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Associations of weight change in middle adulthood with cancer risk, however, are less clear. We examined the association of change in weight and body mass index (BMI) category during middle adulthood with 42 cancers, using multivariable Cox proportional hazards models in the European Prospective Investigation into Cancer and Nutrition cohort. Of 241\u2009323 participants (31% men), 20% lost and 32% gained weight (&gt;0.4 to 5.0 kg\/year) during 6.9\u2009years (average). During 8.0\u2009years of follow\u2010up after the second weight assessment, 20\u2009960 incident cancers were ascertained. Independent of baseline BMI, weight gain (per one kg\/year increment) was positively associated with cancer of the corpus uteri (hazard ratio [HR] = 1.14; 95% confidence interval: 1.05\u20101.23). Compared to stable weight (\u00b10.4 kg\/year), weight gain (&gt;0.4 to 5.0 kg\/year) was positively associated with cancers of the gallbladder and bile ducts (HR = 1.41; 1.01\u20101.96), postmenopausal breast (HR = 1.08; 1.00\u20101.16) and thyroid (HR = 1.40; 1.04\u20101.90). Compared to maintaining normal weight, maintaining overweight or obese BMI (World Health Organisation categories) was positively associated with most obesity\u2010related cancers. Compared to maintaining the baseline BMI category, weight gain to a higher BMI category was positively associated with cancers of the postmenopausal breast (HR = 1.19; 1.06\u20101.33), ovary (HR = 1.40; 1.04\u20101.91), corpus uteri (HR = 1.42; 1.06\u20101.91), kidney (HR = 1.80; 1.20\u20102.68) and pancreas in men (HR = 1.81; 1.11\u20102.95). Losing weight to a lower BMI category, however, was inversely associated with cancers of the corpus uteri (HR = 0.40; 0.23\u20100.69) and colon (HR = 0.69; 0.52\u20100.92). Our findings support avoiding weight gain and encouraging weight loss in middle adulthood.<\/jats:p>","DOI":"10.1002\/ijc.33339","type":"journal-article","created":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T19:41:01Z","timestamp":1602358861000},"page":"1637-1651","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Weight change in middle adulthood and risk of cancer in the European Prospective Investigation into Cancer and Nutrition (<scp>EPIC<\/scp>) cohort"],"prefix":"10.1002","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9219-4436","authenticated-orcid":false,"given":"Sofia","family":"Christakoudi","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Imperial College London  London UK"},{"name":"MRC Centre for Transplantation King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Pagoni","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Epidemiology University of Ioannina School of Medicine  Ioannina Greece"},{"name":"MRC Integrative Epidemiology Unit University of Bristol  Bristol UK"},{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9358-7338","authenticated-orcid":false,"given":"Pietro","family":"Ferrari","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer World Health Organization  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Cross","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Tzoulaki","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Imperial College London  London UK"},{"name":"Department of Hygiene and Epidemiology University of Ioannina School of Medicine  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Muller","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabete","family":"Weiderpass","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer World Health Organization  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Freisling","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer World Health Organization  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3347-8249","authenticated-orcid":false,"given":"Neil","family":"Murphy","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer World Health Organization  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"Dossus","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer World Health Organization  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee","family":"Turzanski Fortner","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology German Cancer Research Center (DKFZ)  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Agudo","sequence":"additional","affiliation":[{"name":"Unit of Nutrition and Cancer. Cancer Epidemiology Research Program Catalan Institute of Oncology\u2010IDIBELL. L'Hospitalet de Llobregat  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Overvad","sequence":"additional","affiliation":[{"name":"Department of Public Health Aarhus University  Aarhus Denmark"},{"name":"Department of Cardiology Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Perez\u2010Cornago","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Key","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Brennan","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer World Health Organization  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Johansson","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer World Health Organization  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Tj\u00f8nneland","sequence":"additional","affiliation":[{"name":"Danish Cancer Society Research Center  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jytte","family":"Halkj\u00e6r","sequence":"additional","affiliation":[{"name":"Danish Cancer Society Research Center  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5956-5693","authenticated-orcid":false,"given":"Marie\u2010Christine","family":"Boutron\u2010Ruault","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris\u2010Saclay, UVSQ, Univ. Paris\u2010Sud, Inserm, \u00c9quipe \"Exposome, H\u00e9r\u00e9dit\u00e9, Cancer et Sant\u00e9\", CESP, Gustave Roussy  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Artaud","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris\u2010Saclay, UVSQ, Univ. Paris\u2010Sud, Inserm, \u00c9quipe \"Exposome, H\u00e9r\u00e9dit\u00e9, Cancer et Sant\u00e9\", CESP, Gustave Roussy  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7157-419X","authenticated-orcid":false,"given":"Gianluca","family":"Severi","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris\u2010Saclay, UVSQ, Univ. Paris\u2010Sud, Inserm, \u00c9quipe \"Exposome, H\u00e9r\u00e9dit\u00e9, Cancer et Sant\u00e9\", CESP, Gustave Roussy  Villejuif France"},{"name":"Department of Statistics, Computer Science, and Applications \"G. 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