Body weight, fat distribution and colorectal cancer risk: a report from cohort studies of 134 255 Chinese men and women

Abstract

OBJECTIVETo evaluate the association of body size and fat distribution with risk of colorectal cancer (CRC) in Chinese men and women.DESIGNPopulation-based, prospective cohort study.SUBJECTSThe analysis included 134 255 Chinese adults enrolled in the Shanghai Women’s Health Study and the Shanghai Men’s Health Study, with an average follow-up of 11.0 and 5.5 years, respectively.MEASUREMENTSWaist circumference (WC), body mass index (BMI) and waist-to-hip ratio (WHR) were measured by trained interviewers at baseline. Multivariable Cox models were used to calculate adjusted hazard ratios (HRs) for incident CRC.RESULTSA total of 935 incident CRC cases were identified. Both measures of general adiposity (measured by BMI) and central adiposity (measured by WHR and WC) were significantly associated with increased risk of colon cancer in men but not in women. Multivariable adjusted HRs for colon cancer in men in the highest compared with the lowest quintiles were 2.15 (95% CI: 1.35-3.43; P for trend = 0.0006) for BMI, 1.97 (95% CI: 1.19-3.24; P for trend = 0.0004) for WHR and 2.00 (95% CI: 1.21-3.29; P for trend = 0.0002) for WC. The BMI-associated risk was attenuated in analyses stratified by WHR, while the WHR-associated risk remained significant in the high BMI stratum (HR for comparison of extreme tertiles of WHR: 3.38, 95% CI: 1.47-7.75; P for trend =0.0002). None of these anthropometric measures were significantly associated with rectal cancer.CONCLUSIONObesity, particularly central obesity, was associated with increased risk of colon cancer in men.

Is obesity an advantage in patients with colorectal cancer?

“…Similar results were reported by Larsson et al with a 5-unit increase in BMI leading to an increased risk of carcinogenesis [2]. These associations seem to be stronger for men [1][2][3]. The 'Health Professionals Follow-Up Study' that included 46,349 men over a prospective 28-year period, the 'Melbourne Collaborative Cohort Study' with 16,188 men and 23,438 women with almost a 14-year follow-up, and the 'Norwegian population-based Study' of 8,822 men and 37,357 women corroborated these findings [4][5][6].…”

Plasma Adiponectin and Soluble Leptin Receptor and Risk of Colorectal Cancer: A Prospective Study

“…With regard to obesity and female rectal cancer, a recent meta-analysis found that abdominal adiposity assessed by waist circumference was significantly associated with increased risk of rectal cancer in women, with the magnitude even larger than in men (52). However, this result failed to replicate in either of the two subsequent large studies in the U.S. and Chinese women (53, 54). Thus, further studies on sex-specific rectal cancer risk associated with obesity are warranted.…”

Prospective cohort study of general and central obesity, weight change trajectory and risk of major cancers among Chinese women

“…Therefore, the association of colorectal cancer risk with BMI is complex and heterogeneous between genders, and null findings for associations of colorectal cancer risk with BMI for Asian females have been reported previously. 3,5,6,32,33 Further studies are warranted to determine whether the observed null associations are truly absent in our study population or veiled due to limited statistical power.…”