista and R.
Kaaks$^*$ and R. Turzanski-Fortner$^*$ and K. Aleksandrova
and M. B. Schulze and C. C. Dahm and H. Tilma Vistisen and
A. L. Rostgaard-Hansen and A. Tjønneland and C. Bonet and
M.-J. Sánchez and S. Colorado-Yohar and G. Masala and D.
Palli and V. Krogh and F. Ricceri and O. Rolandsson and S.
S. M. Lu and K. K. Tsilidis and E. Weiderpass and M. J.
Gunter and P. Ferrari and U. Berger and M. Arnold},
title = {{I}mpact of cumulative body mass index and cardiometabolic
diseases on survival among patients with colorectal and
breast cancer: a multi-centre cohort study.},
journal = {BMC cancer},
volume = {22},
number = {1},
issn = {1471-2407},
address = {Heidelberg},
publisher = {Springer},
reportid = {DKFZ-2022-00968},
pages = {546},
year = {2022},
abstract = {Body 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.},
keywords = {Body mass index (Other) / Breast cancer (Other) /
Cardiovascular disease (Other) / Cohort study (Other) /
Colorectal cancer (Other) / Comorbidity (Other) / Cumulative
exposure (Other) / Diabetes (Other) / Survival (Other)},
cin = {C020},
ddc = {610},
cid = {I:(DE-He78)C020-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:35568802},
doi = {10.1186/s12885-022-09589-y},
url = {https://inrepo02.dkfz.de/record/179919},
}