Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Epidemiology and Population Health

Birthweight, childhood overweight, height and growth and adult cancer risks: a review of studies using the Copenhagen School Health Records Register

International Journal of Obesity volume 44, pages 1546–1560 (2020)Cite this article

Subjects

Abstract

Background

Most identified risk factors for cancer primarily occur in adulthood. As cancers generally have long latency periods, it is possible that risk factors acting earlier in life and accumulation of risks across the life course are important. Thus, focusing only on adult overweight as a modifiable risk factor may overlook childhood as an important aetiologic time window when body size is relevant for future cancer risks. The objective of this study was to review the evidence for associations between birthweight, body mass index (BMI), height and growth from 7–13 years and adult cancer risks based on studies using the Copenhagen School Health Records Register.

Methods

The register contains measured anthropometric information on 372,636 children born in 1930–1989. All studies examining associations between early life body size and risks of adult cancer (until 85 years, diagnosed in 1968–2015) were included, comprising 31 studies on 16 different cancer sites. Cancer diagnoses were retrieved via individual-level linkages to the Danish Cancer Registry.

Results

Birthweight was differentially associated with bladder, breast, colon, glioma, Hodgkin’s disease, liver, kidney (renal cell), melanoma, ovarian, rectal, testicular and thyroid cancer. BMI in childhood was positively associated with risks of bladder (only late childhood), colon, endometrial, kidney, liver, oesophageal (only late childhood), ovarian, pancreatic (<70 years), prostate (only before childhood height adjustment) and thyroid cancer, whereas it was inversely associated with breast cancer. Child height was positively associated with breast, colon, endometrial, glioma, Hodgkin’s disease, kidney, melanoma, oesophageal (only women), ovarian, prostate, testicular and thyroid cancer and inversely associated with bladder cancer. Greater than average increases in childhood BMI or linear growth at ages 7–13 increased risks of several cancers.

Conclusions

Early life body size and growth are associated with many, but not all adult cancers, suggesting that the aetiology of several cancers may lie earlier in life than previously thought.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Childhood body mass index at age 7 years and cancer risks (per z-score).
Fig. 2: Childhood body mass index at age 13 years and cancer risks (per z-score)*.
Fig. 3: Childhood height at age 7 years and cancer risks (per z-score).
Fig. 4: Childhood height at age 13 years and cancer risks (per z-score)*.

References

  1. Global Cancer Observatory. International Agency on Cancer (IARC). World Health Organization (WHO). (Lyon, France, 2020). https://gco.iarc.fr/.

  2. Pearson-Stuttard J, Zhou B, Kontis V, Bentham J, Gunter MJ, Ezzati M. Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment. Lancet Diabetes Endocrinol. 2018;6:e6–15.

    PubMed  PubMed Central  Google Scholar 

  3. World Cancer Research Fund/American Institute for Cancer Research. Continous Update Project Expert Report 2018. Body fatness and weight gain and the risk of cancer. (World Cancer Research Fund International, 2018) dietandcancerreport.org.

  4. IARC. Absence of excess body fatness. IARC Handb Cancer Prev.2018;16:1–646. http://publications.iarc.fr/570.

  5. World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report 2018. Height and birthweight and the risk of cancer. (World Cancer Research Fund International, 2018) dietandcancerreport.org.

  6. NCD Risk Factor Collaboration. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017;390:2627–42.

    Google Scholar 

  7. Bogin B. Secular changes in childhood, adolescent and adult stature. Nestle Nutr Inst Workshop Ser. 2013;71:115–26.

    PubMed  Google Scholar 

  8. Meza R, Jeon J, Renehan AG, Luebeck EG. Colorectal cancer incidence trends in the United States and United kingdom: evidence of right- to left-sided biological gradients with implications for screening. Cancer Res. 2010;70:5419–29.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Hidayat K, Yang CM, Shi BM. Body fatness at a young age, body fatness gain and risk of breast cancer: systematic review and meta-analysis of cohort studies. Obes Rev. 2018;19:254–68.

    CAS  PubMed  Google Scholar 

  10. Hidayat K, Du X, Shi BM. Body fatness at a young age and risks of eight types of cancer: systematic review and meta-analysis of observational studies. Obes Rev. 2018;19:1385–94.

    CAS  PubMed  Google Scholar 

  11. Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev. 2016;17:56–67.

    CAS  PubMed  Google Scholar 

  12. Okasha M, McCarron P, Gunnell D, Smith GD. Exposures in childhood, adolescence and early adulthood and breast cancer risk: a systematic review of the literature. Breast Cancer Res Treat. 2003;78:223–76.

