Weight fluctuation and cancer risk in post-menopausal women: The Women's Health Initiative
A partir des données de la cohorte "Women's Health Initiative" incluant 80 943 participantes sur la période 1994-2014, cette étude évalue l'association entre des variations de poids au début et au milieu de l'âge adulte et le risque de cancer lié à l'obésité (sein, endomètre, côlon-rectum) après la ménopause (7 464 cas)
Résumé en anglais
Background:Weight cycling, defined by an intentional weight loss and subsequent regain, commonly occurs in overweight and obese women and is associated with some negative health outcomes. We examined the role of various weight-change patterns during early to mid- adulthood and associated risk of highly prevalent, obesity-related cancers (breast, endometrial, colorectal) in postmenopausal women.
Methods:80,943 postmenopausal women (age: 63.4±7.4 years) in the Women's Health Initiative Observational Study were categorized by self-reported weight change (weight stable; weight gain; lost weight; weight cycled [1-3, 4-6, 7-10, >10 times]) during early to mid- adulthood (18-50 years). Three site-specific associations were investigated using Cox proportional hazard models (age, race/ethnicity, income, education, smoking, alcohol, physical activity, hormone therapy, diet, BMI).
Results: 7,464 (breast=5,564; endometrial=788; colorectal=1,290) incident cancer cases were identified between September 1994 and August 2014. Compared with weight stability, weight gain was significantly associated with risk of breast cancer (HR=1.11, 1.03-1.20) after adjustment for BMI. Similarly, weight cycling was significantly associated with risk of endometrial cancer (HR=1.23, 1.01-1.49). Weight cycling "4-6 times" was most consistently associated with cancer risk, showing a 38% increased risk for endometrial cancer (95% CI: 1.08-1.76) compared to weight stable women.
Conclusions: Weight gain and weight cycling were positively associated with risk of breast and endometrial cancer, respectively.
Impact: These data suggest weight cycling and weight gain increase risk of prevalent cancers in postmenopausal women. Adopting ideal body weight maintenance practices before and after weight loss should be encouraged to reduce risk of incident breast and endometrial cancers.
