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, Tjønneland, 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, Göran, Gonzalez, Carlos Alberto, Dorronsoro, Miren, Barricarte, Aurelio, Navarro, Carmen, Martinez, Carmen, Quirós, J. Ramón, Roddam, Andrew, Allen, Naomi, Bingham, Sheila, Khaw, Kay-Tee, Ferrari, Pietro, Kaaks, Rudolf, Slimani, Nadia and Riboli, Elio (2006) Body size and risk of colon and rectal cancer in the European prospective investigation into cancer and nutrition (EPIC). Journal of the National Cancer Institute, 98 13: 920-931. doi:10.1093/jnci/djj246

Author Pischon, Tobias
Lahmann, Petra H.
Boeing, Heiner
Friedenreich, Christine
Norat, Teresa
Tjønneland, 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, Göran
Gonzalez, Carlos Alberto
Dorronsoro, Miren
Barricarte, Aurelio
Navarro, Carmen
Martinez, Carmen
Quirós, J. Ramón
Roddam, Andrew
Allen, Naomi
Bingham, Sheila
Khaw, Kay-Tee
Ferrari, Pietro
Kaaks, Rudolf
Slimani, Nadia
Riboli, Elio
Title Body size and risk of colon and rectal cancer in the European prospective investigation into cancer and nutrition (EPIC)
Journal name Journal of the National Cancer Institute   Check publisher's open access policy
ISSN 0027-8874
Publication date 2006-06-05
Sub-type Article (original research)
DOI 10.1093/jnci/djj246
Volume 98
Issue 13
Start page 920
End page 931
Total pages 12
Editor Barnett S. Kramer
Place of publication Oxford, U.K.
Publisher Oxford University Press
Collection year 2012
Language eng
Subject 320000 Medical and Health Sciences
Formatted 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; Ptrend = .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; Ptrend = .001; women, RR = 1.48, 95% CI = 1.08 to 2.03; Ptrend = .008), waist-to-hip ratio (WHR; men, RR = 1.51, 95% CI = 1.06 to 2.15; Ptrend = .006; women, RR = 1.52, 95% CI = 1.12 to 2.05; Ptrend = .002), and height (men, RR = 1.40, 95% CI = 0.99 to 1.98; Ptrend = .04; women, RR = 1.79, 95% CI = 1.30 to 2.46; Ptrend<.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.
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: ERA 2012 Admin Only
School of Public Health Publications
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Created: Wed, 02 Jan 2008, 13:40:31 EST by Thelma Whitbourne on behalf of School of Public Health