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Epidemiology

Early-life body mass index and risks of breast, endometrial, and ovarian cancers: a dose–response meta-analysis of prospective studies

British Journal of Cancer volume 126, pages 664–672 (2022)Cite this article

Subjects

Abstract

Background

The evidence for the associations between early-life adiposity and female cancer risks is mixed. Little is known about the exact shape of the relationships and whether the associations are independent of adult adiposity.

Methods

We conducted dose–response meta-analyses of prospective studies to summarise the relationships of early-life body mass index (BMI) with breast, endometrial, and ovarian cancer risks. Pubmed and Embase were searched through June 2020 to identify relevant studies. Using random-effects models, the summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated per 5-kg/m2 increase in BMI at ages ≤ 25 years. A nonlinear dose–response meta-analysis was conducted using restricted cubic spline analysis.

Results

After screening 33,948 publications, 37 prospective studies were included in this analysis. The summary RRs associated with every 5-kg/m2 increase in early-life BMI were 0.84 (95% CI = 0.81–0.87) for breast, 1.40 (95% CI = 1.25–1.57) for endometrial, and 1.15 (95% CI = 1.07–1.23) for ovarian cancers. For breast cancer, the association remained statistically significant after adjustment for adult BMI (RR = 0.80, 95% CI = 0.73–0.87). For premenopausal breast, endometrial, and ovarian cancers, the dose–response curves suggested evidence of nonlinearity.

Conclusions

With early-life adiposity, our data support an inverse association with breast cancer and positive associations with ovarian and endometrial cancer risks.

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Fig. 1: Linear and nonlinear dose–response relationships for early-life BMI and breast cancer risk.
Fig. 2: Linear and nonlinear dose–response relationships for early-life BMI and endometrial cancer risk.
Fig. 3: Linear and nonlinear dose–response relationships for early-life BMI and ovarian cancer risk.

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Data availability

Available upon request.

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Acknowledgements

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Funding

HO was supported by the National Research Foundation of Korea (NRF) grants (2019R1G1A1004227, 2019S1A3A2099973) and Korea University grant L1906811. NK was supported by the National Research Foundation of Korea (NRF) grants (2018R1C1B6008822, 2018R1A4A1022589). The funders were not involved in the study design or data analysis and the views expressed in this publication are those of the authors.

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  1. These authors contributed equally: Dohyun Byun, SungEun Hong, NaNa Keum, Hannah Oh.

Authors and Affiliations

  1. Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea

    Dohyun Byun, Seaun Ryu, Hajin Jang, Yoonkyoung Cho & Hannah Oh

  2. Department of Food Science and Biotechnology, Dongguk University, Goyang, Republic of Korea

    SungEun Hong & NaNa Keum

  3. Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea

    Yeonju Nam & Hannah Oh

  4. Department of Nutrition, Harvard T.H. Chan School of Public Health, BostonMA, USA

    NaNa Keum

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DB conducted literature search, performed data extraction, and wrote the paper. SH performed statistical analyses and wrote the paper. SR, YN, HJ and YC conducted literature search and performed data extraction. HO and NK designed the research and made substantial contributions to interpretation of data, and critical revision and editing of the manuscript. All authors revised the manuscript for important intellectual content and gave final approval of the version to be published.

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Byun, D., Hong, S., Ryu, S. et al. Early-life body mass index and risks of breast, endometrial, and ovarian cancers: a dose–response meta-analysis of prospective studies. Br J Cancer 126, 664–672 (2022). https://doi.org/10.1038/s41416-021-01625-1

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