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Epidemiology and Population Health

Consecutive gain and loss in body weight and waist circumference with risk of subsequent breast cancer in Korean women

Abstract

Background

This study investigated the association between longitudinal changes in weight and waist circumference and breast cancer risk according to menopausal status.

Methods

This retrospective cohort study used data from the population-based Korean National Health Insurance Service (NHI) database. The study population included women aged ≥40 years who consecutively underwent three biennial breast cancer screenings between 2009–2014 and were followed up until 2020. The percentage changes in weight and waist circumference during the three screenings were calculated and categorized into five groups based on the level of increase or decrease in these two factors. Hazard ratios (HRs) and 95% confidence intervals (95% CI) for breast cancer risk were calculated and adjusted for other factors.

Results

Of 691,253 premenopausal and 1,519,211 postmenopausal women, 9485 and 12,553 breast cancer cases were identified, respectively, during a median 6.9 follow-up years. Postmenopausal women with two consecutive weight gains had an increased risk of breast cancer risk (HR = 1.11, 95% CI = 1.01 to 1.22); meanwhile, consecutive weight loss was associated with a decreased risk (HR = 0.84, 95% CI = 0.76 to 0.93). Single time and continuous decreases in waist circumference were associated with a decreased risk (HR = 0.91, 95% CI = 0.85 to 0.98, and HR = 0.84, 95% CI = 0.76–0.93), while single time and continuous increases were associated with an increased risk (HR = 1.08, 95% CI = 1.01 to 1.15, and HR = 1.13, 95% CI = 1.04 to 1.22). Single weight gain was associated with the increased breast cancer risk in premenopausal women (HR = 1.07, 95% CI = 1.01 1.13).

Conclusions

Our findings suggest a dose-response relationship between weight, waist circumference change, and the risk of future breast cancer.

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Fig. 1: Our initial database included women aged ≥40 years who underwent all three breast cancer screenings during the three periods.
Fig. 2: Changes in body weight and waist circumference between the 1st and 2nd period, and between 2nd and 3rd period were assessed.
Fig. 3: Multivariable cox regression models for association of change in body weight and waist circumference with breast cancer using restricted cubic splines.

Data availability

Data are available through the Korean National Health Insurance Sharing Service (NHISS).

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Funding

This work was supported by a National Research Foundation of Korea grant funded by the Korean government (MSIT) (grant no. 2021R1A2C1011958). This work was partly supported by Institute of Information & communications Technology Planning & Evaluation (IITP) grant funded by the Korea government (MSIT) (No. 2020-0-01373, Artificial Intelligence Graduate School Program (Hanyang University)) and the research fund of Hanyang University (HY-202100000670036).

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Contributions

TXMT was responsible for designing the study, extracting and analyzing data, interpreting results, creating tables, and writing the original draft of the manuscript. HS and SK were responsible for data analysis and reviewing and revising the manuscript. SR, YC, and BP contributed to the design of the study, supervised the research, and reviewed and revised the manuscript.

Corresponding author

Correspondence to Boyoung Park.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The Institutional Review Board of the Hanyang University College of Medicine (approval no. HYUIRB-202106-003-1), approved this study.

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Tran, T.X.M., Kim, S., Song, H. et al. Consecutive gain and loss in body weight and waist circumference with risk of subsequent breast cancer in Korean women. Int J Obes (2022). https://doi.org/10.1038/s41366-022-01173-5

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