Abstract 13355: Obesity is Associated With Incident Cancer in the Community

Introduction: Obesity and cardiometabolic dysfunction may be shared risk factors for development of cancer. We sought to examine the association of obesity and abdominal adiposity with incident cancer. Methods: We studied participants of the Framingham Heart Study and Prevention of Renal and Vascular End-Stage Disease study. We examined the association of obesity, body-mass index (BMI), waist circumference (WC), and visceral adiposity (VAT) with future cancer in Cox models. We adjusted for age, sex, diabetes, systolic blood pressure, hypertension treatment, smoking status (current, former, never), and cholesterol ratio. Results: Among 20,667 individuals (mean age 50, 53% women) free of cancer at baseline, we observed 2,619 incident cancer events over a mean follow-up of 13.3±3.3 years. Obesity (BMI≥30 kg/m 2 ) was associated with 30% increased hazard of future gastrointestinal cancer (HR 1.30, 95% CI 1.05-1.60, P=0.01), 62% increased hazard of gynecologic cancers (HR 1.62, 95% CI 1.08-2.45, P=0.02), and by contrast, 38% lower risk of lung cancer (HR 0.62, 95% CI 0.44-0.87, P=0.006). We found similar associations of future cancer with continuous BMI and WC ( Figure ). Among 3,077 individuals with CT scans, VAT was associated with incident cancer (HR 1.16, 95% CI 1.03-1.31, P=0.01 per 1-SD change in VAT). After adjusting for BMI, higher VAT was associated with greater risk of lung cancer (HR 1.92, 95% CI 1.01-3.65, P=0.045). Conclusions: We observed that obesity and abdominal adiposity were associated with future cancer events, including gastrointestinal and gynecologic cancers. Interestingly, obesity was associated with lower risk of lung cancer. However, greater VAT was associated with greater lung cancer risk after adjusting for BMI. These findings highlight the importance of specific obesity-related phenotypes and adipose depots in better understanding the association between obesity and cancer.