Selected Articles from This Issue

General markers of obesity such as the body mass index are associated with cancer incidence and mortality. However, associations among specific adipose tissue depots and cancer risk are not well understood. Katzmarzyk and colleagues conducted a prospective cohort study in a bi-racial sample of men and women. Total body fat mass and abdominal visceral adipose tissue were positively associated with cancer incidence, while visceral adipose tissue was also associated with cancer mortality. Race and sex interactions were not statistically significant, suggesting similar associations among Black and White men and women. 

Smoking is associated with anal cancer incidence. Umutoni and colleagues sought to determine if smoking was associated with anal HPV prevalence, incidence, and persistence in men without HIV. The authors found that current smokers were more likely to have a higher prevalence, incidence and persistence of anal HPV compared to never smokers. There was no difference in anal HPV natural history between former and never smokers. Smoking may alter the immune response to HPV infection and smoking cessation could be an important step in preventing anal cancer. Prevention initiatives should raise awareness about smoking as a risk factor for anal HPV infection.

In this paper, Rosner and colleagues integrate separate models for incident cancer and prognosis after cancer diagnosis to identify risk factors for lethal cancer among disease-free subjects. It was applied to identify risk factors for lethal breast cancer among 56,346 disease-free women in the Nurses’ Health Study. Some risk factors were associated with incidence (e.g., E&P HT), but not lethal breast cancer. Other risk factors (e.g., current cigarette smoking) were associated with lethal breast cancer, but not incidence. The implications are that cancer prevention should emphasize risk factors associated with lethal cancer, which may include risk factors not traditionally associated with incidence.

Current knowledge on the breast cancer risk conferred by pathogenic germline variants is primarily based on studies of European ancestry women. This study by Ahearn and colleagues provided relative and absolute risk estimates for Ghanaian women. The authors showed that pathogenic variants in BRCA1 and BRCA2 are more frequent in Ghanaian women. While relative risk estimates for these and other high- and moderate-risk breast cancer genes are similar to other populations, absolute risk estimates are lower than in Western populations. The provided absolute risk estimates can help counsel women carrying pathogenic mutations in West African countries with similar breast cancer rates as in Ghana.