Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Mar 29:14:04067.
doi: 10.7189/jogh.14.04067.

Role of body mass index and weight change in the risk of cancer: A systematic review and meta-analysis of 66 cohort studies

Xiaoye Shi #  1   2 , Gengwen Deng #  1   3 , Haiteng Wen  1   2 , Anqi Lin  1 , Haitao Wang  4 , Lingxuan Zhu  1   5 , Weiming Mou  1   6 , Zaoqu Liu  7   8 , Xiaohua Li  9 , Jian Zhang  1 , Quan Cheng  10   11 , Peng Luo  1
Affiliations
Meta-Analysis

Role of body mass index and weight change in the risk of cancer: A systematic review and meta-analysis of 66 cohort studies

Xiaoye Shi et al. J Glob Health. .

Abstract

Background: This study was designed to evaluate the effects of body mass index (BMI) and weight change on the risk of developing cancer overall and cancer at different sites.

Methods: We searched PubMed and other databases up to July 2023 using the keywords related to 'risk', 'cancer', 'weight', 'overweight', and 'obesity'. We identified eligible studies, and the inclusion criteria encompassed cohort studies in English that focused on cancer diagnosis and included BMI or weight change as an exposure factor. Multiple authors performed data extraction and quality assessment, and statistical analyses were carried out using RevMan and R software. We used random- or fixed-effects models to calculate the pooled relative risk (RR) or hazard ratio along with 95% confidence intervals (CIs). We used the Newcastle-Ottawa Scale to assess study quality.

Results: Analysis included 66 cohort studies. Compared to underweight or normal weight, overweight or obesity was associated with an increased risk of endometrial cancer, kidney cancer, and liver cancer but a decreased risk of prostate cancer and lung cancer. Being underweight was associated with an increased risk of gastric cancer and lung cancer but not that of postmenopausal breast cancer or female reproductive cancer. In addition, weight loss of more than five kg was protective against overall cancer risk.

Conclusions: Overweight and obesity increase the risk of most cancers, and weight loss of >5 kg reduces overall cancer risk. These findings provide insights for cancer prevention and help to elucidate the mechanisms underlying cancer development.

Registration: Reviewregistry1786.

PubMed Disclaimer

Conflict of interest statement

Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests.

Figures

Figure 1
Figure 1
Flow diagram for the search strategy and study selection. BMI – body mass index.
Figure 2
Figure 2
Summary risk estimated by different BMI comparisons for overall cancer incidence. RR – relative risk, CI – confidence interval.
Figure 3
Figure 3
Summary risk estimated by different cancer sites in different BMI comparisons. Panel A. Overweight or obesity vs underweight or normal weight. Panel B. Underweight vs normal weight. Panel C. Overweight vs normal weight. Panel D. Obesity vs normal weight. Panel E. Overweight or obesity vs normal weight. RR – relative risk, CI – confidence interval.
Figure 4
Figure 4
Summary risk estimated by different cancer types and different degrees of weight change. Panel A. Weight gain. Panel B. Weight loss. RR – relative risk, CI – confidence interval.
Figure 5
Figure 5
Potential mechanisms linking inflammation and oestrogen to obesity and liver, colorectal and endometrial cancers. Created in Biorender (https://biorender.com/). ER – oestrogen receptor, FFAs – free fatty acids, NAFLD – non-alcoholic fatty liver disease, ROS – reactive oxygen species.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. World Health Organization. Cancer. 2022. Available: https://www.who.int/news-room/fact-sheets/detail/cancer. Accessed: 2 January 2023.
    1. Chhikara BS, Parang K.Global Cancer Statistics 2022: the trends projection analysis. Chemical Biology Letters. 2023;10:451.
    1. Rawla P, Sunkara T, Muralidharan P, Raj JP.Update in global trends and aetiology of hepatocellular carcinoma. Contemp Oncol (Pozn). 2018;22:141–50. 10.5114/wo.2018.78941 - DOI - PMC - PubMed
    1. Hirsch FR, Scagliotti GV, Mulshine JL, Kwon R, Curran WJ, Wu Y-L, et al. Lung cancer: current therapies and new targeted treatments. Lancet. 2017;389:299–311. 10.1016/S0140-6736(16)30958-8 - DOI - PubMed
    1. Bagnardi V, Blangiardo M, La Vecchia C, Corrao G.Alcohol consumption and the risk of cancer: a meta-analysis. Alcohol Res Health. 2001;25:263–70. - PMC - PubMed