Body size and risk of colon and rectal cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC).

TitleBody size and risk of colon and rectal cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC).
Publication TypeJournal Article
Year of Publication2006
AuthorsPischon, T, Lahmann, PH, Boeing, H, Friedenreich, C, Norat, T, Tjønneland, A, Halkjaer, J, Overvad, K, Clavel-Chapelon, F, Boutron-Ruault, M-C, Guernec, G, Bergmann, MM, Linseisen, J, Becker, N, Trichopoulou, A, Trichopoulos, D, Sieri, S, Palli, D, Tumino, R, Vineis, P, Panico, S, Peeters, PHM, H Bueno-de-Mesquita, B, Boshuizen, HC, Van Guelpen, B, Palmqvist, R, Berglund, G, Gonzalez, CAlberto, Dorronsoro, M, Barricarte, A, Navarro, C, Martinez, C, J Quirós, R, Roddam, A, Allen, N, Bingham, S, Khaw, K-T, Ferrari, P, Kaaks, R, Slimani, N, Riboli, E
JournalJ Natl Cancer Inst
Volume98
Issue13
Pagination920-31
Date Published2006 Jul 05
ISSN1460-2105
KeywordsAbdominal Fat, Adult, Aged, Body Fat Distribution, Body Mass Index, Body Size, Colonic Neoplasms, Confounding Factors (Epidemiology), Estrogen Replacement Therapy, Europe, Feeding Behavior, Female, Follow-Up Studies, Humans, Life Style, Male, Middle Aged, Multivariate Analysis, Obesity, Postmenopause, Proportional Hazards Models, Prospective Studies, Rectal Neoplasms, Risk Assessment, Risk Factors, Sex Distribution, Sex Factors, Waist-Hip Ratio
Abstract

BACKGROUND: Body weight and body mass index (BMI) are positively related to risk of colon cancer in men, whereas weak or no associations exist in women. This discrepancy may be related to differences in fat distribution between sexes or to the use of hormone replacement therapy (HRT) in women.METHODS: We used multivariable adjusted Cox proportional hazards models to examine the association between anthropometric measures and risks of colon and rectal cancer among 368 277 men and women who were free of cancer at baseline from nine countries of the European Prospective Investigation Into Cancer and Nutrition. All statistical tests were two-sided.RESULTS: During 6.1 years of follow-up, we identified 984 and 586 patients with colon and rectal cancer, respectively. Body weight and BMI were statistically significantly associated with colon cancer risk in men (highest versus lowest quintile of BMI, relative risk [RR] = 1.55, 95% confidence interval [CI] = 1.12 to 2.15; P(trend) = .006) but not in women. In contrast, comparisons of the highest to the lowest quintile showed that several anthropometric measures, including waist circumference (men, RR = 1.39, 95% CI = 1.01 to 1.93; P(trend) = .001; women, RR = 1.48, 95% CI = 1.08 to 2.03; P(trend) = .008), waist-to-hip ratio (WHR; men, RR = 1.51, 95% CI = 1.06 to 2.15; P(trend) = .006; women, RR = 1.52, 95% CI = 1.12 to 2.05; P(trend) = .002), and height (men, RR = 1.40, 95% CI = 0.99 to 1.98; P(trend) = .04; women, RR = 1.79, 95% CI = 1.30 to 2.46; P(trend)<.001) were related to colon cancer risk in both sexes. The estimated absolute risk of developing colon cancer within 5 years was 203 and 131 cases per 100,000 men and 129 and 86 cases per 100,000 women in the highest and lowest quintiles of WHR, respectively. Upon further stratification, no association of waist circumference and WHR with risk of colon cancer was observed among postmenopausal women who used HRT. None of the anthropometric measures was statistically significantly related to rectal cancer.CONCLUSIONS: Waist circumference and WHR, indicators of abdominal obesity, were strongly associated with colon cancer risk in men and women in this population. The association of abdominal obesity with colon cancer risk may vary depending on HRT use in postmenopausal women; however, these findings require confirmation in future studies.

DOI10.1093/jnci/djj246
Alternate JournalJ. Natl. Cancer Inst.
Citation Key10.1093/jnci/djj246
PubMed ID16818856
Grant ListG0401527 / / Medical Research Council / United Kingdom