Cancer incidence linked with two or more metabolic risk factors

Background: Obesity, hypertension, diabetes, and hyperlipidemia have been separately implicated as metabolic risk factors (MRF) for cancer. While metabolic syndrome is defined as having three or more MRF, this study evaluated the hypothesis that two or more such factors elevate cancer risk. Methods: Data were derived from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study (NHEFS), a cohort study which followed 14,407 non-institutionalized civilian adults from 1971-75 until 1992. A multi-stage, stratified probability sampling procedure was used for cohort selection. This current study was confined to 8,338 female and 5,703 male participants aged 25-74 years who were cancer-free at baseline. Multivariable logistic regression analysis was used to examine the research hypothesis. Results: An unadjusted odds ratio of 1.59 (95% CI: 1.30-1.95) provided preliminary evidence that participants with two or more MRF had an excess likelihood for developing cancer relative to those with one or none. Hypertension, overweight/obesity, and hyperlipidemia (even at 170 mg/dL), were each associated with excess cancer risk. Controlling for race, age, sex, family income, education, physical activity, smoking, and blood-relatives with a cancer diagnosis, participants with two or more MRF were 26% more likely to develop cancer than the referent (adjusted odds ratio: 1.26; 95% CI: 1.01-1.57). Conclusion: Augmenting the evidence base, this research indicates combinations of metabolic risk factors are cancer determinants. Interventions which control these factors can significantly reduce the burden of healthcare cost and suffering from multiple diseases that include cancer.