Body mass index trajectories, weight gain and risks of liver and biliary tract cancers

Wanshui Yang; Xufen Zeng; Jessica L Petrick; Christopher J Danford; Andrea A Florio; Bing Lu; Hongmei Nan; Jiantao Ma; Liang Wang; Hongmei Zeng; Staci L Sudenga; Peter T Campbell; Edward Giovannucci; Katherine A McGlynn; Xuehong Zhang

doi:10.1093/jncics/pkac056

Body mass index trajectories, weight gain and risks of liver and biliary tract cancers

JNCI Cancer Spectr. 2022 Aug 12;6(4):pkac056. doi: 10.1093/jncics/pkac056. Online ahead of print.

Authors

Wanshui Yang^{1

2}, Xufen Zeng², Jessica L Petrick³, Christopher J Danford⁴, Andrea A Florio⁵, Bing Lu⁶, Hongmei Nan⁷, Jiantao Ma^{8

9}, Liang Wang¹⁰, Hongmei Zeng¹¹, Staci L Sudenga¹², Peter T Campbell¹³, Edward Giovannucci^{1

14

11}, Katherine A McGlynn⁵, Xuehong Zhang^{1

11}

Affiliations

¹ Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
² Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China.
³ Slone Epidemiology Center, Boston University, Boston, MA, USA.
⁴ Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Dana 603, Boston, 02215, MA, USA.
⁵ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
⁶ Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁷ Department of Epidemiology, Richard M Fairbanks School of Public Health, Indiana University, and Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN.
⁸ Framingham Heart Study, Framingham, MA, USA.
⁹ Division of Nutrition Data Science, Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA.
¹⁰ Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Texas, USA.
¹¹ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
¹² Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA.
¹³ Department of Epidemiology and Population Science, Albert Einstein College of Medicine, Bronx, NY, USA.
¹⁴ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.

Abstract

Background: Little is known about the role of early obesity or weight change during adulthood in the development of liver cancer and biliary tract cancer (BTC).

Methods: We investigated the associations of body mass index (BMI) and weight trajectories with the risk of liver cancer and BTC in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO). BMI was self-reported at ages 20, 50, and at enrollment. BMI trajectories were determined using latent class growth models. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: During a median follow-up of 15.9 years among 138,922 participants, 170 liver cancer and 143 BTC cases were identified. Compared with those whose BMI does not exceed 25 kg/m2, participants with BMI exceeding 25 kg/m2 at age 20 had increased risks of liver cancer (HR = 2.03, 95% CI: 1.26-3.28) and BTC (HR = 1.99, 95% CI: 1.16-3.39). Compared to participants maintaining normal BMI until enrollment, trajectory of normal weight at age 20 to obesity at enrollment was associated with increased risk for liver cancer (HR = 2.50, 95% CI: 1.55-4.04) and BTC (HR = 1.83, 95% CI: 1.03-3.22). Compared to adults with stable weight (+/-5kg) between age 20 to 50 years, weight gain ≥20 kg between ages 20 to 50 years had higher HRs of 2.24 (95%CI: 1.40-3.58) for liver cancer and 1.86 (95% CI: 1.12-3.09) for BTC.

Conclusions: Being overweight/obese at age 20, and BMI trajectories that result in being overweight and/or obese, may increase risk for both liver cancer and BTC.

Keywords: adiposity; biliary tract cancer; body mass index; liver cancer; trajectory modeling; weight gain.

Grants and funding

K07 CA225404/CA/NCI NIH HHS/United States