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Metabolic risk score and cancer risk: pooled analysis of seven cohorts.

Stocks T, Bjørge T, Ulmer H, Manjer J, Häggström C, Nagel G, Engeland A, Johansen D, Hallmans G, Selmer R, Concin H, Tretli S, Jonsson H, Stattin P - Int J Epidemiol (2015)

Bottom Line: We weighted those factors equally into a standardized metabolic risk score [MRS, mean = 0, standard deviation (SD) = 1], with an individual's level indicated as SDs from the sex- and cohort-specific means.All statistical tests were two-sided.In men, risk per SD MRS was increased by 43% (95% confidence interval: 27-61) for renal cell cancer, 43% (16-76) for liver cancer, 29% (20-38) for colon cancer, 27% (5-54) for oesophageal cancer, 20% (9-31) for rectal cancer, 19% (4-37) for leukaemias, 15% (1-30) for oral cancer and 10% (2-19) for bladder cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden, Department of Clinical Sciences in Malmö, Diabetes and Cardiovascular Diseases, Genetic Epidemiology, Lund University, Lund, Sweden, tanja.stocks@med.lu.se.

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Hazard ratio (HR) and 95% confidence interval of incident cancer at separate sites in men (A), women (B) and men and women combined (C) by the metabolic risk score (MRS, mean = 0, SD = 1). HRs were derived from Cox regression models with attained age as timescale, strata for cohort, birth year and sex and adjustment for baseline age and smoking status. HRs were corrected for a regression dilution ratio of 0.69 for metabolic risk score by exp(log(HR)/0.69). ICD-7 180.0 and 180.9 denoting renal cell cancer, and ICD-7172 denoting endometrial cancer, include a fraction of tumours that morphologically differ from the clinical classification of these cancers. HRs for cancer of the stomach, colon and pancreas differed significantly between men and women, so these cancers are not included in (C). Phet refers to P-value for heterogeneity between cohorts which was tested by likelihood ratio tests in which a model with the continuous metabolic risk score was compared with a model additionally including a product term of metabolic risk score and cohort.
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dyv001-F2: Hazard ratio (HR) and 95% confidence interval of incident cancer at separate sites in men (A), women (B) and men and women combined (C) by the metabolic risk score (MRS, mean = 0, SD = 1). HRs were derived from Cox regression models with attained age as timescale, strata for cohort, birth year and sex and adjustment for baseline age and smoking status. HRs were corrected for a regression dilution ratio of 0.69 for metabolic risk score by exp(log(HR)/0.69). ICD-7 180.0 and 180.9 denoting renal cell cancer, and ICD-7172 denoting endometrial cancer, include a fraction of tumours that morphologically differ from the clinical classification of these cancers. HRs for cancer of the stomach, colon and pancreas differed significantly between men and women, so these cancers are not included in (C). Phet refers to P-value for heterogeneity between cohorts which was tested by likelihood ratio tests in which a model with the continuous metabolic risk score was compared with a model additionally including a product term of metabolic risk score and cohort.

Mentions: Associations between continuous MRS and risk of cancer at separate sites are shown in Figure 2. A positive association was found in both sexes for renal cell, colon and rectal cancer, and several other cancers showed associations in men or in women. In men, the risk increase per SD MRS increment was 43% (95% CI: 16–76%) for renal cancer, 43% (95% CI: 27–61%) for liver cancer, 29% (95% CI: 20–38%) for colon cancer, 27% (95% CI: 5–54%) for oesophageal cancer [58%, (95% CI: 17–114%) for oesophageal adenocarcinoma], 20% (95% CI: 9–31%) for rectal cancer, 19% (95% CI: 4–37%) for leukaemias, 15% (95% CI: 1–30%) for oral cancers and 10% (95% CI: 2–19%) for bladder cancer. In women, the risk increase per SD MRS was 56% (95% CI: 42–70%) for endometrial cancer, 53% (95% CI: 29–81%) for pancreatic cancer, 40% (95% CI: 16–67%) for renal cell cancer, 27% (95% CI: 9–47%) for cervical cancer and 17% (95% CI: 3–32%) for rectal cancer. One SD increment of the MRS was also associated with a small [5%, (95% CI: 1–9%)] decrease in breast cancer risk. This association was driven by results in women who were <50 years old (premenopausal) at the time of diagnosis [18% decreased risk (95% CI: 10%–25%)], and there was no association in women ≥60 years old (postmenopausal) at diagnosis [4% increased risk (95% CI: –3–12%)].The association between MRS and gallbladder cancer was non-significant in men and women separately but was associated with a 28% (95% CI: 3–60%) risk increment per SD of the MRS in men and women combined. There were no significant interactions between MRS and cohort in relation to risk of separate cancer forms except for pancreas and stomach cancer among men (Phet = 0.01 and 0.048, respectively) and non-Hodgkin lymphoma among women (Phet = 0.01).Figure 2.


