Skip to main content
Top
Published in: Digestive Diseases and Sciences 9/2017

01-09-2017 | Original Article

BMI Is a Risk Factor for Colorectal Cancer Mortality

Authors: Aasma Shaukat, Allison Dostal, Jeremiah Menk, Timothy R. Church

Published in: Digestive Diseases and Sciences | Issue 9/2017

Login to get access

Abstract

Background

The relationship between dietary and lifestyle risk factors and long-term mortality from colorectal cancer is poorly understood. Several factors, such as obesity, intakes of red meat, and use of aspirin, have been reported to be associated with risk of colorectal cancer mortality, though these findings have not been replicated in all studies to date.

Methods

In the Minnesota Colon Cancer Control Study, 46,551 participants 50–80 years old were randomly assigned to usual care (control) or annual or biennial screening by fecal occult blood testing. Colon cancer mortality was assessed after 30 years of follow-up. Dietary intake and lifestyle risk factors were assessed by questionnaire at baseline.

Results

Age [hazard ratio (HR) 1.09; 95% CI 1.07, −1.11], male sex (HR 1.25; 95% CI 1.01, 1.57), and higher body mass index (BMI) (HR 1.03; 95% CI 1.00–1.05) increased the risk of CRC mortality, while undergoing screening for CRC was associated with a reduced risk of colorectal cancer mortality (HR 0.76; 95% CI 0.61–0.94 and 0.67; 95% CI 0.53–0.83 for biennial and annual screening, respectively). Intakes of grains, meats, proteins, coffee, alcohol, aspirin, fiber, fruits, and vegetables were not associated with colorectal cancer mortality.

