Relative handgrip strength, lifestyles and cancer risk in older adults: a multi-country cohort study

The role of muscle strength in cancer prevention and the impact of modifiable factors on this association remain unclear.

This study investigated the association between relative handgrip strength and cancer risk while also examining the role of lifestyle factors on this association in adults aged 50+.

Prospective cohort study using data from 16 countries across three surveys.

Relative handgrip strength was the dominant-hand maximum grip divided by body mass index (BMI) and sex-standardized. Cancer cases were self-reported physician diagnoses. Cox proportional hazards models assessed the association between relative handgrip strength and cancer risk. Restricted cubic splines assessed potential nonlinear associations, with dose-response curves illustrating the relationship stratified by three lifestyle factors.

Of 29,924 participants, 2614 developed cancer over 8.3 years of follow-up. Each 1-unit increase in relative handgrip strength was associated with a 7% lower cancer risk [HR (95% CI): 0.93 (0.89-0.97)]. Cancer risk declined progressively across strength quartiles, with Quartile 4 showing a 16% lower risk [HR (95% CI): 0.84 (0.74-0.95)] compared to Quartile 1, while Quartile 1 had a 20% higher risk [HR (95% CI): 1.20 (1.06-1.35)] than Quartile 4. Drinkers, smokers and physically inactive individuals consistently exhibited higher cancer risk than their healthier counterparts. A sex-specific tool was developed to estimate relative handgrip strength from BMI and absolute grip strength.

Higher relative handgrip strength was linearly associated with a lower cancer risk, with a stronger protective effect in individuals with healthy lifestyles.