Background
Body mass index (BMI), the most common indicator of general adiposity, has been associated with the risk of several cancer types. Some researchers have started using large databases containing health information of millions of people for health research. With these databases we can study the role of overweight and obesity in the probability of cancer.
Aims
Investigate the association between adiposity and cancer risk. As a prior step, we aimed to evaluate the suitability of a large EHR database from Catalonia, Spain for research and, more specifically, for cancer-related research.
How it was done
Use Information System for Research in Primary Care (SIDIAP) database and check if 25 types of cancer cases were also registered in regional cancer registries. Study the relationships between BMI and the chance of having 26 cancer types and compare if the probability of having cancer is different whether you look at waist circumference over BMI.
Findings
SIDIAP is a good database to do health and cancer-related research and includes most of the cancer cases that are in the regional cancer registries of Catalonia. A higher BMI increases the probability of 12 cancers (some of which researchers were not sure about before, like hematological and head and neck cancers. The probability of having different types of cancer whether we look at BMI or WC is similar. People living with overweight and/or obesity for many years during early adulthood have a higher probability of developing 16 cancer types after the age of 40 years. Including some cancers that we were not sure about, like leukemia, non-Hodgkin lymphoma, malignant melanoma of skin, and prostate cancers.
Impact
Findings provide new and meaningful knowledge on how adiposity impacts on a wider range of cancers than those currently acknowledged in the literature. These findings will specifically contribute to an updated evaluation of adiposity and site-specific cancer risk; providing precise risk estimates across the range of BMI values and length of overweight/obesity duration for 26 cancer types, thus, accentuating the public health implications in view of the overall increase in BMI population distributions in many countries. The findings of this project also provide new information about important effect modifiers, specifically the effect of smoking status which helps with improved knowledge of the risk in specific groups of the general population. In the future, this information might help to refine risk prediction models for screening and primary prevention targeted to specific population sub- groups. Another important question that was answered is that abdominal adiposity does not seem to be a superior indicator in terms of risk discrimination compared to general adiposity.
Published papers
- Recalde, M., Pistillo, A., Davila-Batista, V. et al. Longitudinal body mass index and cancer risk: a cohort study of 2.6 million Catalan adults. Nat Commun 14, 3816 (2023).
- Recalde, M., Rodríguez, C., Burn, E. et al. Data Resource Profile: The Information System for Research in Primary Care (SIDIAP). International Journal of Epidemiology (2022)
- Recalde, M., Davila-Batista, V., Díaz, Y. et al. Body mass index and waist circumference in relation to the risk of 26 types of cancer: a prospective cohort study of 3.5 million adults in Spain. BMC Medicine (2021)
- Recalde, M., Manzano-Salgado, CB., Díaz, Y. et al. Validation Of Cancer Diagnoses In Electronic Health Records: Results From The Information System For Research In Primary Care (SIDIAP) In Northeast Spain. Clinical Epidemiology (2019)
> Read more about the evidence linking obesity, weight gain and cancer
> Browse our policy database to see how Spain is tackling obesity