Prospective weight change and colon cancer risk in male US health professionals

Abstract

Epidemiological studies are remarkably consistent, especially among men, in showing that overweight and obesity [body mass index (BMI) >25] are associated with increased risk of colon cancer. However, no prospective studies address the influence of weight change in adulthood on subsequent colon cancer risk. In this study, we investigated whether weight change influences colon cancer risk utilizing prospectively collected weight data. We included 46,349 men aged 40–75 participating in the Health Professionals Follow-Up Study. Questionnaires including items on weight were completed every second year during follow-up from 1986 to 2004. Updated weight change between consecutive questionnaires during follow-up and recalled weight gain since age 21 was evaluated. All eligible men were cancer-free at baseline. Proportional hazard and restricted spline regression models were implemented. Over an 18-year period, we documented 765 cases of colon cancer. Cumulative mean BMI >22.5 was associated with significantly increased risk of colon cancer. The short-term weight change in the prior 2 to 4 years was positively and significantly associated with risk [HR = 1.14 (95% confidence interval, 1.00–1.29) for 4.54 kg (10 pounds) increment, p = 0.04 for overall trend]. Weight gain per 10 years since age 21 was associated with significantly increased risk [HR = 1.33 (1.12–1.58) for 4.54 kg increase per 10 years, p = 0.001]. We estimated that 29.5% of all colon cancer cases was attributable to BMI above 22.5. Our results add support that overweight and obesity are modifiable risk factors for colon cancer among men and suggest that weight has an important influence on colon cancer risk even in later life.

Body Size, Weight Change, and Risk of Colon Cancer

“…Our findings for men are comparable with those from other prospective cohort (6,18) and case-control studies (13,19,20,25) that examined weight gain since early adulthood. The Health Professionals Study reported weight gain to be positively associated with colon cancer risk; men gaining >7.5 kg per 10 years have a HR of 1.41 (18).…”

“…Our findings for men are comparable with those from other prospective cohort (6,18) and case-control studies (13,19,20,25) that examined weight gain since early adulthood. The Health Professionals Study reported weight gain to be positively associated with colon cancer risk; men gaining >7.5 kg per 10 years have a HR of 1.41 (18). One case-control study (13) reported a relative risk of 1.77 for men who gained >20 kg since age 20 years, whereas a pooled analysis of several case-control studies (including the aforementioned study) gave a relative risk of 1.5 for weight gain of >20 kg since age 20 (20).…”

“…Positive associations between adult weight gain and colon cancer risk have been reported by some prospective cohort studies (6,18) and case-control studies (13,19,20) for men but only weak or null associations for women (13,(19)(20)(21)(22). One study reported that this relationship was stronger for older men (6).…”

Self-reported and measured anthropometric data and risk of colorectal cancer in the EPIC–Norfolk study

“…3 Many studies have shown that general obesity as measured by BMI is positively associated with colon or colorectal cancer in men, [4][5][6][7][8][9][10][11] whereas weaker or no associations have been found in women. 4,6,8,[12][13][14] Findings for rectal cancer risk in association with height, weight or BMI have been inconsistent and nonsignificant.…”

Is obesity an advantage in patients with colorectal cancer?

“…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].…”