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Meta-Analysis
. 2022 Mar;126(4):664-672.
doi: 10.1038/s41416-021-01625-1. Epub 2021 Nov 12.

Early-life body mass index and risks of breast, endometrial, and ovarian cancers: a dose-response meta-analysis of prospective studies

Dohyun Byun #  1 , SungEun Hong #  2 , Seaun Ryu  1 , Yeonju Nam  3 , Hajin Jang  1 , Yoonkyoung Cho  1 , NaNa Keum #  4   5 , Hannah Oh #  6   7
Affiliations
Meta-Analysis

Early-life body mass index and risks of breast, endometrial, and ovarian cancers: a dose-response meta-analysis of prospective studies

Dohyun Byun et al. Br J Cancer. 2022 Mar.

Abstract

Background: The evidence for the associations between early-life adiposity and female cancer risks is mixed. Little is known about the exact shape of the relationships and whether the associations are independent of adult adiposity.

Methods: We conducted dose-response meta-analyses of prospective studies to summarise the relationships of early-life body mass index (BMI) with breast, endometrial, and ovarian cancer risks. Pubmed and Embase were searched through June 2020 to identify relevant studies. Using random-effects models, the summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated per 5-kg/m2 increase in BMI at ages ≤ 25 years. A nonlinear dose-response meta-analysis was conducted using restricted cubic spline analysis.

Results: After screening 33,948 publications, 37 prospective studies were included in this analysis. The summary RRs associated with every 5-kg/m2 increase in early-life BMI were 0.84 (95% CI = 0.81-0.87) for breast, 1.40 (95% CI = 1.25-1.57) for endometrial, and 1.15 (95% CI = 1.07-1.23) for ovarian cancers. For breast cancer, the association remained statistically significant after adjustment for adult BMI (RR = 0.80, 95% CI = 0.73-0.87). For premenopausal breast, endometrial, and ovarian cancers, the dose-response curves suggested evidence of nonlinearity.

Conclusions: With early-life adiposity, our data support an inverse association with breast cancer and positive associations with ovarian and endometrial cancer risks.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Linear and nonlinear dose–response relationships for early-life BMI and breast cancer risk.
This figure shows the results from a linear dose–response relationship with total breast cancer; b nonlinear dose–response relationship with total breast cancer (p-nonlinearity = 0.19); c subgroup analysis by menopausal status (p-heterogeneity = 0.78); d nonlinear dose–response relationship with premenopausal breast cancer (p-nonlinearity = 0.004); e nonlinear dose–response relationship with postmenopausal breast cancer (p-nonlinearity = 0.16); f subgroup analysis by adjustment for adult BMI (p-heterogeneity = 0.36). The black squares and horizontal lines represent study-specific relative risks and their 95% confidence intervals. The area of each black square reflects the weight each study contributes to the meta-analysis. The middle and horizontal tips of diamonds represent summary RRs and their 95% confidence intervals, respectively. The P values were calculated from Cochran’s Q test; all statistical tests were two-sided.
Fig. 2
Fig. 2. Linear and nonlinear dose–response relationships for early-life BMI and endometrial cancer risk.
This figure shows the results from a linear dose–response relationship with endometrial cancer; b nonlinear dose–response relationship with endometrial cancer (p-nonlinearity = 0.004); c subgroup analysis by adjustment for adult BMI (p-heterogeneity = 0.19). The black squares and horizontal lines represent study-specific relative risks and their 95% confidence intervals. The area of each black square reflects the weight each study contributes to the meta-analysis. The middle and horizontal tips of diamonds represent summary RRs and their 95% confidence intervals, respectively. The P values were calculated from Cochran’s Q test; all statistical tests were two-sided.
Fig. 3
Fig. 3. Linear and nonlinear dose–response relationships for early-life BMI and ovarian cancer risk.
This figure shows the results from a linear dose–response relationship with ovarian cancer; b nonlinear dose–response relationship with ovarian cancer (p-nonlinearity = 0.05). The black squares and horizontal lines represent study-specific relative risks and their 95% confidence intervals. The area of each black square reflects the weight each study contributes to the meta-analysis. The middle and horizontal tips of diamonds represent summary RRs and their 95% confidence intervals, respectively. The P values were calculated from Cochran’s Q test; all statistical tests were two-sided.
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424. - PubMed
    1. Peeters PHM, Verbeek ALM, Krol A, Matthyssen MMM, Dewaard F. Age at menarche and breast-cancer risk in nulliparous women. Breast Cancer Res Treat. 1995;33:55–61. - PubMed
    1. Hsieh CC, Trichopoulos D, Katsouyanni K, Yuasa S. Age at menarche, age at menopause, height and obesity as risk-factors for breast-cancer - associations and interactions in an international case-control study. Int J Cancer. 1990;46:796–800. - PubMed
    1. McPherson CP, Sellers TA, Potter JD, Bostick RM, Folsom AR. Reproductive factors and risk of endometrial cancer—the Iowa women’s health study. Am J Epidemiol. 1996;143:1195–202. - PubMed
    1. Fujita M, Tase T, Kakugawa Y, Hoshi S, Nishino Y, Nagase S, et al. Smoking, earlier menarche and low parity as independent risk factors for gynecologic cancers in japanese: a case-control study. Tohoku J Exp Med. 2008;216:297–307. - PubMed

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