Abstract 5934: Weight loss and subsequent cancer diagnosis: A prospective cohort study
Authors: Wang Qiao-Li , Babic Ana , Rosenthal Michael H. , Lee Alice A. , Zhang Yin , Zhang Xuehong , Song Mingyang , Rezende Leandro F. , Lee Dong Hoon , Biller Leah , Ng Kimmie , Chan Andrew T. , Stampfer Meir J. , Giovannucci Edward L. , Kraft Peter , Yuan Chen , Wolpin Brian M. 
Published: June 2022

Background: Weight loss is a common symptom in patients with cancer. However, little is known about how much weight loss and over what time period weight loss precedes cancer diagnosis. Herein, we evaluate the association between weight loss and subsequent 2-year cancer diagnosis using repeatedly measured weight data in two large prospective cohorts.

Methods: The analysis included 111,891 US women from the Nurses’ Health Study and 45,498 US men from the Health Professional Follow-up Study, who were enrolled in 1978 and 1988, respectively, and followed through 2012, and who were cancer-free and ≥40 years old at study entry. Current weight and lifestyle information were assessed every 2 years by questionnaire, and weight change in the previous 2 years was calculated by comparing two consecutive questionnaires. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for subsequent risk of cancer diagnosis according to weight change percentage. We also examined 20-year trajectories of body mass index (BMI) before cancer diagnosis.

Results: During 4.1 million person-years of follow-up, we documented 30,441 incident cancers. Participants with recent weight loss were at increased risk for cancer diagnosis in the subsequent 2 years (Ptrend &lt;0.0001). Compared with participants without weight loss, those who had a weight loss of 5-10% or &gt;10% had a multivariable-adjusted HR for total cancer of 1.09 (95% CI, 1.04-1.13) and 1.17 (95% CI, 1.10-1.24), respectively. For individual cancer types, increased weight loss was associated with a subsequent cancer diagnosis of esophagus, liver, pancreas, leukemia, stomach, myeloma, lung, colorectal, and non-Hodgkin lymphoma (all Ptrend &lt;0.005). Comparing participants with weight loss of &gt;10% to those without weight loss, multivariable-adjusted HRs were 4.22 (95% CI, 2.50-7.13) for esophageal cancer, 3.30 (95% CI, 1.65-6.61) for liver cancer, 2.46 (95% CI, 1.84-3.30) for pancreatic cancer, 2.40 (95% CI, 1.59-3.61) for leukemia, 2.26 (95% CI, 1.32-3.87) for stomach cancer, 1.80 (95% CI, 1.14-2.83) for myeloma, 1.45 (95% CI, 1.22-1.73) for lung cancer, 1.38 (95% CI, 1.14-1.66) for colorectal cancer, and 1.35 (95% CI, 1.06-1.72) for non-Hodgkin lymphoma. The 20-year trajectory of BMI indicated that most weight loss occurred in the 2 years before cancer diagnosis, with the magnitude of weight loss increasing closer to the time of subsequent cancer diagnosis.

Conclusion: Recent weight loss of &gt;10% predicts elevated risk of cancer diagnosis in the forthcoming 2 years, particularly for cancers of the upper gastrointestinal tract, hematological system, colorectum, and lung.

Citation Format: Qiao-Li Wang, Ana Babic, Michael H. Rosenthal, Alice A. Lee, Yin Zhang, Xuehong Zhang, Mingyang Song, Leandro F. Rezende, Dong Hoon Lee, Leah Biller, Kimmie Ng, Andrew T. Chan, Meir J. Stampfer, Edward L. Giovannucci, Peter Kraft, Chen Yuan, Brian M. Wolpin. Weight loss and subsequent cancer diagnosis: A prospective cohort study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5934.