Adiposity and risks of colorectal and small intestine cancer in Chinese adults: a prospective study of 0.5 million people

Abstract

BACKGROUND: Uncertainty remains about the associations of adiposity with intestinal cancer in China and by its anatomical subtype. METHODS: The prospective China Kadoorie Biobank recorded 3024 incident cases of colorectal (CRC) and 143 cases of small intestine (SIC) cancer during a 10-year follow-up among 509 568 participants without prior cancer at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for specific cancers associated with adiposity. RESULTS: Overall mean body mass index (BMI) was 23.7 kg/m 2 . BMI was positively associated with CRC (HR per SD 1.10 [95% CI 1.06-1.14]), colon (1.13 [1.07-1.18]), and rectal (1.07 [1.02-1.13]) cancer. For waist circumference, the corresponding HRs per SD were 1.14 (1.10-1.18), 1.18 (1.13-1.24), and 1.11 (1.05-1.16), respectively. The adjusted HRs were somewhat greater in men than women. Adiposity was positively, but non-significantly, associated with SIC risk. CONCLUSIONS: Among relatively lean Chinese adults, adiposity was associated with risks of colon and rectal cancer, with the associations somewhat stronger in men than women.

Comparison of the clinicopathological features and prognoses of patients with schistosomal and nonschistosomal colorectal cancer

“…In China, colorectal cancer (CRC) is one of the top five leading causes of cancer-associated death in men and women (7). A number of risk factors for CRC in Asia have been identified, including age, sex, family history and a high body fat percentage (8).…”

Features of colorectal cancer in China stratified by anatomic sites: A hospital-based study conducted in university-affiliated hospitals from 2014 to 2018

“…Colon cancer has been found to be positively related to Western dietary habits and body mass index (BMI), as shown in studies that evaluated the complex epigenetic interactions among dietary intake, obesity and malignant colon tumor occurrence ( 40 ), and to be negatively related to physical activity, which is not related to the incidence of rectal cancer ( 13 , 41 ). Such alterations are likely to reflect lifestyle factors and dietary trends, including the enhanced intake of animal protein, especially red meat and/or processed meat, and high-sugar foods, the prevalence of sedentary lifestyles with decreased physical activity, and the consequent outcome of excess body weight ( 42 ). Furthermore, an epidemiological study of CRC in China between 1990 and 2009 showed that the increase in the detection rate of CRC in the proximal colorectum was higher than the increase in the detection rate of CRC located in the distal colon and rectum ( 43 ).…”

Metabolic factors and the risk of small intestine cancers: Pooled study of 800 000 individuals in the metabolic syndrome and cancer project

“…That study, like ours, suggested a positive, albeit nonsignificant, association between BMI and carcinoid tumors only. Other prospective studies have been substantially smaller 13‐18 . The mechanistic pathways that would potentially link obesity to small intestine cancers, specifically among men and for carcinoid tumors, are unclear.…”

“…Other prospective studies have been substantially smaller. [13][14][15][16][17][18] The mechanistic pathways that would potentially link obesity to small intestine cancers, specifically among men and for carcinoid tumors, are unclear.…”