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Midlife weight gain is a risk factor for obesity-related cancer

British Journal of Cancervolume 118pages16651671 (2018) | Download Citation



Overweight and diabetes are known cancer risk factors. This study examines independent and combined effects of weight gain and metabolic dysfunction during middle-adult years on obesity-related cancer risk.


Subjects (n = 3850) aged 45–69 years at exams 3–5 in the Framingham Offspring Study were classified according to current and prior (~14 years earlier) weight status, interim weight change and prevalent metabolic dysfunction. Cancer risk among subjects who were overweight at baseline and remained overweight, as well as those who became overweight during follow-up, was compared with risk among normal-weight individuals.


Gaining ≥0.45 kg (≥1.0 pound)/year (vs. maintaining stable weight) over ~14 years increased cancer risk by 38% (95% confidence interval (CI), 1.09, 1.76); combined with metabolic dysfunction, weight gain increased cancer risk by 77% (95% CI, 1.21, 2.59). Compared with non-overweight adults, men and women who became overweight during midlife had 2.18-fold and 1.60-fold increased cancer risks; those who were overweight from baseline had non-statistically significant 28 and 33% increased cancer risks, respectively, despite having a midlife body mass index that was 3.4 kg/m2 higher than those who gained weight later.


Midlife weight gain was a strong cancer risk factor. This excess risk was somewhat stronger among those with concurrent metabolic dysfunction.

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These data were collected with funding from the National Heart, Lung, and Blood Institute (Framingham Study Contract No. N01-HC-25195).

Author contributions

S.C. wrote proposal, oversaw analyses, interpreted results, wrote manuscript; M.R.S. created data set, conducted analyses, critically revised manuscript; B.E.K. directed cancer data collection, adjudicated cancer outcomes, provided analytical advice, critically revised manuscript; M.L.B. conducted background research, edited and critically revised manuscript; L.L.M. provided direction for study design and statistical analyses, interpreted results, edited and critically revised manuscript. All authors consented to manuscript submission and publication.

Author information


  1. Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, 02118, USA

    • Susan Chadid
    • , Martha R. Singer
    • , M. Loring Bradlee
    •  & Lynn L. Moore
  2. General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, 02118, USA

    • Bernard E. Kreger
  3. Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, MA, 01702, USA

    • Bernard E. Kreger


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Competing interest

The authors declare no competing interests.

Ethical approval:

These analyses were approved by the Boston Medical Center and Boston University Medical Campus Institutional Review Board.

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Correspondence to Lynn L. Moore.

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