Early body size and subsequent weight again as predictors of breast cancer incidence (Iowa, United States)

We examined whether associations of adult weight gain with the risk of postmenopausal breast cancer vary by stature, waist-hip ratio (WHR), and early adult size in a cohort of 37,105 Iowa (United States) women. Both low body mass index (kg/m²) (BMI) at age 18 and high subsequent weight-gain were associated independently with increased risk of incident postmenopausal breast cancer. After stratifying on BMI at age 18, high weight gain was associated with increased risk irrespective of whether early BMI was low (relative risk [RR]=1.92, 95 percent confidence interval [CI]=1.45–2.53) or high (RR=1.59, Ci=1.19–2.12). Women with lower BMI at 18 were at a higher risk at all levels of weight change, but having low BMI at age 18 and low subsequent weight gain conferred no significantly excess risk over those with high BMI at 18 and low gain. An inconsistent increase in risk was associated with taller stature; there was no additional risk associated with high WHR. Part of the observed risk from lower early size may reflect greater weight gain by lighter women. Limiting adult weight gain thus may be a feasible method to avoid increasing an individual's risk of breast cancer. Reasons for different effects of early cf late weight gain are not established, but benefits of a greater size at age 18 are likely to be offset by increased risks of other weight-related diseases at older ages.