    CAS  PubMed  Google Scholar 

  13. Fagherazzi G, Guillas G, Boutron-Ruault MC, Clavel-Chapelon F, Mesrine S. Body shape throughout life and the risk for breast cancer at adulthood in the French E3N cohort. Eur J Cancer Prev. 2013;22:29–37.

    PubMed  Google Scholar 

  14. Li J, Eriksson M, He W, Hall P, Czene K. Associations between childhood body size and seventeen adverse outcomes: analysis of 65,057 European women. Sci Rep. 2017;7:16917.

    PubMed  PubMed Central  Google Scholar 

  15. Warner ET, Hu R, Collins LC, Beck AH, Schnitt S, Rosner B, et al. Height and body size in childhood, adolescence, and young adulthood and breast cancer risk according to molecular subtype in the nurses’ health studies. Cancer Prev Res. 2016;9:732–8.

    Google Scholar 

  16. Baker JL, Olsen LW, Andersen I, Pearson S, Hansen B, Sørensen TIA. Cohort profile: the Copenhagen School Health Records Register. Int J Epidemiol. 2009;38:656–62.

    PubMed  Google Scholar 

  17. Gjerstorff ML. The Danish Cancer Registry. Scand J Public Health. 2011;39 (7 Suppl) :42–5.

    PubMed  Google Scholar 

  18. Jensen CB, Gamborg M, Heitmann B, Sørensen TIA, Baker JL. Comparison of birth weight between school health records and medical birth records in Denmark: determinants of discrepancies. BMJ Open. 2015;5:e008628.

    PubMed  PubMed Central  Google Scholar 

  19. Pedersen CB. The Danish Civil Registration System. Scand J Public Health. 2011;39 (7 Suppl) :22–5.

    PubMed  Google Scholar 

  20. Lynge E, Sandegaard JL, Rebolj M. The Danish National Patient Register. Scand J Public Health. 2011;39 (7 Suppl) :30–3.

    PubMed  Google Scholar 

  21. Mors O, Perto GP, Mortensen PB. The Danish Psychiatric Central Research Register. Scand J Public Health. 2011;39 (7 Suppl) :54–7.

    PubMed  Google Scholar 

  22. Helweg-Larsen K. The Danish Register of Causes of Death. Scand J Public Health. 2011;39 (7 Suppl) :26–9.

    PubMed  Google Scholar 

  23. Pottegård A, Schmidt SAJ, Wallach-Kildemoes H, Sørensen HT, Hallas J, Schmidt M. Data resource profile: The Danish National Prescription Registry. Int J Epidemiol. 2017;46:798–f.

    PubMed  Google Scholar 

  24. Andersen KW, Mouridsen HT. Danish Breast Cancer Cooperative Group (DBCG). A description of the register of the nation-wide programme for primary breast cancer. Acta Oncol. 1988;27:627–47.

    CAS  PubMed  Google Scholar 

  25. Vejborg I, Olsen AH, Jensen MB, Rank F, Tange UB, Lynge E. Early outcome of mammography screening in Copenhagen 1991-99. J Med Screen. 2002;9:115–9.

    CAS  PubMed  Google Scholar 

  26. Christensen GT, Molbo D, Ängquist LH, Mortensen EL, Christensen K, Sørensen TIA, et al. Cohort profile: The Danish Conscription Database(DCD): a cohort of 728 160 men born from 1939 through 1959. Int J Epidemiol. 2014;44:432–40.

    PubMed  Google Scholar 

  27. Tjønneland A, Olsen A, Boll K, Stripp C, Christensen J, Engholm G, et al. Study design, exposure variables, and socioeconomic determinants of participation in diet, cancer and health: a population-based prospective cohort study of 57,053 men and women in Denmark. Scand J Public Health. 2007;35:432–41.

    PubMed  Google Scholar 

  28. Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012;7:284–94.

    CAS  PubMed  Google Scholar 

  29. Aarestrup J, Gamborg M, Cook MB, Sørensen TIA, Baker JL. Childhood body mass index and the risk of prostate cancer in adult men. Br J Cancer. 2014;111:207–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Aarestrup J, Gamborg M, Cook MB, Baker JL. Childhood height increases the risk of prostate cancer mortality. Eur J Cancer. 2015;51:1340–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Aarestrup J, Gamborg M, Ulrich LG, Sørensen TIA, Baker JL. Childhood body mass index and height and risk of histologic subtypes of endometrial cancer. Int J Obes. 2016;40:1096–102.

