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The association of body fat composition with risk of breast, endometrial, ovarian and colorectal cancers among normal weight participants in the UK Biobank



The association between body fat composition and risk of cancer in normal weight individuals (body mass index (BMI) 18.5–24.9 kg/m2) is unclear.


We examined the association of measures of adiposity with risk of incident cancers of the breast (postmenopausal), endometrium, ovary and colon/rectum among 149,928 normal weight individuals (40–70 years) who were enrolled in the UK Biobank cohort between 2006 and 2010.


All of the body fat measures were positively associated with invasive postmenopausal breast cancer risk (hazard ratios (HR) for the uppermost quintile (Q5) versus the lowest quintile (Q1) ranged from 1.32 (95% CI: 1.09–1.60) for waist circumference (WC) to 1.56 (1.28–1.90) for BMI). Trunk fat mass index (HRQ5 vs Q1: 1.72, 95% CI: 1.02–2.89) and WC (HRQ5 vs Q1: 1.65, 95% CI: 1.01–2.70)) were positively associated with risk of endometrial cancer. Among males, trunk fat:trunk fat free mass ratio, trunk fat:leg fat mass ratio and (HRQ5 vs Q1: 1.63, 95% CI: 1.02–2.60; 1.92, 1.20–3.07 and 1.68, 1.05–2.66, respectively) were positively associated with colon cancer risk. None of the body fat measures was associated with risk of ovarian cancer or colorectal cancer in women.


The findings of this study suggest that the current normal weight category based on BMI includes individuals who are at increased risk of some obesity-related cancers.

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This study was presented as an e-poster at the 2020 AACR Virtual Annual Meeting 11 on June 22, 2020 during the Obesity, Physical Activity and Related Biomarkers session. This research was conducted using the UK Biobank Resource (Project ID: 40525).

Author information




R.S.A. contributed to the conception and design, analyses and interpretation of the data, writing the manuscript and final approval of the version to be published. A.J.D. contributed to the conception and design, reviewing the manuscript and final approval of the manuscript. M.K. contributed to the analyses and interpretation of the data, reviewing the manuscript and final approval of the manuscript. T.R. contributed to the conception and design, interpretation of the data, reviewing the manuscript and final approval of the manuscript.

Corresponding author

Correspondence to Rhonda S. Arthur.

Ethics declarations

Ethical approval and consent to participate

The study was approved by the North West Multi-centre Research Ethics Committee, the National Information Governance Board for Health and Social Care in England and Wales and the Community Health Index Advisory Group in Scotland. All participants provided written informed consent. The study was performed in accordance with the Declaration of Helsinki.

Data availability

This study was conducted using data from the UK Biobank study. Information on data availability can be obtained via the UK Biobank website (

Competing interests

The authors declare no competing interests.

Funding information

This work was supported by the Breast Cancer Research Foundation (BCRF-16–140 to T.E.R.; BCRF-19–034, NCI U54 CA210184 to A.J.D.).

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Arthur, R.S., Dannenberg, A.J., Kim, M. et al. The association of body fat composition with risk of breast, endometrial, ovarian and colorectal cancers among normal weight participants in the UK Biobank. Br J Cancer 124, 1592–1605 (2021).

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