Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study

Scientists from the International Agency for Research on Cancer (IARC), in collaboration with researchers from Ludwig Maximilian University of Munich (Germany), have found that every extra kilogram per square metre (kg/m²) of body weight that an individual carries is associated with a significant increase in the risk of dying from breast cancer and from colorectal cancer. This association was independent of whether the patient had been diagnosed with cardiometabolic diseases, such as stroke, myocardial infarction, and type 2 diabetes, before being diagnosed with cancer. The association between being diagnosed with a cardiometabolic disease before cancer and survival in patients with breast cancer and in patients with colorectal cancer was independent of body mass index (BMI).

In this study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, the average BMI of each participant at ages 20–50 years was estimated. Participants who developed colorectal cancer or breast cancer after age 50 years were included in the survival analysis to study how well knowing their average BMI and presence of cardiometabolic diseases before the development of cancer could predict their risk of death.

In the total cohort of almost 160 000 participants, more than 1000 developed colorectal cancer and more than 1600 developed breast cancer. Having a higher BMI at ages 20–50 years was associated with poorer survival in patients with breast cancer and in patients with colorectal cancer. In patients with colorectal cancer, the risk of death increased by 6% for every 1 kg/m² higher BMI compared with their peers. Prior cardiometabolic disease increased the risk of death by 25%. In patients with breast cancer, a higher BMI was associated with a 4% increase in the risk of death for each 1 kg/m² above the mean BMI of the cohort. Prior cardiometabolic disease was associated with a 46% increase in the risk of death.

These results suggest that BMI has a direct effect on cancer survival that is independent of pre-diagnostic cardiometabolic disease. This finding may contribute to improved prognostic stratification in patients with cancer who are affected by cardiometabolic comorbidities.

Kohls M, Freisling H, Charvat H, Soerjomataram I, Viallon V, Davila-Batista V, et al.
Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study
BMC Cancer, Published online 14 May 2022;
https://doi.org/10.1186/s12885-022-09589-y

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