    CAS  Google Scholar 

  32. Aarestrup J, Gamborg M, Tilling K, Ulrich LG, Sørensen TIA, Baker JL. Childhood body mass index growth trajectories and endometrial cancer risk. Int J Cancer. 2017;140:310–5.

    CAS  PubMed  Google Scholar 

  33. Aarestrup J, Trabert B, Ulrich LG, Wentzensen N, Sørensen TIA, Baker JL. Childhood overweight, tallness and growth increase risks of ovarian cancer. Cancer Epidemiol Biomarkers Prev. 2019;28:183–8.

    PubMed  Google Scholar 

  34. Aarestrup J, Kitahara CM, Baker JL. Birthweight and risk of thyroid cancer and its histological types: a large cohort study. Cancer Epidemiol. 2019;62:101564.

    PubMed  Google Scholar 

  35. Ahlgren M, Sørensen TIA, Wohlfahrt J, Haflidadottir A, Holst C, Melbye M. Birth weight and risk of breast cancer in a cohort of 106,504 women. Int J Cancer. 2003;107:997–1000.

    CAS  PubMed  Google Scholar 

  36. Ahlgren M, Melbye M, Wohlfahrt J, Sørensen TIA. Growth patterns and the risk of breast cancer in women. N Engl J Med. 2004;351:1619–26.

    CAS  PubMed  Google Scholar 

  37. Ahlgren M, Wohlfahrt J, Olsen LW, Sørensen TIA, Melbye M. Birth weight and risk of cancer. Cancer. 2007;110:412–9.

    PubMed  Google Scholar 

  38. Andersen ZJ, Baker JL, Bihrmann K, Vejborg I, Sørensen TIA, Lynge E. Birth weight, childhood body mass index, and height in relation to mammographic density and breast cancer: a register-based cohort study. Breast Cancer Res. 2014;16:R4.

    PubMed  PubMed Central  Google Scholar 

  39. Berentzen TL, Gamborg M, Holst C, Sørensen TIA, Baker JL. Body mass index in childhood and adult risk of primary liver cancer. J Hepatol. 2014;60:325–30.

    PubMed  Google Scholar 

  40. Bjerregaard LG, Aarestrup J, Gamborg M, Lange T, Tjønneland A, Baker JL. Childhood height, adult height, and the risk of prostate cancer. Cancer Causes Control. 2016;27:561–7.

    PubMed  PubMed Central  Google Scholar 

  41. Cook MB, Gamborg M, Aarestrup J, Sørensen TIA, Baker JL. Childhood height and birth weight in relation to future prostate cancer risk: a cohort study based on the Copenhagen School Health Records Register. Cancer Epidemiol Biomarkers Prev. 2013;22:2232–40.

    PubMed  Google Scholar 

  42. Cook MB, Freedman ND, Gamborg M, Sørensen TIA, Baker JL. Childhood body mass index in relation to future risk of oesophageal adenocarcinoma. Br J Cancer. 2015;112:601–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  43. dos Santos Silva I, De Stavola B, McCormack V. Collaborative group on pre-natal risk factors and subsequent risk of breast cancer. Birth size and breast cancer risk: re-analysis of individual participant data from 32 studies. PLoS Med. 2008;5:e193.

    PubMed Central  Google Scholar 

  44. Isager H, Andersen E. Pre-morbid factors in Hodgkin’s disease. I. Birth weight and growth pattern from 8 to 14 years of age. Scand J Haematol. 1978;21:250–5.

    CAS  PubMed  Google Scholar 

  45. Jensen BW, Gamborg M, Gögenur I, Renehan AG, Sørensen TIA, Baker JL. Childhood body mass index and height in relation to site-specific risks of colorectal cancers in adult life. Eur J Epidemiol. 2017;32:1097–106.

    CAS  PubMed  Google Scholar 

  46. Jensen BW, Bjerregaard LG, Ängquist L, Gögenur I, Renehan AG, Osler M, et al. Change in weight status from childhood to early adulthood and late adulthood risk of colon cancer in men: a population-based cohort study. Int J Obes. 2018;42:1797–803.

    Google Scholar 

  47. Jensen BW, Meyle KD, Madsen K, Friis S, Sørensen TIA, Baker JL. Associations between childhood body size and risk of renal cell carcinoma in adulthood. 2020. (In press).

