Paper Title
Body Mass Indexis Positively Associated With Overall Cancer Risk Among College Students in the United States: Results From the National College Health Assessment

Abstract
Background: To understand the dose-response relation between body mass index (BMI) and cancer, as well as the associations between overweight/obesity and overall cancer risk in US college students, we conducted the first epidemiologic study to examine these associations using data from the American College Health Association-National College Health Assessment (ACHA-NCHA). Method: The ACHA-NCHA provided self-reported data on demographic information, physical activity, BMI, smoking status, and overall cancer during 2019-2022 (n=275,185; 0.08% cancer cases). A cubic spline model and logistic regression analyses were used to evaluate associations between BMI and cancer risk adjusting for covariates. Result: The cubic spline observed that BMI (kg/m2) was positively associated with the odds of overall cancer risk after adjusting for age, sex, race, ethnicity, education level, physical activity, and smoking status (P for linear relation=0.02 and P for overall association<0.0001); a one kg/m2increase in BMI was associated with a 1% increased overall cancer risk. Multivariable-adjusted logistic regression analyses showed that overweight (30>BMI≥25kg/m2)) [odds ratio (OR): 1.20 (95% confidence interval (CI): 1.08-1.34)], and obesity (BMI≥30kg/m2) [1.48 (1.32-1.65)] were positively associated with cancer risk. Conclusion: BMI, especially overweight/obesity, may be positively associated with overall cancer among college students in the US. To reduce cancer risks, targeted interventions to keep healthy weight among college students are warranted.