Increasing BMI Tied to Higher Risk of Liver and Biliary Tract Cancers

Individuals who are overweight or obese — or who become overweight or obese over time — have a higher risk of developing liver cancer and biliary tract cancer (BTC), according to a study published in JNCI Cancer Spectrum.

“We found that being overweight at ages 20 or 50 was associated with higher risks of both liver cancer and BTC,” researchers wrote. “Although we do not know the exact age at which adiposity begins to influence cancer development, these findings indicate that maintaining a healthy weight, especially in young adulthood, could protect against development of these cancers.” 

For this study, researchers evaluated data from 138,922 patients enrolled in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. The patients were 42 to 78 years of age between 1993 and 2001. 

The researchers evaluated patients’ body mass index (BMI) at study enrollment, age 20, and age 50. A normal BMI was 18.5-24.9 kg/m², overweight was 25-29.9 kg/m², and obese was 30 kg/m² or higher. 

At a median follow-up of 15.9 years, 170 patients had developed liver cancer, and 143 had developed BTC. 

In a multivariable analysis, there was an increased risk of liver cancer among patients who were:

• Overweight (hazard ratio [HR], 1.35; 95% CI, 0.92-1.99) or obese (HR, 2.54; 95% CI, 1.18-5.46) at age 20
• Overweight (HR, 1.40; 95% CI, 0.98-2.01) or obese (HR, 2.58; 95% CI, 1.69-3.96) at age 50
• Overweight (HR, 1.56; 95% CI, 1.13-2.16) or obese (HR, 1.86; 95% CI, 1.06-3.26) from age 20 to study enrollment.

Similarly, there was an increased risk of BTC among patients who were:

• Overweight (HR, 1.32; 95% CI, 0.83-2.08) or obese (HR, 2.15; 95% CI, 0.87-5.31) at age 20 
• Overweight (HR, 1.46; 95% CI, 0.99-2.14) or obese (HR, 2.15; 95% CI, 1.33-3.47) at age 50
• Overweight (HR, 1.38; 95% CI, 0.96-1.98) or obese (HR, 2.01; 95% CI, 1.14-3.54) from age 20 to study enrollment.

The researchers also identified 4 trajectories of body adiposity from age 20 to study enrollment. There were patients who maintained a normal BMI throughout the period analyzed (28.1%), those who had a normal to overweight trajectory (48.5%), a normal to obese trajectory (18.6%), and an overweight to obese trajectory (4.8%).

There was an increased risk of liver cancer for patients with a normal to overweight trajectory (HR, 1.33; 95% CI, 0.86-2.05), an overweight to obese trajectory (HR, 1.99; 95% CI, 0.89-4.44), and a normal to obese trajectory (HR, 2.50; 95% CI, 1.55-4.04).

Likewise, there was an increased risk of BTC for patients with a normal to overweight trajectory (HR, 1.75; 95% CI, 1.09-2.79), an overweight to obese trajectory (HR, 4.26; 95% CI, 2.16-8.41), and a normal to obese trajectory (HR, 1.83; 95% CI, 1.03-3.22).

Reference

Yang W, Zeng X, Petrick JL, et al. Body mass index trajectories, weight gain and risks of liver and biliary tract cancers. JNCI Cancer Spectr. Published online August 12, 2022. doi:10.1093/jncics/pkac056

This article originally appeared on Cancer Therapy Advisor