  48. Kitahara CM, Gamborg M, Rajaraman P, Sørensen TIA, Baker JL. A prospective study of height and body mass index in childhood, birth weight, and risk of adult glioma over 40 years of follow-up. Am J Epidemiol. 2014;180:821–9.

    PubMed  PubMed Central  Google Scholar 

  49. Kitahara CM, Gamborg M, Berrington de Gonzalez A, Sørensen TIA, Baker JL. Childhood height and body mass index were associated with risk of adult thyroid cancer in a large cohort study. Cancer Res. 2014;74:235–42.

    CAS  PubMed  Google Scholar 

  50. McGlynn KA, Petrick JL, Gamborg M, Aarestrup J, Baker JL. Childhood height and risk of testicular germ cell tumors in adulthood. Int J Cancer. 2018;143:767–72.

  51. Meyle KD, Gamborg M, Hölmich LR, Baker JL. Associations between childhood height and morphologically different variants of melanoma in adulthood. Eur J Cancer. 2016;67:99–105.

    PubMed  PubMed Central  Google Scholar 

  52. Meyle KD, Gamborg M, Sørensen TIA, Baker JL. Childhood body size and the risk of malignant melanoma in adulthood. Am J Epidemiol. 2017;185:673–80.

    PubMed  PubMed Central  Google Scholar 

  53. Nogueira L, Stolzenberg-Solomon R, Gamborg M, Sørensen TIA, Baker JL. Childhood body mass index and risk of adult pancreatic cancer. Curr Dev Nutr. 2017;1:e001362.

  54. Petrick JL, Jensen BW, Sørensen TIA, Cook MB, Baker JL. Overweight patterns between childhood and early adulthood and esophageal and gastric cardia adenocarcinoma risk. Obesity. 2019;27:1520–6.

  55. Piltoft JS, Larsen SB, Dalton SO, Johansen C, Baker JL, Cederkvist L, et al. Early life risk factors for testicular cancer: a case-cohort study based on the Copenhagen School Health Records Register. Acta Oncol. 2017;56:220–4.

    PubMed  Google Scholar 

  56. Smith NR, Jensen BW, Zimmermann E, Gamborg M, Sørensen TIA, Baker JL. Associations between birth weight and colon and rectal cancer risk in adulthood. Cancer Epidemiol. 2016;42:181–5.

    PubMed  PubMed Central  Google Scholar 

  57. Sørensen KK, Jensen BW, Thomas PE, Madsen K, Eriksson F, Aarestrup J, et al. Early life body size and its associations with adult bladder cancer. Ann Hum Biol. 2020. (In press).

  58. Trabert B, Aarestrup J, Ulrich LG, Wentzensen N, Sørensen TIA, Baker JL. Birth weight and the risk of histological subtypes of ovarian and endometrial cancers: results from the Copenhagen School Health Records Register. Gynecol Oncol. 2018;148:547–52.

    PubMed  PubMed Central  Google Scholar 

  59. Zimmermann E, Berentzen TL, Gamborg M, Sørensen TIA, Baker JL. Sex-specific associations between birth weight and adult primary liver cancer in a large cohort of Danish children. Int J Cancer. 2016;138:1410–5.

    CAS  PubMed  Google Scholar 

  60. Baker JL, Olsen LW, Sørensen TIA. Weight at birth and all-cause mortality in adulthood. Epidemiology. 2008;19:197–203.

    PubMed  Google Scholar 

  61. Olsen LW, Baker JL, Holst C, Sørensen TIA. Birth cohort effect on the obesity epidemic in Denmark. Epidemiology. 2006;17:292–5.

    PubMed  Google Scholar 

  62. Jeffreys M, Smith GD, Martin RM, Frankel S, Gunnell D. Childhood body mass index and later cancer risk: a 50-year follow-up of the Boyd Orr study. Int J Cancer. 2004;112:348–51.

    CAS  PubMed  Google Scholar 

  63. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med. 1992;327:1350–5.

    CAS  PubMed  Google Scholar 

  64. Stavola BL, Hardy R, Kuh D, dos Santos Silva I, Wadsworth M, Swerdlow AJ. Birthweight, childhood growth and risk of breast cancer in a British cohort. Br J Cancer. 2000;83:964–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  65. Engeland A, Tretli S, Bjorge T. Height, body mass index, and ovarian cancer: a follow-up of 1.1 million Norwegian women. J Natl Cancer Inst. 2003;95:1244–8.

