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

被引:401
作者
Pischon, Tobias
Lahmann, Petra H.
Boeing, Heiner
Friedenreich, Christine
Norat, Teresa
Tjonneland, Anne
Halkjaer, Jytte
Overvad, Kim
Clavel-Chapelon, Francoise
Boutron-Ruault, Marie-Christine
Guernec, Gregory
Bergmann, Manuela M.
Linseisen, Jakob
Becker, Nikolaus
Trichopoulou, Antonia
Trichopoulos, Dimitrios
Sieri, Sabina
Palli, Domenico
Tumino, Rosario
Vineis, Paolo
Panico, Salvatore
Peeters, Petra H. M.
Bueno-de-Mesquita, H. Bas
Boshuizen, Hendriek C.
Van Guelpen, Bethany
Palmqvist, Richard
Berglund, Goeran
Gonzalez, Carlos Alberto
Dorronsoro, Miren
Barricarte, Aurelio
Navarro, Carmen
Martinez, Carmen
Quiros, J. Ramon
Roddam, Andrew
Allen, Naomi
Bingham, Sheila
Khaw, Kay-Tee
Ferrari, Pietro
Kaaks, Rudof
Slimani, Nadia
Riboli, Elio
机构
[1] German Inst Human Nutr, Dept Epidemiol, Potsdam, Germany
[2] Alberta Canc Board, Div Populat Hlth & Informat, Calgary, AB, Canada
[3] Int Agcy Res Canc, F-69372 Lyon, France
[4] Danish Canc Soc, Inst Canc Epidemiol, Copenhagen, Denmark
[5] Aarhus Univ Hosp, Aalborg Hosp, Dept Clin Epidemiol, Aalborg, Denmark
[6] Inst Gustave Roussy, INSERM, U521, F-94805 Villejuif, France
[7] German Canc Res Ctr, Div Clin Epidemiol, D-6900 Heidelberg, Germany
[8] Univ Athens, Sch Med, Dept Hyg & Epidemiol, GR-11527 Athens, Greece
[9] Natl Canc Inst, Epidemiol Unit, I-20133 Milan, Italy
[10] CSPO Sci Inst Tuscany, Mol & Nutr Epidemiol Unit, Florence, Italy
[11] Azienda Osped Civile MP Arezzo, Canc Registry, Ragusa, Italy
[12] Univ London Imperial Coll Sci Technol & Med, London SW7 2AZ, England
[13] Univ Turin, Turin, Italy
[14] Univ Naples, Dipartimento Med Clin & Sperimentale, Naples, Italy
[15] Univ Utrecht, Med Ctr, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
[16] Natl Inst Publ Hlth & Environm, Ctr Nutr & Hlth, NL-3720 BA Bilthoven, Netherlands
[17] Natl Inst Publ Hlth & Environm, Ctr Informat Technol & Informat, NL-3720 BA Bilthoven, Netherlands
[18] Umea Univ, Dept Med Biosci, Umea, Sweden
[19] Lund Univ, Dept Med, Malmo, Sweden
[20] IDIBELL, Catalan Inst Oncol, Dept Epidemiol, Barcelona, Spain
[21] Dept Publ Hlth Guipuzkoa, San Sebastian, Spain
[22] Publ Hlth Inst Navarra, Pamplona, Spain
[23] Murcia Hlth Council, Dept Epidemiol, Murcia, Spain
[24] Escuela Andaluza Salud Publ, Granada, Spain
[25] Publ Hlth & Hlth Planning Directorate, Hlth Informat Unit, Asturias, Spain
[26] Univ Oxford, Canc Res UK Epidemiol Unit, Oxford, England
[27] MRC, Dunn Human Nutr Unit, Cambridge, England
[28] Univ Cambridge, Sch Clin Med, Dept Publ Hlth & Primary Care, Cambridge, England
基金
英国医学研究理事会;
关键词
D O I
10.1093/jnci/djj246
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
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收藏
页码:920 / 931
页数:12
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