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Comparison of associations of body mass index, abdominal adiposity, and risk of colorectal cancer in a large prospective cohort study.
Cancer Epidemiol Biomarkers Prev. 2013 Aug; 22(8):1383-94.CE

Abstract

BACKGROUND

Increased body mass index (BMI) is an established colorectal cancer risk factor. High waist circumference or waist-hip-ratio (WHR) may better reflect an abnormal metabolic state and be more predictive of colorectal cancer risk than BMI.

METHODS

We examined BMI, waist circumference, WHR, and hip circumference in relation to colorectal cancer risk among 203,177 participants followed for 10 years. We derived standardized colorectal cancer risk estimates for each anthropometric parameter and compared predictive characteristics (Harrell's C-index). In women, we examined whether hormone replacement therapy (HRT) use modified the associations between anthropometric measures and colorectal cancer.

RESULTS

We ascertained 2,869 colorectal cancers. In men, increased colon cancer risks were associated with BMI [HR per SD, 1.14; 95% confidence interval (CI), 1.08-1.20], waist circumference (HR per SD, 1.17; 95% CI, 1.08-1.27), and WHR (HR per SD, 1.09; 95% CI, 1.04-1.14). In women, anthropometric variables were unrelated to colon cancer. For men and women, anthropometric variables were unrelated to rectal cancer. Compared with BMI, waist circumference and WHR did not materially influence colon cancer prediction models [C-index changes: -0.0041 and 0.0046 (men); 0.0004 and 0.0005 (women)]. In current HRT users, colon cancer was inversely or suggestively inversely associated with waist circumference (HR per SD, 0.78; 95% CI, 0.63-0.97) and WHR (HR per SD, 0.88; 95% CI, 0.76-1.01), but positively related to hip circumference (HR per SD, 1.39; 95% CI, 1.13-1.71).

CONCLUSION

BMI, waist circumference, and WHR show comparable positive associations with colon cancer in men. Associations between anthropometric measures and colon cancer are weak or null in women, but there is some evidence for effect modification by HRT.

IMPACT

These findings may improve our understanding of the relation of adiposity to colorectal cancer.

Authors+Show Affiliations

Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany. Marlen.Keimling@ukr.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Intramural

Language

eng

PubMed ID

23720402

Citation

Keimling, Marlen, et al. "Comparison of Associations of Body Mass Index, Abdominal Adiposity, and Risk of Colorectal Cancer in a Large Prospective Cohort Study." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 22, no. 8, 2013, pp. 1383-94.
Keimling M, Renehan AG, Behrens G, et al. Comparison of associations of body mass index, abdominal adiposity, and risk of colorectal cancer in a large prospective cohort study. Cancer Epidemiol Biomarkers Prev. 2013;22(8):1383-94.
Keimling, M., Renehan, A. G., Behrens, G., Fischer, B., Hollenbeck, A. R., Cross, A. J., & Leitzmann, M. F. (2013). Comparison of associations of body mass index, abdominal adiposity, and risk of colorectal cancer in a large prospective cohort study. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 22(8), 1383-94. https://doi.org/10.1158/1055-9965.EPI-13-0353
Keimling M, et al. Comparison of Associations of Body Mass Index, Abdominal Adiposity, and Risk of Colorectal Cancer in a Large Prospective Cohort Study. Cancer Epidemiol Biomarkers Prev. 2013;22(8):1383-94. PubMed PMID: 23720402.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of associations of body mass index, abdominal adiposity, and risk of colorectal cancer in a large prospective cohort study. AU - Keimling,Marlen, AU - Renehan,Andrew G, AU - Behrens,Gundula, AU - Fischer,Beate, AU - Hollenbeck,Albert R, AU - Cross,Amanda J, AU - Leitzmann,Michael F, Y1 - 2013/05/29/ PY - 2013/5/31/entrez PY - 2013/5/31/pubmed PY - 2013/11/7/medline SP - 1383 EP - 94 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 22 IS - 8 N2 - BACKGROUND: Increased body mass index (BMI) is an established colorectal cancer risk factor. High waist circumference or waist-hip-ratio (WHR) may better reflect an abnormal metabolic state and be more predictive of colorectal cancer risk than BMI. METHODS: We examined BMI, waist circumference, WHR, and hip circumference in relation to colorectal cancer risk among 203,177 participants followed for 10 years. We derived standardized colorectal cancer risk estimates for each anthropometric parameter and compared predictive characteristics (Harrell's C-index). In women, we examined whether hormone replacement therapy (HRT) use modified the associations between anthropometric measures and colorectal cancer. RESULTS: We ascertained 2,869 colorectal cancers. In men, increased colon cancer risks were associated with BMI [HR per SD, 1.14; 95% confidence interval (CI), 1.08-1.20], waist circumference (HR per SD, 1.17; 95% CI, 1.08-1.27), and WHR (HR per SD, 1.09; 95% CI, 1.04-1.14). In women, anthropometric variables were unrelated to colon cancer. For men and women, anthropometric variables were unrelated to rectal cancer. Compared with BMI, waist circumference and WHR did not materially influence colon cancer prediction models [C-index changes: -0.0041 and 0.0046 (men); 0.0004 and 0.0005 (women)]. In current HRT users, colon cancer was inversely or suggestively inversely associated with waist circumference (HR per SD, 0.78; 95% CI, 0.63-0.97) and WHR (HR per SD, 0.88; 95% CI, 0.76-1.01), but positively related to hip circumference (HR per SD, 1.39; 95% CI, 1.13-1.71). CONCLUSION: BMI, waist circumference, and WHR show comparable positive associations with colon cancer in men. Associations between anthropometric measures and colon cancer are weak or null in women, but there is some evidence for effect modification by HRT. IMPACT: These findings may improve our understanding of the relation of adiposity to colorectal cancer. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/23720402/Comparison_of_associations_of_body_mass_index_abdominal_adiposity_and_risk_of_colorectal_cancer_in_a_large_prospective_cohort_study_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=23720402 DB - PRIME DP - Unbound Medicine ER -