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

Abstract

Background: Epidemiological studies have shown inconsistent results for the association between body size and colorectal cancer (CRC) risk. Inconsistencies may be because of the reliance on self-reported measures of body size. Objective: We examined the association of self-reported and directly assessed anthropometric data (body height, weight, body mass index (BMI), waist, hip, waist-to-hip ratio (WHR) and chest circumference) with CRC risk in the EPIC-Norfolk study. Design: A total of 20 608 participants with complete self-reported and measured height and weight and without any history of cancer were followed up an average of 11 years, during which 357 incident CRC cases were recorded. Hazard Ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. Results: After adjustment for confounders, HRs among women in the highest quintile of the body size measure relative to the lowest quintile showed that measured height (HR ¼ 1.98, 95% CI ¼ 1.19-3.28, P trend ¼ 0.009), measured waist circumference (HR ¼ 1.65, 95% CI ¼ 0.97-2.86, P trend ¼ 0.009) and measured WHR (HR ¼ 2.07, 95% CI ¼ 1.17-3.67, P trend ¼ 0.001) were associated with increased CRC risk. Associations using corresponding self-reported measures were attenuated and not statistically significant. Conversely, the association of BMI with CRC risk in women was weaker using measured BMI (HR ¼ 1.57, 95% CI ¼ 0.91-2.73, P trend ¼ 0.05) compared with self-reported BMI (HR ¼ 1.97, 95% CI ¼ 1.18-3.30, P trend ¼ 0.02). In men no significantly increased CRC risk was observed with any of the anthropometric measures. Conclusions: Measured height, waist circumference and WHR were associated with CRC risk in women, whereas any significant associations with those measures were attenuated when self-reported data were used.

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

“…Some previous studies reported that WHR might be an independent risk factor for cancer, but most of these studies used a case-control design, anthropometric measures were not taken directly but were self-reported or did not adjust for BMI in their analyses. (16-18) We found that all observed WHR-cancer associations disappeared after adjusting for BMI, which suggests that general obesity, probably through excessive endogenous sex hormone production in adipose tissue, might play a more important role in the etiology of cancer than central adiposity, which is more closely related to insulin resistance than general obesity. (4) We found similar cancer risk associations for waist circumference and BMI, which strengthen the hypothesis that waist circumference, similar to BMI, is more strongly correlated with total body fat than visceral fat, especially among elderly individuals.…”

“…(15) However, previous reports of central obesity and cancer risks have not been consistent,(16-18) and the literature lacks studies from Asian populations. Additionally, it has been shown that there are population differences in body fat distribution in comparisons between Asians and other ethnic and racial groups.…”

A longitudinal study of the metabolic syndrome and risk of colorectal cancer in postmenopausal women

“…Increased central adiposity (as measured by waist circumference and/or waist-hip-ratio) has been associated with increased risk of colorectal cancer in most cohort studies and meta-analyses (Larsson & Wolk, 2007; Moghaddam et al , 2007; Ning et al , 2010; Oxentenko et al , 2010; Park et al , 2011; Schoen et al , 1999; Wang et al , 2008). Findings regarding dyslipidemia, including total cholesterol (Jarvinen et al , 2001; Schatzkin et al , 1988; Tornberg et al , 1986) and triglycerides (Tsushima et al , 2005; van Duijnhoven et al , 2011) have been inconsistent or null.…”

Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors

“…Self-reported height and weight have repeatedly been shown to be valid for identifying relationships in epidemiologic studies, as self-reported and measured weights show strong correlation. [25–26] Previous studies have also demonstrated that recalled weight at 18 years of age and self-reported height are highly valid,[27] including Troy et al (1995) in which women aged 25–42 in the Nurses’ Health Study II were examined. [28]…”