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Weight gain ups cancer risk among middle-aged individuals

11 Jul 2018

Individuals who gain weight during middle life appear to be at greater risk of developing obesity-related cancer irrespective of metabolic function and body mass index (BMI), according to a study.

Researchers examined independent and combined effects of weight gain and metabolic dysfunction during middle-adult years on obesity-related cancer risk in a cohort of 3,850 individuals (aged 45–69 years) from the Framingham Offspring Study.

Obesity-related cancer outcomes included those that involved the female reproductive organs (postmenopausal breast, uterine/endometrial and ovarian), colon, rectum, stomach, liver, gallbladder, pancreas, kidney, thyroid, oesophageal adenocarcinoma, leukaemia, non-Hodgkin lymphoma and multiple myeloma.

During about 14 years of follow up, 145 men and 90 women lost ≥0.45 kg/years (mean weight loss, –0.72 and –0.77 lbs/year, respectively), and 530 men and 805 women gained 0.45 kg/year (mean weight gain, 0.81 and 0.80 kg/year, respectively). Weight remained stable in 1,166 men and 1,112 women.

Compared with maintaining stable weight, gaining ≥0.45 kg/year over about 14 years was associated with a 38-percent increased cancer risk (hazard ratio [HR], 1.38; 95 percent CI, 1.09–1.76). Of note, the elevated cancer risk associated with weight gain increased by 77 percent in men and women with metabolic dysfunction (HR, 1.77; 1.21–2.59).

Compared with nonoverweight adults, men and women who became overweight (BMI 30 and 25 kg/m2, respectively) during midlife also had increased cancer risk (men: HR, 2.18; 1.33–3.56; women: HR, 1.60; 1.12–2.28).

The risk increased by 28 percent and 33 percent, although not significantly, in men and women who were already overweight at baseline. This is despite having a midlife BMI that was higher by 3.4 kg/m2 than the midlife BMI of those who gained weight later.

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In advanced-stage, newly diagnosed classical, CD30-positive Hodgkin lymphoma (HL), front-line therapy has resulted in durable remission rates in up to 70–90% of patients, although approximately 25–30% of advanced stage HL patients are refractory or relapse following first-line treatment with ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy.1–3 The standard of care for patients with relapsed or refractory (r/r) classical HL is salvage therapy using second-line high-dose chemotherapy (HDCT), followed by autologous haematopoietic stem cell transplant (ASCT) in eligible patients, which can induce a complete remission (CR) in about 50% of patients.4 Nevertheless, the prognosis of patients who relapse after the salvage HDCT/ASCT is exceedingly poor, with a median survival duration of approximately 1.2 years.5
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