Conclusions

Our study confirms the relationship between BMI and long-term colorectal cancer mortality. Modulation of BMI may reduce risk of CRC mortality.
Literature
1.
2.
go back to reference Tarraga Lopez PJ, Albero JS, Rodriguez-Montes JA. Primary and secondary prevention of colorectal cancer. Clin Med Insights Gastroenterol. 2014;7:33–46.CrossRefPubMedPubMedCentral Tarraga Lopez PJ, Albero JS, Rodriguez-Montes JA. Primary and secondary prevention of colorectal cancer. Clin Med Insights Gastroenterol. 2014;7:33–46.CrossRefPubMedPubMedCentral
3.
go back to reference Parkin E, O’Reilly DA, Sherlock DJ, Manoharan P, Renehan AG. Excess adiposity and survival in patients with colorectal cancer: a systematic review. Obes Rev. 2014;15:434–451.CrossRefPubMed Parkin E, O’Reilly DA, Sherlock DJ, Manoharan P, Renehan AG. Excess adiposity and survival in patients with colorectal cancer: a systematic review. Obes Rev. 2014;15:434–451.CrossRefPubMed
4.
go back to reference McCullough ML, Gapstur SM, Shah R, Jacobs EJ, Campbell PT. Association between red and processed meat intake and mortality among colorectal cancer survivors. J Clin Oncol. 2013;31:2773–2782.CrossRefPubMedPubMedCentral McCullough ML, Gapstur SM, Shah R, Jacobs EJ, Campbell PT. Association between red and processed meat intake and mortality among colorectal cancer survivors. J Clin Oncol. 2013;31:2773–2782.CrossRefPubMedPubMedCentral
5.
go back to reference Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R. Association of coffee drinking with total and cause-specific mortality. N Engl J Med. 2012;366:1891–1904.CrossRefPubMedPubMedCentral Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R. Association of coffee drinking with total and cause-specific mortality. N Engl J Med. 2012;366:1891–1904.CrossRefPubMedPubMedCentral
6.
go back to reference Lopez-Garcia E, van Dam RM, Li TY, Rodriguez-Artalejo F, Hu FB. The relationship of coffee consumption with mortality. Ann Intern Med. 2008;148:904–914.CrossRefPubMedPubMedCentral Lopez-Garcia E, van Dam RM, Li TY, Rodriguez-Artalejo F, Hu FB. The relationship of coffee consumption with mortality. Ann Intern Med. 2008;148:904–914.CrossRefPubMedPubMedCentral
7.
go back to reference Sugiyama K, Kuriyama S, Akhter M, et al. Coffee consumption and mortality due to all causes, cardiovascular disease, and cancer in Japanese women. J Nutr. 2010;140:1007–1013.CrossRefPubMed Sugiyama K, Kuriyama S, Akhter M, et al. Coffee consumption and mortality due to all causes, cardiovascular disease, and cancer in Japanese women. J Nutr. 2010;140:1007–1013.CrossRefPubMed
8.
go back to reference Tamakoshi A, Lin Y, Kawado M, Yagyu K, Kikuchi S, Iso H. Effect of coffee consumption on all-cause and total cancer mortality: findings from the JACC study. Eur J Epidemiol. 2011;26:285–293.CrossRefPubMed Tamakoshi A, Lin Y, Kawado M, Yagyu K, Kikuchi S, Iso H. Effect of coffee consumption on all-cause and total cancer mortality: findings from the JACC study. Eur J Epidemiol. 2011;26:285–293.CrossRefPubMed
9.
go back to reference Cai S, Li Y, Ding Y, Chen K, Jin M. Alcohol drinking and the risk of colorectal cancer death: a meta-analysis. Eur J Cancer Prev. 2014;23:532–539.CrossRefPubMed Cai S, Li Y, Ding Y, Chen K, Jin M. Alcohol drinking and the risk of colorectal cancer death: a meta-analysis. Eur J Cancer Prev. 2014;23:532–539.CrossRefPubMed
10.
go back to reference Breslow RA, Chen CM, Graubard BI, Mukamal KJ. Prospective study of alcohol consumption quantity and frequency and cancer-specific mortality in the US population. Am J Epidemiol. 2011;174:1044–1053.CrossRefPubMedPubMedCentral Breslow RA, Chen CM, Graubard BI, Mukamal KJ. Prospective study of alcohol consumption quantity and frequency and cancer-specific mortality in the US population. Am J Epidemiol. 2011;174:1044–1053.CrossRefPubMedPubMedCentral
11.
go back to reference Gilbertsen V. Colon cancer screening: the Minnesota experience. Gastrointest Endosc. 1980;26:31S–32S.CrossRefPubMed Gilbertsen V. Colon cancer screening: the Minnesota experience. Gastrointest Endosc. 1980;26:31S–32S.CrossRefPubMed
12.
go back to reference Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993;328:1365–1371.CrossRefPubMed Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993;328:1365–1371.CrossRefPubMed
13.
go back to reference Shaukat A, Mongin SJ, Geisser MS, et al. Long-term mortality after screening for colorectal cancer. N Engl J Med. 2013;369:1106–1114.CrossRefPubMed Shaukat A, Mongin SJ, Geisser MS, et al. Long-term mortality after screening for colorectal cancer. N Engl J Med. 2013;369:1106–1114.CrossRefPubMed
14.
go back to reference Kaplan EL, Meier P. Non parametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481.CrossRef Kaplan EL, Meier P. Non parametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481.CrossRef
15.
go back to reference Little RJA, Rubin DB. Statistical Analysis with Missing Data. 2nd ed. London: Wiley; 2002. Little RJA, Rubin DB. Statistical Analysis with Missing Data. 2nd ed. London: Wiley; 2002.
16.
go back to reference Buuren SV, Groothuis-Oudshoorn K. mice: multivariate imputation by chained equations in R. J Stat Softw. 2011;45:1.CrossRef Buuren SV, Groothuis-Oudshoorn K. mice: multivariate imputation by chained equations in R. J Stat Softw. 2011;45:1.CrossRef
17.
