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Abstract Details
Adiposity, Adulthood Weight Change and Risk of Incident Hepatocellular Carcinoma
Cancer Prev Res (Phila). 2021 Jul 15;canprevres.0549.2020.doi: 10.1158/1940-6207.CAPR-20-0549. Online ahead of print.
Tracey G Simon1, Mi Na Kim2, Xiao Luo3, Xing Liu3, Wanshui Yang4, Yanan Ma4, Dawn Qingqing Chong5, Charles S Fuchs6, Meir J Stampfer7, Edward L Giovannucci8, Andrew T Chan9, Xuehong Zhang10
Author information
1Department of Medicine, Massachusetts General Hospital and Harvard Medical School.
2Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
3Nutrition, Harvard T.H. Chan School of Public Health.
4Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston MA.
5Medical Oncology, National Cancer Centre Singapore.
6Yale Cancer Center, Yale School of Medicine.
7Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School.
8Department of Nutrition, Harvard T.H. Chan School of Public Health.
9Clinical and Translational Epidemiology Unit, Division of Gastroenterology, Massachusetts General Hospital.
10Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital xuehong.zhang@channing.harvard.edu.
Abstract
Prospective data are limited regarding dynamic adulthood weight changes and hepatocellular carcinoma (HCC) risk. We included 77,238 women (1980-2012) and 48,026 men (1986-2012), who recalled young-adult weight (age 18 years [women]; 21 years [men]), and provided biennially-updated information regarding weight, body mass index (BMI) and comorbidities. Overall adulthood weight change was defined as the difference in weight (kilograms) between young-adulthood and present. Using Cox proportional hazards models, we calculated multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Over 3,676,549 person-years, we documented 158 incident HCC cases. Elevated HCC risk was observed with higher BMI in both young-adulthood and later-adulthood (continuous aHRs per each 1-unit=1.05, 95%CI=1.02-1.09 [Ptrend=0.019], and 1.08, 95%CI=1.06-1.10 [Ptrend=0.004], respectively). Moreover, overall adulthood weight gain was also significantly associated with increased HCC risk (aHR per each 1-kg increase=1.03, 95%CI=1.01-1.08; Ptrend=0.010), including after further adjusting for young-adult BMI (Ptrend=0.010) and later-adult BMI (Ptrend=0.008). Compared to adults with stable weight (+/-5kg), the multivariable-aHRs with weight gain of 5-<10kg, 10-<20kg and {greater than or equal to}20kg were, 1.40 (95%CI=0.67-2.16), 2.09 (95%CI=1.11-3.95) and 2.61 (95%CI=1.42-5.22), respectively. In two prospective, nationwide cohorts, adulthood weight gain was significantly associated with increased HCC risk.