Metabolic risk score and cancer risk: pooled analysis of seven cohorts.

Stocks T, Bjørge T, Ulmer H, Manjer J, Häggström C, Nagel G, Engeland A, Johansen D, Hallmans G, Selmer R, Concin H, Tretli S, Jonsson H, Stattin P - Int J Epidemiol (2015)

Hazard ratio (HR) and 95% confidence interval of incident cancer at separate sites in men (A), women (B) and men and women combined (C) by the metabolic risk score (MRS, mean = 0, SD = 1). HRs were derived from Cox regression models with attained age as timescale, strata for cohort, birth year and sex and adjustment for baseline age and smoking status. HRs were corrected for a regression dilution ratio of 0.69 for metabolic risk score by exp(log(HR)/0.69). ICD-7 180.0 and 180.9 denoting renal cell cancer, and ICD-7172 denoting endometrial cancer, include a fraction of tumours that morphologically differ from the clinical classification of these cancers. HRs for cancer of the stomach, colon and pancreas differed significantly between men and women, so these cancers are not included in (C). Phet refers to P-value for heterogeneity between cohorts which was tested by likelihood ratio tests in which a model with the continuous metabolic risk score was compared with a model additionally including a product term of metabolic risk score and cohort.
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Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4588859&req=5

dyv001-F2: Hazard ratio (HR) and 95% confidence interval of incident cancer at separate sites in men (A), women (B) and men and women combined (C) by the metabolic risk score (MRS, mean = 0, SD = 1). HRs were derived from Cox regression models with attained age as timescale, strata for cohort, birth year and sex and adjustment for baseline age and smoking status. HRs were corrected for a regression dilution ratio of 0.69 for metabolic risk score by exp(log(HR)/0.69). ICD-7 180.0 and 180.9 denoting renal cell cancer, and ICD-7172 denoting endometrial cancer, include a fraction of tumours that morphologically differ from the clinical classification of these cancers. HRs for cancer of the stomach, colon and pancreas differed significantly between men and women, so these cancers are not included in (C). Phet refers to P-value for heterogeneity between cohorts which was tested by likelihood ratio tests in which a model with the continuous metabolic risk score was compared with a model additionally including a product term of metabolic risk score and cohort.
Mentions: Associations between continuous MRS and risk of cancer at separate sites are shown in Figure 2. A positive association was found in both sexes for renal cell, colon and rectal cancer, and several other cancers showed associations in men or in women. In men, the risk increase per SD MRS increment was 43% (95% CI: 16–76%) for renal cancer, 43% (95% CI: 27–61%) for liver cancer, 29% (95% CI: 20–38%) for colon cancer, 27% (95% CI: 5–54%) for oesophageal cancer [58%, (95% CI: 17–114%) for oesophageal adenocarcinoma], 20% (95% CI: 9–31%) for rectal cancer, 19% (95% CI: 4–37%) for leukaemias, 15% (95% CI: 1–30%) for oral cancers and 10% (95% CI: 2–19%) for bladder cancer. In women, the risk increase per SD MRS was 56% (95% CI: 42–70%) for endometrial cancer, 53% (95% CI: 29–81%) for pancreatic cancer, 40% (95% CI: 16–67%) for renal cell cancer, 27% (95% CI: 9–47%) for cervical cancer and 17% (95% CI: 3–32%) for rectal cancer. One SD increment of the MRS was also associated with a small [5%, (95% CI: 1–9%)] decrease in breast cancer risk. This association was driven by results in women who were <50 years old (premenopausal) at the time of diagnosis [18% decreased risk (95% CI: 10%–25%)], and there was no association in women ≥60 years old (postmenopausal) at diagnosis [4% increased risk (95% CI: –3–12%)].The association between MRS and gallbladder cancer was non-significant in men and women separately but was associated with a 28% (95% CI: 3–60%) risk increment per SD of the MRS in men and women combined. There were no significant interactions between MRS and cohort in relation to risk of separate cancer forms except for pancreas and stomach cancer among men (Phet = 0.01 and 0.048, respectively) and non-Hodgkin lymphoma among women (Phet = 0.01).Figure 2.

Bottom Line: We weighted those factors equally into a standardized metabolic risk score [MRS, mean = 0, standard deviation (SD) = 1], with an individual's level indicated as SDs from the sex- and cohort-specific means.All statistical tests were two-sided.In men, risk per SD MRS was increased by 43% (95% confidence interval: 27-61) for renal cell cancer, 43% (16-76) for liver cancer, 29% (20-38) for colon cancer, 27% (5-54) for oesophageal cancer, 20% (9-31) for rectal cancer, 19% (4-37) for leukaemias, 15% (1-30) for oral cancer and 10% (2-19) for bladder cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden, Department of Clinical Sciences in Malmö, Diabetes and Cardiovascular Diseases, Genetic Epidemiology, Lund University, Lund, Sweden, tanja.stocks@med.lu.se.

No MeSH data available.


Related in: MedlinePlus