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Abdominal and gluteofemoral size and risk of liver cancer: The liver cancer pooling project |
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| Authors: | Andrea A Florio Peter T Campbell Xuehong Zhang Anne Zeleniuch-Jacquotte Jean Wactawski-Wende Stephanie A Smith-Warner Rashmi Sinha Tracey G Simon Howard D Sesso Catherine Schairer Lynn Rosenberg Thomas E Rohan Kim Robien Andrew G Renehan Mark P Purdue Jenny N Poynter Julie R Palmer Christina C Newton Yunxia Lu Martha S Linet Linda M Liao I-Min Lee Jill Koshiol Cari M Kitahara Victoria A Kirsh Jonathan N Hofmann Barry I Graubard Edward Giovannucci John M Gaziano Susan M Gapstur Neal D Freedman Jane Demuth Dawn Q Chong Andrew T Chan Julie E Buring Patrick T Bradshaw Laura E Beane Freeman Katherine A McGlynn Jessica L Petrick |
| Institution: | 1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD;2. Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA;3. Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA;4. Department of Population Health, New York University School of Medicine, New York, NY;5. Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY;6. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;7. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA;8. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA;9. Slone Epidemiology Center, Boston University, Boston, MA;10. Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY;11. Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC;12. Faculty Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom;13. Division of Pediatric Epidemiology and Clinical Research and Masonic Cancer Center, University of Minnesota, Minneapolis, MN;14. Department of Population Health and Disease Prevention, Program in Public Health, University of California Irvine, Irvine, CA;15. Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada;16. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;17. Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA VA Boston Healthcare System, Boston, MA;18. Information Management Services Inc, Silver Spring, MD;19. Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore;20. Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA;21. Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA |
| Abstract: | Obesity is known to be associated with primary liver cancer (PLC), but the separate effects of excess abdominal and gluteofemoral size are unclear. Thus, we examined the association between waist and hip circumference with risk of PLC overall and by histologic type—hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). The Liver Cancer Pooling Project is a consortium of prospective cohort studies that include data from 1,167,244 individuals (PLC n = 2,208, HCC n = 1,154, ICC n = 335). Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using proportional hazards regression. Waist circumference, per 5 cm increase, was associated with an 11% increased PLC risk (HR = 1.11, 95%CI: 1.09–1.14), including when adjusted for hip circumference (HR = 1.12, 95%CI: 1.08–1.17) and also when restricted to individuals in a normal body mass index (BMI) range (18.5 to <25 kg/m2; HR = 1.14, 95%CI: 1.07–1.21). Hip circumference, per 5 cm increase, was associated with a 9% increased PLC risk (HR = 1.09, 95%CI: 1.06–1.12), but no association remained after adjustment for waist circumference (HR = 0.99, 95%CI: 0.94–1.03). HCC and ICC results were similar. These findings suggest that excess abdominal size is associated with an increased risk of liver cancer, even among individuals considered to have a normal BMI. However, excess gluteofemoral size alone confers no increased risk. Our findings extend prior analyses, which found an association between excess adiposity and risk of liver cancer, by disentangling the separate effects of excess abdominal and gluteofemoral size through utilization of both waist and hip circumference measurements. |
| Keywords: | hepatocellular carcinoma intrahepatic cholangiocarcinoma abdominal obesity gluteofemoral obesity epidemiology |