go back to reference Horvitz D, Thompson D. A generalization of sampling without replacement from a finite universe. J Am Stat Assoc. 1952;47:663–685.CrossRef Horvitz D, Thompson D. A generalization of sampling without replacement from a finite universe. J Am Stat Assoc. 1952;47:663–685.CrossRef
18.
go back to reference Efron B, Tibshirani R. Cross validation and the bootstrap: estimating the error rate of a prediction rule. Technical report 176, Department of Statistics, Stanford University; 1995. Efron B, Tibshirani R. Cross validation and the bootstrap: estimating the error rate of a prediction rule. Technical report 176, Department of Statistics, Stanford University; 1995.
19.
go back to reference Esposito K, Chiodini P, Capuano A, et al. Colorectal cancer association with metabolic syndrome and its components: a systematic review with meta-analysis. Endocrine. 2013;44:634–647.CrossRefPubMed Esposito K, Chiodini P, Capuano A, et al. Colorectal cancer association with metabolic syndrome and its components: a systematic review with meta-analysis. Endocrine. 2013;44:634–647.CrossRefPubMed
21.
22.
go back to reference Xu XT, Xu Q, Tong JL, et al. Meta-analysis: circulating adiponectin levels and risk of colorectal cancer and adenoma. J Dig Dis. 2011;12:234–244.CrossRefPubMed Xu XT, Xu Q, Tong JL, et al. Meta-analysis: circulating adiponectin levels and risk of colorectal cancer and adenoma. J Dig Dis. 2011;12:234–244.CrossRefPubMed
23.
go back to reference Winzer BM, Whiteman DC, Reeves MM, Paratz JD. Physical activity and cancer prevention: a systematic review of clinical trials. Cancer Causes Control. 2011;22:811–826.CrossRefPubMed Winzer BM, Whiteman DC, Reeves MM, Paratz JD. Physical activity and cancer prevention: a systematic review of clinical trials. Cancer Causes Control. 2011;22:811–826.CrossRefPubMed
24.
go back to reference Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371:569–578.CrossRefPubMed Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371:569–578.CrossRefPubMed
25.
go back to reference Rothwell PM, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW. Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet. 2011;377:31–41.CrossRefPubMed Rothwell PM, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW. Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet. 2011;377:31–41.CrossRefPubMed
26.
go back to reference Li P, Wu H, Zhang H, et al. Aspirin use after diagnosis but not prediagnosis improves established colorectal cancer survival: a meta-analysis. Gut. 2014;64:1419.CrossRefPubMed Li P, Wu H, Zhang H, et al. Aspirin use after diagnosis but not prediagnosis improves established colorectal cancer survival: a meta-analysis. Gut. 2014;64:1419.CrossRefPubMed
27.
go back to reference Cardwell CR, Kunzmann AT, Cantwell MM, et al. Low-dose aspirin use after diagnosis of colorectal cancer does not increase survival: a case-control analysis of a population-based cohort. Gastroenterology. 2014;146:700-8e2.CrossRef Cardwell CR, Kunzmann AT, Cantwell MM, et al. Low-dose aspirin use after diagnosis of colorectal cancer does not increase survival: a case-control analysis of a population-based cohort. Gastroenterology. 2014;146:700-8e2.CrossRef
28.
go back to reference Domingo E, Church DN, Sieber O, et al. Evaluation of PIK3CA mutation as a predictor of benefit from nonsteroidal anti-inflammatory drug therapy in colorectal cancer. J Clin Oncol. 2013;31:4297–4305.CrossRefPubMed Domingo E, Church DN, Sieber O, et al. Evaluation of PIK3CA mutation as a predictor of benefit from nonsteroidal anti-inflammatory drug therapy in colorectal cancer. J Clin Oncol. 2013;31:4297–4305.CrossRefPubMed
29.
30.
go back to reference Hsing AW, McLaughlin JK, Schuman LM, et al. Diet, tobacco use, and fatal prostate cancer: results from the Lutheran Brotherhood Cohort Study. Cancer Res. 1990;50:6836–6840.PubMed Hsing AW, McLaughlin JK, Schuman LM, et al. Diet, tobacco use, and fatal prostate cancer: results from the Lutheran Brotherhood Cohort Study. Cancer Res. 1990;50:6836–6840.PubMed
31.
go back to reference German RR, Fink AK, Heron M, et al. The accuracy of cancer mortality statistics based on death certificates in the United States. Cancer Epidemiol. 2011;35:126–131.CrossRefPubMed German RR, Fink AK, Heron M, et al. The accuracy of cancer mortality statistics based on death certificates in the United States. Cancer Epidemiol. 2011;35:126–131.CrossRefPubMed
32.
go back to reference Zauber AG, Winawer SJ, O’Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366:687–696.CrossRefPubMedPubMedCentral Zauber AG, Winawer SJ, O’Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366:687–696.CrossRefPubMedPubMedCentral
33.
go back to reference Ederer F, Geisser MS, Mongin SJ, Church TR, Mandel JS. Colorectal cancer deaths as determined by expert committee and from death certificate: a comparison. The Minnesota Study. J Clin Epidemiol. 1999;52:447–452.CrossRefPubMed Ederer F, Geisser MS, Mongin SJ, Church TR, Mandel JS. Colorectal cancer deaths as determined by expert committee and from death certificate: a comparison. The Minnesota Study. J Clin Epidemiol. 1999;52:447–452.CrossRefPubMed
Metadata
Title
BMI Is a Risk Factor for Colorectal Cancer Mortality
Authors
Aasma Shaukat
Allison Dostal
Jeremiah Menk
Timothy R. Church
Publication date
01-09-2017
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 9/2017
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4682-z

Other articles of this Issue 9/2017

Digestive Diseases and Sciences 9/2017 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.