Research Papers:

Sociodemographic and economic factors are associated with weight gain between before and after cancer diagnosis: results from the prospective population-based NutriNet-Santé cohort

Philippine Fassier _, Laurent Zelek, Patrick Bachmann, Marina Touillaud, Nathalie Druesne-Pecollo, Valentin Partula, Serge Hercberg, Pilar Galan, Patrice Cohen, Hélène Hoarau, Paule Latino-Martel, Bernard Srour, Rebeca Gonzalez, Mélanie Deschasaux and Mathilde Touvier

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Oncotarget. 2017; 8:54640-54653. https://doi.org/10.18632/oncotarget.17676

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Philippine Fassier1, Laurent Zelek1,2, Patrick Bachmann3, Marina Touillaud3, Nathalie Druesne-Pecollo1, Valentin Partula1, Serge Hercberg1,4, Pilar Galan1, Patrice Cohen5, Hélène Hoarau5, Paule Latino-Martel1, Bernard Srour1, Rebeca Gonzalez1, Mélanie Deschasaux1 and Mathilde Touvier1

1Nutritional Epidemiology Research Team (EREN): Inserm U1153, Inra U1125, Cnam, Paris 5, 7 and 13 Universities, Sorbonne Paris Cité Epidemiology and Statistics Research Center, F-93017, Bobigny, France

2Oncology Department, Avicenne Hospital, F-93017, Bobigny, France

3Cancer, Environment and Nutrition Unit, Léon Bérard Center, F-69000, Lyon, France

4Public Health Department, Avicenne Hospital, F-93017, Bobigny, France

5Sociology Department, University of Rouen, DySola, EA 4701, F-76821, Rouen, France

Correspondence to:

Philippine Fassier, email: [email protected]

Keywords: weight gain, weight loss, cancer diagnosis, breast cancer, socio-demographic factors

Abbreviations: BMI: body mass index; OR: odds ratio; CI: confidence interval

Received: November 25, 2016     Accepted: March 27, 2017     Published: May 08, 2017


Purpose: While many cancer patients are affected by weight loss, others tend to gain weight, which may impact prognosis and risk of recurrence and of second cancer. The aim of this prospective study was to investigate weight variation between before and after cancer diagnosis and socio-demographic, economic, lifestyle and clinical factors associated with moderate-to-severe weight gain.

Methods: 1051 incident cases of first primary cancer were diagnosed in the NutriNet-Santé cohort between 2009 and 2015. Weight was prospectively collected every 6 months since subjects’ inclusion (i.e. an average of 2y before diagnosis). Mean weights before and after cancer diagnosis were compared with paired Student’s t-test. Factors associated with moderate-to-severe weight gain (≥5% of initial weight) were investigated by age and sex-adjusted logistic regression.

Results: Weight loss was observed in men (-3.54±4.39kg in those who lost weight, p=0.0002) and in colorectal cancer patients (-3.94±4.40kg,p=0.001). Weight gain was observed in breast and skin cancers (2.83±3.21kg,p=0.04, and 2.96±2.75kg,p=0.04 respectively). Women (OR=1.75[1.06-2.87],p=0.03), younger patients (2.44[1.51-3.70],p<0.0001), those with lower income (OR=1.30[1.01-1.72],p-trend=0.007), lower education (OR=1.32[1.03-2.70],p-trend=0.03), excess weight before diagnosis (OR=1.64[1.12-2.42],p=0.01), lower physical activity (OR=1.28[1.01-1.64],p=0.04) and those who stopped smoking (OR=4.31[1.99-9.35],p=0.005]) were more likely to gain weight. In breast cancer patients, induced menopause was associated with weight gain (OR=4.12[1.76-9.67]), but no association was detected for tumor characteristics or treatments.

Conclusion: This large prospective cohort provided original results on weight variation between before and after cancer diagnosis, highlighting different weight trajectories. Socio-demographic and economic factors appeared to influence the risk of weight gain, illustrating social inequalities in health.

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