News
Links between excess body fat and breast cancer may be underestimated – study

Around 40 per cent of postmenopausal hormone positive breast cancer cases may be linked to excess body fat, suggests Spanish research.
This proportion is significantly higher than 1 in 10 such cases currently attributed to excess weight, using the widely used measure of body mass index (BMI), and indicates that the real impact of obesity on breast cancer risk has likely been underestimated, say the researchers.
BMI is not necessarily a very accurate measure of body fat, particularly in older women, since it doesn’t account for age, sex, or ethnicity, they point out.
Researchers therefore compared BMI with the CUN-BAE (Clínica Universidad de Navarra–Body Adiposity Estimator), a validated measure of body fat that does account for age and sex, in 1033 white postmenopausal women with breast cancer and 1143 free of the disease, but matched for age, sex, and geographical region.
All participants were quizzed on potentially influential risk factors: sociodemographics; lifestyle; and personal/family medical and reproductive histories.
Dietary information was collected through a validated semi structured 140-item Food Frequency Questionnaire, and a self-administered questionnaire was used to gather information on usual alcohol intake between the ages of 30 and 40.
No similar trend was observed for BMI, prompting the researchers to estimate that 23 per cent of breast cancer cases were attributable to excess body fat using BMI, but 38% using the CUN-BAE.
But these differences were only apparent for hormone positive cancers (680 cases) for which the estimated proportions attributable to excess body fat were 20 per cent (BMI) and 42 per cent (CUN-BAE).
Causal factors can’t be established from the findings of this case-control study, say the researchers, who also acknowledge that the CUN-BAE formula was calculated from a sample of sedentary people; and the number of breast cancers that weren’t hormone positive was small.
Nevertheless, they conclude: “The results of our study indicate that excess body fat is a significant risk factor for hormone receptor positive breast cancer in postmenopausal women.
“Our findings suggest that the population impact could be underestimated when using traditional BMI estimates, and that more accurate measures of body fat, such as CUN-BAE, should be considered when estimating the cancer burden attributable to obesity in postmenopausal breast cancer.”
This is crucial for planning effective prevention initiatives, they add.
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Cancer
Ovarian cancer cases rising among younger adults, study finds

Ovarian cancer cases are rising among younger adults in England, with bowel cancer showing a similar pattern, a new study suggests.
Researchers said excess weight is a key contributor, but is unlikely on its own to explain the pattern.
The authors wrote: “These patterns suggest that while similar risk factors across ages are likely, some cancers may have age-specific exposures, susceptibilities, or differences in screening and detection practices.”
They added: “Although overweight and obesity are linked to 10 of the 11 cancers evaluated and account for a substantial proportion of cancer cases, both BMI-attributable and BMI-non-attributable incidence rates have increased, though the latter more slowly, suggesting other contributors.”
The study analysed cancer incidence, meaning new diagnoses, in England between 2001 and 2019 across more than 20 cancer types, comparing adults aged 20 to 49 with those aged 50 and over.
Among younger women, cases of 16 out of 22 cancers increased significantly over the period, while among younger men, 11 out of 21 cancers increased significantly.
In particular, there was a significant rise in 11 cancers with known behavioural risk factors among adults under 50. These were thyroid, multiple myeloma, liver, kidney, gallbladder, bowel, pancreatic, endometrial, mouth, breast and ovarian cancers.
Rates of all 11 also rose significantly among adults aged 50 and over, with the notable exceptions of bowel and ovarian cancer.
Five cancers, endometrial, kidney, pancreatic, multiple myeloma and thyroid cancer, increased significantly faster in younger than in older women, while multiple myeloma increased faster in younger than in older men.
The researchers looked at established risk factors including smoking, alcohol intake, diet, physical inactivity and body mass index, a measure used to assess whether someone is underweight, a healthy weight, overweight or obese.
With the exception of mouth cancer, all 11 cancers were associated with obesity. Six, liver, bowel, mouth, pancreatic, kidney and ovarian, were also linked to smoking.
Four, liver, bowel, mouth and breast, were associated with alcohol intake. Three, bowel, breast and endometrial, were linked to physical inactivity, and one, bowel, was associated with dietary factors.
But apart from excess weight, trends in those risk factors over the past one to two decades were stable or improving among younger adults.
That suggests other factors may also play a part, including reproductive history, early-life or prenatal exposures, and changes in diagnosis and detection.
The study noted that red meat consumption fell among younger adults, while fibre intake remained stable or slightly improved in both sexes between 2009 and 2019, although more than 90 per cent of younger adults were still not eating enough fibre in 2018.
Established behavioural risk factors accounted for a substantial share of cancer cases.
Excess weight was the risk factor associated with most cancers in 2019, ranging from 5 per cent for ovarian cancer to 37 per cent for endometrial cancer.
The researchers said the findings were based on observational data, meaning the study could identify patterns but could not prove cause and effect.
They also noted there were no consistent long-term national data for several risk factors, that the analysis was limited to England rather than the UK, and that cancer remains far more common overall in older adults despite the rise in cases among younger people.
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