    PubMed  Google Scholar 

  66. Celind J, Ohlsson C, Bygdell M, Nethander M, Kindblom JM. Childhood body mass index is associated with risk of adult colon cancer in men: an association modulated by pubertal change in body mass index. Cancer Epidemiol Biomarkers Prev. 2019;28:974–9.

    PubMed  Google Scholar 

  67. Hidayat K, Yang CM, Shi BM. Body fatness at an early age and risk of colorectal cancer. Int J Cancer. 2018;142:729–40.

    CAS  PubMed  Google Scholar 

  68. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4:579–91.

    CAS  PubMed  Google Scholar 

  69. Renehan AG, Zwahlen M, Egger M. Adiposity and cancer risk: new mechanistic insights from epidemiology. Nat Rev Cancer. 2015;15:484–98.

    CAS  PubMed  Google Scholar 

  70. Aarestrup J, Bjerregaard LG, Gamborg M, Ängquist L, Tjønneland A, Overvad K, et al. Tracking of body mass index from 7 to 69 years of age. Int J Obes. 2016;40:1376–83.

    CAS  Google Scholar 

  71. Pedersen DC, Meyle KD, Ängquist L, Andersen I, Tjønneland A, Linneberg A, et al. Changes and correlations in height from 7 to 69 years of age across the birth years of 1930 to 1989. Am J Hum Biol. 2019:e23378.

  72. Andersen E, Isager H. Pre-morbid factors in Hodgkin’s disease. II. BCG-vaccination status, tuberculosis, infectious diseases, tonsillectomy, and appendectomy. Scand J Haematol. 1978;21:273–7.

    CAS  PubMed  Google Scholar 

  73. Prener A, Hsieh CC, Engholm G, Trichopoulos D, Jensen OM. Birth order and risk of testicular cancer. Cancer Causes Control. 1992;3:265–72.

    CAS  PubMed  Google Scholar 

  74. Villumsen M, Sorup S, Jess T, Ravn H, Relander T, Baker JL, et al. Risk of lymphoma and leukaemia after bacille Calmette-Guerin and smallpox vaccination: a Danish case-cohort study. Vaccine. 2009;27:6950–8.

    PubMed  Google Scholar 

  75. Rieckmann A, Meyle KD, Rod NH, Baker JL, Benn CS, Aaby P, et al. Smallpox and BCG vaccination in childhood and cutaneous malignant melanoma in Danish adults followed from 18 to 49 years. Vaccine. 2019;37:6730–6.

    PubMed  Google Scholar 

  76. Angell-Andersen E, Tretli S, Bjerknes R, Forsen T, Sørensen TIA, Eriksson JG, et al. The association between nutritional conditions during World War II and childhood anthropometric variables in the Nordic countries. Ann Hum Biol. 2004;31:342–55.

Download references

Acknowledgements

The authors thank Dr. Michael Gamborg for his valuable statistical contributions and input to the studies included in this review. The CSHRR was initiated and planned by Dr. Thorkild I.A. Sørensen and built by the Institute of Preventive Medicine, The Capital Region of Denmark.

Funding

This work was supported by the European Research Council under the European Union’s Seventh Framework Programme [(FP/2007–2013)/ERC, 281419 to JLB], the Danish Council for Independent Research [(DFF)|FSS 1331–00218 to JLB], and Dr. Sofus Carl Emil Friis and wife Olga Doris’ Fund to JLB.

Author information

Authors and Affiliations

  1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark

    Julie Aarestrup, Lise G. Bjerregaard, Kathrine D. Meyle, Dorthe C. Pedersen, Line K. Gjærde, Britt W. Jensen & Jennifer L. Baker

  2. Novo Nordisk Foundation Center for Basic Metabolic Research, Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Copenhagen, Denmark

    Jennifer L. Baker

Authors
  1. Julie Aarestrup
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lise G. Bjerregaard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathrine D. Meyle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dorthe C. Pedersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Line K. Gjærde
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Britt W. Jensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jennifer L. Baker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer L. Baker.

Ethics declarations

Conflict of interest

At present, KDM works at Pfizer ApS (Denmark); however, her work in relation to this review was conducted while KDM worked at the Center for Clinical Research and Prevention. Other authors declare no potential conflicts of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aarestrup, J., Bjerregaard, L.G., Meyle, K.D. et al. Birthweight, childhood overweight, height and growth and adult cancer risks: a review of studies using the Copenhagen School Health Records Register. Int J Obes 44, 1546–1560 (2020). https://doi.org/10.1038/s41366-020-0523-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41366-020-0523-9

This article is cited by

Search

Advanced search

Quick links