Body Fatness, Physical Activity and the Risk of Cervical Cancer: Results From the Epic Cohort

Body Fatness, Physical Activity and the Risk of Cervical Cancer: Results From the Epic Cohort | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Body Fatness, Physical Activity and the Risk of Cervical Cancer: Results From the Epic Cohort Esther Roura, Jon Aritz Panera, Catalina Bonet, Noemie Travier, and 26 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9404575/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background: Obesity is a recognized risk factor for several types of cancer, while being physically active is known to reduce cancer risk. However, evidence for both remains inconclusive for cervical cancer. We evaluated the associations between body fatness and physical activity and the risk of invasive cervical cancer (ICC) within the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. Methods: This analysis included 293,523 women who completed lifestyle questionnaires and provided serum samples at baseline. The anthropometric indicators assessed were Body Mass Index (BMI), “a body shape index” (ABSI), waist circumference and waist-to-hip ratio. Physical activity was evaluated using a combined index of total physical activity (occupational, household and recreational activities), an index of physical activity determined in a Cambridge validation study (occupational and recreational activities excluding walking), and a specific recreational activity variable (walking, cycling, sports). Over a median follow-up of 15 years, 369 incident ICC cases were reported. In a nested case-control study, serum from 171 cases and 342 matched controls were tested for L1 antibodies against Human Papillomavirus (HPV) types 11, 16, 18, 31, 33, 35, 45, 52, 58, Chlamydia trachomatis and Human herpesvirus 2. Multivariable Cox and conditional regression models adjusted for potential confounders were performed. Results: Women with BMI over 30 kg/m2 had a nonsignificant increased risk of ICC (Hazard Ratio (HR)=1.19, 95%CI: 0.87-1.65) compared to women with BMI between 18.5-24.9 kg/m2. Women engaging occupational, household and recreational activities had a reduced risk of ICC (HR=0.74, 95%CI: 0.55-0.99) compared to being inactive. Sensitivity analysis incorporating HPV serology yielded similar results. Conclusions: These findings support the potential protective effect of physical activity against ICC, though the evidence for anthropometric measures remains inconclusive. Article category : Research article – Cancer Epidemiology cervical cancer body fatness physical activity risk factors prevention Full Text Additional Declarations No competing interests reported. Supplementary Files EPICCXBMIPADraft202604supplementarymaterial.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 17 May, 2026 Reviewers agreed at journal 04 May, 2026 Reviews received at journal 02 May, 2026 Reviewers agreed at journal 02 May, 2026 Reviewers agreed at journal 30 Apr, 2026 Reviewers invited by journal 30 Apr, 2026 Editor assigned by journal 30 Apr, 2026 Editor invited by journal 22 Apr, 2026 Submission checks completed at journal 22 Apr, 2026 First submitted to journal 22 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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However, evidence for both remains inconclusive for cervical cancer. We evaluated the associations between body fatness and physical activity and the risk of invasive cervical cancer (ICC) within the European Prospective Investigation into Cancer and Nutrition (EPIC) Study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: This analysis included 293,523 women who completed lifestyle questionnaires and provided serum samples at baseline. The anthropometric indicators assessed were Body Mass Index (BMI), “a body shape index” (ABSI), waist circumference and waist-to-hip ratio. Physical activity was evaluated using a combined index of total physical activity (occupational, household and recreational activities), an index of physical activity determined in a Cambridge validation study (occupational and recreational activities excluding walking), and a specific recreational activity variable (walking, cycling, sports). Over a median follow-up of 15 years, 369 incident ICC cases were reported. In a nested case-control study, serum from 171 cases and 342 matched controls were tested for L1 antibodies against Human Papillomavirus (HPV) types 11, 16, 18, 31, 33, 35, 45, 52, 58, Chlamydia trachomatis and Human herpesvirus 2. Multivariable Cox and conditional regression models adjusted for potential confounders were performed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: Women with BMI over 30 kg/m2 had a nonsignificant increased risk of ICC (Hazard Ratio (HR)=1.19, 95%CI: 0.87-1.65) compared to women with BMI between 18.5-24.9 kg/m2. Women engaging occupational, household and recreational activities had a reduced risk of ICC (HR=0.74, 95%CI: 0.55-0.99) compared to being inactive. Sensitivity analysis incorporating HPV serology yielded similar results.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusions: These findings support the potential protective effect of physical activity against ICC, though the evidence for anthropometric measures remains inconclusive.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eArticle category\u003c/strong\u003e: Research article – Cancer Epidemiology\u003c/p\u003e","manuscriptTitle":"Body Fatness, Physical Activity and the Risk of Cervical Cancer: Results From the Epic Cohort","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-08 22:12:10","doi":"10.21203/rs.3.rs-9404575/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-17T07:03:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"154444357476741962083180804238782566822","date":"2026-05-04T07:15:54+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-02T12:21:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"326053895314101178987881739862743715165","date":"2026-05-02T08:18:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"328405385085966153053280012999387176425","date":"2026-05-01T03:10:19+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-30T20:45:22+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-30T20:37:52+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-22T18:21:47+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-22T09:36:03+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cancer","date":"2026-04-22T09:03:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcan","sideBox":"Learn more about [BMC Cancer](http://bmccancer.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcan/default.aspx","title":"BMC Cancer","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b12a8dc4-a28c-482c-83be-441dc56e2ba7","owner":[],"postedDate":"May 8th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-17T07:03:16+00:00","index":43,"fulltext":""},{"type":"reviewerAgreed","content":"154444357476741962083180804238782566822","date":"2026-05-04T07:15:54+00:00","index":40,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-02T12:21:52+00:00","index":39,"fulltext":""},{"type":"reviewerAgreed","content":"326053895314101178987881739862743715165","date":"2026-05-02T08:18:23+00:00","index":38,"fulltext":""},{"type":"reviewerAgreed","content":"328405385085966153053280012999387176425","date":"2026-05-01T03:10:19+00:00","index":35,"fulltext":""},{"type":"reviewersInvited","content":"8","date":"2026-04-30T20:45:22+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-30T20:37:52+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-08T22:12:10+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-08 22:12:10","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9404575","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9404575","identity":"rs-9404575","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}