Intensive Weight Loss Intervention and Cancer Risk in Adults with Type 2 Diabetes: Analysis of the Look AHEAD Randomized Clinical Trial

Hsin Chieh Yeh, John P. Bantle, Maria Cassidy-Begay, George Blackburn, George A. Bray, Tim Byers, Jeanne M. Clark, Mace Coday, Caitlin Egan, Mark A. Espeland, John P. Foreyt, Katelyn Garcia, Valerie Goldman, Edward W. Gregg, Helen P. Hazuda, Louise Hesson, James O. Hill, Edward S. Horton, John M. Jakicic, Robert W. JefferyKaren C. Johnson, Steven E. Kahn, William C. Knowler, Mary Korytkowski, Anne Kure, Cora E. Lewis, Christos Mantzoros, Maria Meacham, Maria G. Montez, David M. Nathan, Nicholas Pajewski, Jennifer Patricio, Anne Peters, F. Xavier Pi-Sunyer, Henry Pownall, Donna H. Ryan, Monika Safford, Rebecca L. Sedjo, Helmut Steinburg, Mara Vitolins, Thomas A. Wadden, Lynne E. Wagenknecht, Rena R. Wing, Antonio C. Wolff, Holly Wyatt, Susan Z. Yanovski

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This study was designed to determine whether intensive lifestyle intervention (ILI) aimed at weight loss lowers cancer incidence and mortality. Methods: Data from the Look AHEAD trial were examined to investigate whether participants randomized to ILI designed for weight loss would have reduced overall cancer incidence, obesity-related cancer incidence, and cancer mortality, as compared with the diabetes support and education (DSE) comparison group. This analysis included 4,859 participants without a cancer diagnosis at baseline except for nonmelanoma skin cancer. Results: After a median follow-up of 11 years, 684 participants (332 in ILI and 352 in DSE) were diagnosed with cancer. The incidence rates of obesity-related cancers were 6.1 and 7.3 per 1,000 person-years in ILI and DSE, respectively, with a hazard ratio (HR) of 0.84 (95% CI: 0.68-1.04). There was no significant difference between the two groups in total cancer incidence (HR, 0.93; 95% CI: 0.80-1.08), incidence of nonobesity-related cancers (HR, 1.02; 95% CI: 0.83-1.27), or total cancer mortality (HR, 0.92; 95% CI: 0.68-1.25). Conclusions: An ILI aimed at weight loss lowered incidence of obesity-related cancers by 16% in adults with overweight or obesity and type 2 diabetes. The study sample size likely lacked power to determine effect sizes of this magnitude and smaller.

Original languageEnglish (US)
Pages (from-to)1678-1686
Number of pages9
JournalObesity
Volume28
Issue number9
DOIs
StatePublished - Sep 1 2020

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics

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