Assessing the Association Between Body Mass Index, Cholesterol, and Cancer Among United States Adults in the Medical Expenditure Panel Survey Using a Cross-Sectional Design

OBJECTIVES: Increased levels of obesity and cholesterol are commonly associated with increased prevalence of various diseases. However, the association between Body Mass Index (BMI), cholesterol, and cancer is not well understood. The purpose of this study was to identify if a relationship exists between cholesterol, obesity and cancer among United States (US) adults.

METHODS: This cross-sectional study collected data from the 2020 Medical Expenditure Panel Survey (MEPS). Eligible participants were US adults (≥18 years) with existing data on BMI, cholesterol, and cancer status, who were alive at the end of the data collection period. The independent variable was constructed as a combination of BMI and cholesterol with eight possible categories, where each individual could be underweight, normal weight, overweight, or obese, with either normal or increased cholesterol. The dependent variable was diagnosis of any cancer or not. A logistic regression model, adjusted for demographic characteristics, assessed associations between BMI/cholesterol and cancer. The a priori alpha value=0.05. The analysis maintained the complex survey data and was weighted to produce nationally representative estimates.

RESULTS: Among 27,805 individuals in the 2020 MEPS data, 20,818 met the eligibility criteria (weighted N=252,340,615). Of these 2,668 (weighted N=29,770,359) had cancer and 18,150 (weighted N=222,570,256) did not have cancer. In the adjusted logistic regression model, underweight and normal weight individuals with high cholesterol were associated with higher odds of cancer (odds ratio, OR=2.002 95% confidence interval, CI=1.032-3.885 and OR=1.326, 95% CI=1.047-1.681, respectively), while obese individuals with normal cholesterol had lower odds of cancer (OR=0.681, 95% CI=0.543-0.853) compared to normal weight individuals with normal cholesterol.

CONCLUSIONS: This study offers insights into the association between BMI, cholesterol, and cancer among US adults, and identifies specific groups of individuals who may be prioritized for cancer prevention interventions and screening. Further research is required to investigate these findings in additional subpopulations.