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.
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.
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.
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.
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Obesity during childhood is associated with higher cancer mortality rate during adulthood: the i3C Consortium
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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.
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.
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.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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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
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