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Body size and risk of colon and rectal cancer in the European prospective investigation into cancer and nutrition (EPIC)

Pischon, Tobias ; Lahmann, Petra H. ; Boeing, Heiner ; Friedenreich, Christine ; Norat, Teresa ; Tjonneland, Anne ; Halkjaer, Jytte ; Overvad, Kim ; Clavel-Chapelon, Francoise and Boutron-Ruault, Marie-Christine , et al. (2006) In Journal of the National Cancer Institute 98(13). p.920-931
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... (More)
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 100000 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. (Less)
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Journal of the National Cancer Institute
volume
98
issue
13
pages
920 - 931
publisher
Oxford University Press
external identifiers
  • pmid:16818856
  • wos:000238817800010
  • scopus:33745774113
ISSN
1460-2105
DOI
10.1093/jnci/djj246
language
English
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yes
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b2298af9-a5ef-460d-8a97-dcd5913055f7 (old id 403995)
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2016-04-01 15:28:56
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@article{b2298af9-a5ef-460d-8a97-dcd5913055f7,
  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 &lt;.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 100000 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.},
  author       = {Pischon, Tobias and Lahmann, Petra H. and Boeing, Heiner and Friedenreich, Christine and Norat, Teresa and Tjonneland, Anne and Halkjaer, Jytte and Overvad, Kim and Clavel-Chapelon, Francoise and Boutron-Ruault, Marie-Christine and Guernec, Gregory and Bergmann, Manuela M. and Linseisen, Jakob and Becker, Nikolaus and Trichopoulou, Antonia and Trichopoulos, Dimitrios and Sieri, Sabina and Palli, Domenico and Tumino, Rosario and Vineis, Paolo and Panico, Salvatore and Peeters, Petra H. M. and Bueno-de-Mesquita, H. Bas and Boshuizen, Hendriek C. and Van Guelpen, Bethany and Palmqvist, Richard and Berglund, Göran and Gonzalez, Carlos Alberto and Dorronsoro, Miren and Barricarte, Aurelio and Navarro, Carmen and Martinez, Carmen and Quiros, J. Ramon and Roddam, Andrew and Allen, Naomi and Bingham, Sheila and Khaw, Kay-Tee and Ferrari, Pietro and Kaaks, Rudof and Slimani, Nadia and Riboli, Elio},
  issn         = {1460-2105},
  language     = {eng},
  number       = {13},
  pages        = {920--931},
  publisher    = {Oxford University Press},
  series       = {Journal of the National Cancer Institute},
  title        = {Body size and risk of colon and rectal cancer in the European prospective investigation into cancer and nutrition (EPIC)},
  url          = {http://dx.doi.org/10.1093/jnci/djj246},
  doi          = {10.1093/jnci/djj246},
  volume       = {98},
  year         = {2006},
}