Trajectories of body mass index across the lifecourse and associations with post-menopausal breast cancer by estrogen receptor status
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Trajectories of body mass index across the lifecourse and associations with post-menopausal breast cancer by estrogen receptor status. / Pedersen, Dorthe C.; Aarestrup, Julie; Blond, Kim; Jensen, Britt W.; Andersen, Zorana J.; Mellemkjær, Lene; Tjønneland, Anne; Baker, Jennifer L.
In: Cancer Epidemiology, Vol. 87, 102479, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Trajectories of body mass index across the lifecourse and associations with post-menopausal breast cancer by estrogen receptor status
AU - Pedersen, Dorthe C.
AU - Aarestrup, Julie
AU - Blond, Kim
AU - Jensen, Britt W.
AU - Andersen, Zorana J.
AU - Mellemkjær, Lene
AU - Tjønneland, Anne
AU - Baker, Jennifer L.
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023
Y1 - 2023
N2 - Background: Associations between a high body mass index (BMI) at single timepoints during child- and adulthood and risks of post-menopausal breast cancer are well-established, but associations with BMI across the lifecourse remains largely unknown. Therefore, we examined whether lifecourse BMI trajectories were associated with risks of post-menopausal breast cancer overall and by estrogen receptor (ER) status. Methods: We included 6698 Danish women born 1930–1946. Information on BMI at ages 6–15 years came from the Copenhagen School Health Records Register, and information on BMI at ages 20, 30, 40, 50 and/or 50–64 years came from the Diet, Cancer and Health cohort. Breast cancer cases (n = 577) were identified in the Danish Breast Cancer Cooperative Group database. Six BMI trajectories were identified using latent class trajectory modelling. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression models. Results: Compared to women with a trajectory characterized by an average BMI gain across life, women with the two trajectories with steep increases in BMI during childhood and adolescence that thereafter largely stabilized, had lower risks of post-menopausal breast cancer and ER-positive tumors. The adjusted HRs for ER-positive tumors were 0.67 (95% CI: 0.47–0.95) and 0.68 (95% CI: 0.46–1.01), respectively. In contrast, women with a trajectory with a low gain in BMI during childhood and adolescence followed by a subsequent steep increase during adulthood, had higher risks of post-menopausal breast cancer and ER-positive tumors when compared to women with an average BMI gain. The adjusted HR for ER-positive tumors was 1.28 (95% CI: 0.98–1.67). Conclusions: Our findings suggest that the timing of excess gain in BMI across the lifecourse impacts subsequent post-menopausal breast cancer risks. Thus, the BMI development across life is likely useful in the identification of women at increased risks of post-menopausal breast cancer.
AB - Background: Associations between a high body mass index (BMI) at single timepoints during child- and adulthood and risks of post-menopausal breast cancer are well-established, but associations with BMI across the lifecourse remains largely unknown. Therefore, we examined whether lifecourse BMI trajectories were associated with risks of post-menopausal breast cancer overall and by estrogen receptor (ER) status. Methods: We included 6698 Danish women born 1930–1946. Information on BMI at ages 6–15 years came from the Copenhagen School Health Records Register, and information on BMI at ages 20, 30, 40, 50 and/or 50–64 years came from the Diet, Cancer and Health cohort. Breast cancer cases (n = 577) were identified in the Danish Breast Cancer Cooperative Group database. Six BMI trajectories were identified using latent class trajectory modelling. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression models. Results: Compared to women with a trajectory characterized by an average BMI gain across life, women with the two trajectories with steep increases in BMI during childhood and adolescence that thereafter largely stabilized, had lower risks of post-menopausal breast cancer and ER-positive tumors. The adjusted HRs for ER-positive tumors were 0.67 (95% CI: 0.47–0.95) and 0.68 (95% CI: 0.46–1.01), respectively. In contrast, women with a trajectory with a low gain in BMI during childhood and adolescence followed by a subsequent steep increase during adulthood, had higher risks of post-menopausal breast cancer and ER-positive tumors when compared to women with an average BMI gain. The adjusted HR for ER-positive tumors was 1.28 (95% CI: 0.98–1.67). Conclusions: Our findings suggest that the timing of excess gain in BMI across the lifecourse impacts subsequent post-menopausal breast cancer risks. Thus, the BMI development across life is likely useful in the identification of women at increased risks of post-menopausal breast cancer.
KW - Body mass index trajectories
KW - Breast cancer
KW - Cohort study
KW - Estrogen receptor status
KW - Lifecourse epidemiology
U2 - 10.1016/j.canep.2023.102479
DO - 10.1016/j.canep.2023.102479
M3 - Journal article
C2 - 37897969
AN - SCOPUS:85174918622
VL - 87
JO - Cancer Epidemiology
JF - Cancer Epidemiology
SN - 1877-7821
M1 - 102479
ER -
ID: 375208341