Obesity and cancer death in white and black adults: A prospective cohort study

Abstract

Objective: This study aimed to determine whether race modifies the association between obesity and cancer death.

Methods: The Pennington Center Longitudinal Study included 18,296 adults; 35.0% were male and 34.3% were Black. The primary end point was death from cancer.

Results: During a follow-up of 14.3 years, 346 cancer deaths occurred. Among men, race modified the association of BMI and cancer death (pinteraction = 0.045); compared with a BMI of 22 kg/m2 , a BMI of 35 in White men was associated with a hazard ratio of 1.74 (95% CI: 1.38-2.21), and in Black men, the hazard ratio was 0.64 (95% CI: 0.45-0.90). Among women, race did not modify the association of BMI and cancer death (pinteraction =0.43); however, compared with a BMI of 22, a BMI of 35 in White women was associated with a hazard ratio of 1.42 (95% CI: 1.18-1.70) and in Black women, the hazard ratio was 0.99 (95% CI: 0.82-1.20).

Conclusions: In this diverse cohort of adults, having obesity was associated with an increased risk of cancer death in White men and women. In contrast, having obesity was associated with a reduced risk of cancer death in Black men and did not influence risk in Black women.

© 2021 The Obesity Society.

Figures

Figure 1.

Risk of cancer death by anthropometric measure of obesity on the relative hazard scale. Shaded regions indicate 95% confidence bands for the risk of cancer death as a function of body mass index among men (Panel A) and body mass index among women (Panel B); waist circumference among men (Panel C) and waist circumference among women (Panel D); and waist circumference residuals among men (Panel E) and waist circumference residuals among women (Panel F). White participants are depicted in blue color and black participants are depicted in red color. Estimates are multivariable adjusted.