TY - JOUR
T1 - Cancer Diagnoses after Recent Weight Loss
AU - Wang, Qiao Li
AU - Babic, Ana
AU - Rosenthal, Michael H.
AU - Lee, Alice A.
AU - Zhang, Yin
AU - Zhang, Xuehong
AU - Song, Mingyang
AU - Rezende, Leandro F.M.
AU - Lee, Dong Hoon
AU - Biller, Leah
AU - Ng, Kimmie
AU - Giannakis, Marios
AU - Chan, Andrew T.
AU - Meyerhardt, Jeffrey A.
AU - Fuchs, Charles S.
AU - Eliassen, A. Heather
AU - Birmann, Brenda M.
AU - Stampfer, Meir J.
AU - Giovannucci, Edward L.
AU - Kraft, Peter
AU - Nowak, Jonathan A.
AU - Yuan, Chen
AU - Wolpin, Brian M.
N1 - Publisher Copyright:
© 2024 American Medical Association. All rights reserved.
PY - 2024/1/23
Y1 - 2024/1/23
N2 - Importance: Weight loss is common in primary care. Among individuals with recent weight loss, the rates of cancer during the subsequent 12 months are unclear compared with those without recent weight loss. Objective: To determine the rates of subsequent cancer diagnoses over 12 months among health professionals with weight loss during the prior 2 years compared with those without recent weight loss. Design, Setting, and Participants: Prospective cohort analysis of females aged 40 years or older from the Nurses' Health Study who were followed up from June 1978 until June 30, 2016, and males aged 40 years or older from the Health Professionals Follow-Up Study who were followed up from January 1988 until January 31, 2016. Exposure: Recent weight change was calculated from the participant weights that were reported biennially. The intentionality of weight loss was categorized as high if both physical activity and diet quality increased, medium if only 1 increased, and low if neither increased. Main Outcome and Measures: Rates of cancer diagnosis during the 12 months after weight loss. Results: Among 157474 participants (median age, 62 years [IQR, 54-70 years]; 111912 were female [71.1%]; there were 2631 participants [1.7%] who self-identified as Asian, Native American, or Native Hawaiian; 2678 Black participants [1.7%]; and 149903 White participants [95.2%]) and during 1.64 million person-years of follow-up, 15809 incident cancer cases were identified (incident rate, 964 cases/100000 person-years). During the 12 months after reported weight change, there were 1362 cancer cases/100000 person-years among all participants with recent weight loss of greater than 10.0% of body weight compared with 869 cancer cases/100000 person-years among those without recent weight loss (between-group difference, 493 cases/100000 person-years [95% CI, 391-594 cases/100000 person-years]; P <.001). Among participants categorized with low intentionality for weight loss, there were 2687 cancer cases/100000 person-years for those with weight loss of greater than 10.0% of body weight compared with 1220 cancer cases/100000 person-years for those without recent weight loss (between-group difference, 1467 cases/100000 person-years [95% CI, 799-2135 cases/100000 person-years]; P <.001). Cancer of the upper gastrointestinal tract (cancer of the esophagus, stomach, liver, biliary tract, or pancreas) was particularly common among participants with recent weight loss; there were 173 cancer cases/100000 person-years for those with weight loss of greater than 10.0% of body weight compared with 36 cancer cases/100000 person-years for those without recent weight loss (between-group difference, 137 cases/100000 person-years [95% CI, 101-172 cases/100000 person-years]; P <.001). Conclusions and Relevance: Health professionals with weight loss within the prior 2 years had a significantly higher risk of cancer during the subsequent 12 months compared with those without recent weight loss. Cancer of the upper gastrointestinal tract was particularly common among participants with recent weight loss compared with those without recent weight loss.
AB - Importance: Weight loss is common in primary care. Among individuals with recent weight loss, the rates of cancer during the subsequent 12 months are unclear compared with those without recent weight loss. Objective: To determine the rates of subsequent cancer diagnoses over 12 months among health professionals with weight loss during the prior 2 years compared with those without recent weight loss. Design, Setting, and Participants: Prospective cohort analysis of females aged 40 years or older from the Nurses' Health Study who were followed up from June 1978 until June 30, 2016, and males aged 40 years or older from the Health Professionals Follow-Up Study who were followed up from January 1988 until January 31, 2016. Exposure: Recent weight change was calculated from the participant weights that were reported biennially. The intentionality of weight loss was categorized as high if both physical activity and diet quality increased, medium if only 1 increased, and low if neither increased. Main Outcome and Measures: Rates of cancer diagnosis during the 12 months after weight loss. Results: Among 157474 participants (median age, 62 years [IQR, 54-70 years]; 111912 were female [71.1%]; there were 2631 participants [1.7%] who self-identified as Asian, Native American, or Native Hawaiian; 2678 Black participants [1.7%]; and 149903 White participants [95.2%]) and during 1.64 million person-years of follow-up, 15809 incident cancer cases were identified (incident rate, 964 cases/100000 person-years). During the 12 months after reported weight change, there were 1362 cancer cases/100000 person-years among all participants with recent weight loss of greater than 10.0% of body weight compared with 869 cancer cases/100000 person-years among those without recent weight loss (between-group difference, 493 cases/100000 person-years [95% CI, 391-594 cases/100000 person-years]; P <.001). Among participants categorized with low intentionality for weight loss, there were 2687 cancer cases/100000 person-years for those with weight loss of greater than 10.0% of body weight compared with 1220 cancer cases/100000 person-years for those without recent weight loss (between-group difference, 1467 cases/100000 person-years [95% CI, 799-2135 cases/100000 person-years]; P <.001). Cancer of the upper gastrointestinal tract (cancer of the esophagus, stomach, liver, biliary tract, or pancreas) was particularly common among participants with recent weight loss; there were 173 cancer cases/100000 person-years for those with weight loss of greater than 10.0% of body weight compared with 36 cancer cases/100000 person-years for those without recent weight loss (between-group difference, 137 cases/100000 person-years [95% CI, 101-172 cases/100000 person-years]; P <.001). Conclusions and Relevance: Health professionals with weight loss within the prior 2 years had a significantly higher risk of cancer during the subsequent 12 months compared with those without recent weight loss. Cancer of the upper gastrointestinal tract was particularly common among participants with recent weight loss compared with those without recent weight loss.
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U2 - 10.1001/jama.2023.25869
DO - 10.1001/jama.2023.25869
M3 - Article
C2 - 38261044
AN - SCOPUS:85183267410
SN - 0098-7484
VL - 331
SP - 318
EP - 328
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
IS - 4
ER -