October 31, 2016
2 min read

BMI, waist circumference, type 2 diabetes associated with risk for liver cancer

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High BMI, greater waist circumference and type 2 diabetes appeared to increase risk for liver cancer, according to an analysis of data from the Liver Cancer Pooling Project published in Cancer Research.

“We found that each of these three factors was associated, robustly, with liver cancer risk,” Peter Campbell, PhD, strategic director of digestive system cancer research at American Cancer Society, said in a press release. “All three relate to metabolic dysfunction. This adds substantial support to liver cancer being on the list of obesity-associated cancers.”

Peter Campbell

Liver cancer rates have tripled over the past several decades. Because obesity rates also are on the rise, Campbell and colleagues evaluated whether obesity — measured by BMI, waist circumference and type 2 diabetes — was associated with liver cancer risk.

Researchers used the Liver Cancer Pooling Project to evaluate data from 1.57 million American adults (mean age, 58.2 years; mean BMI, 26.6 kg/m2; mean waist circumference, 89.8 cm) without cancer enrolled in 14 prospective studies conducted in the United States.

Participants provided their height, weight, alcohol intake, tobacco use and other factors potentially related to cancer risk.

Overall, 2,162 participants developed liver cancer during 19 million person-years of follow-up.

Researchers found that for every 5-kg/m2 increase in BMI there was a 38% increase in the risk for liver cancer among men (HR = 1.38; 95% CI, 1.3-1.46), and a 25% increase among women (HR = 1.25; 95% CI, 1.17-1.35).

Participants classified as overweight had a 21% greater risk for liver cancer compared with participants with normal BMI. That risk increased to 87% for participants classified as having class 1 obesity, 142% for class II obesity and 116% for class III obesity.

For every 5-cm increase in waist circumference, there was an 8% increased liver cancer risk in both men and women (HR = 1.08; 95% CI, 1.04-1.13).

When adjusted for alcohol intake, tobacco use and race, participants with type 2 diabetes were found to be 2.61 times more likely to be diagnosed with liver cancer (HR = 2.61; 95% CI, 2.34-2.91).

“This is yet another reason to maintain a body weight in the ‘normal’ range for your height,” Campbell said. “Liver cancer isn’t simply related to excess alcohol intake and viral hepatitis infection.”

Researchers acknowledged study limitations, most notably the reliance of self-reported BMI and diabetes and self-measured waist circumference. Cross-sectional data show that self-reported BMIs and waist circumferences are typically slightly lower than those directly measured. – by Chuck Gormley

Disclosure: The study was supported by the National Cancer Institute and the American Cancer Society. Campbell reports no relevant financial disclosures. One researcher reports speakers bureau honoraria from Janssen-Cilag.