Association Among Obesity, Metabolic Health, and the Risk for Colorectal Cancer in the General Population in Korea Using the National Health Insurance Service–National Sample Cohort

Shin, Cheol Min; Han, Kyungdo; Lee, Dong Hoon; Choi, Yoon Jin; Kim, Nayoung; Park, Young Soo; Yoon, Hyuk

doi:10.1097/dcr.0000000000000876

Cited by 49 publications

(45 citation statements)

References 38 publications

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“…Obesity is also a risk factor for colorectal cancer [26,27]. Shin et al [28] reported that high BMI is a risk factor for colorectal cancer in men, and low BMI is a protective factor in women.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Colorectal Cancer in Korea: A Population-Based Retrospective Cohort Study

et al. 2019

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The incidence of colorectal cancer in Korea has recently increased, making it the second most common cancer in men and the third most common cancer in women. Risk factors for colorectal cancer have been studied worldwide, but risk factors specific for the Korean population have not been established. In this study, we investigated incidence trends and risk factors of colorectal cancer in Korea. Methods: A total of 8,846,749 subjects were included. Colorectal cancer incidence was investigated using Korea National Health Insurance Service claim data from 2004 to 2014. Colorectal cancer diagnoses were obtained by evaluating colorectal cancer diagnostic codes and the cancer registry for cost sharing. Risk factor identification for colorectal cancer was obtained from National Health Examination data from 2004 to 2005. Cox proportional hazard model statistical analysis was used to determine risk factors of colorectal cancer. Results: The incidence of colorectal cancer gradually increased from 2006 to 2014 (from 45.4/100,000 to 54.5/100,000). There was a predominance among men (1.47:1), but incidence trends were similar in both sexes. Old age, high body mass index, and no history of colonoscopy were identified as risk factors in both sexes. High fasting blood glucose, familial history of cancer, frequent alcohol intake, and current smoker were identified as risk factors, especially in men. Conclusion: The incidence of colorectal cancer has been increasing in Korea. Colonoscopy screening was a protective factor for colorectal cancer, and active use of colonoscopy may reduce incidence. Early diagnosis and care are important, particularly for the high-risk group.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Colorectal Cancer in Korea: A Population-Based Retrospective Cohort Study

et al. 2019

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“…In addition, This study showed that using the cutoff level of BMI ≥23 kg/m 2 had enough power to detect more advanced CRN (OR, 1.5; 95% CI, 1.1-2.1) similar to using the higher cutoff BMI ≥25 kg/ m 2 (OR, 1.4; 1.1-1.9) (Sung et al, 2018). Another study from Korea supports that there was no difference between using the cutoff level of BMI 23 kg/m 2 and BMI 25 kg/ m 2 on the risk of CRC (Shin et al, 2017). The authors showed that when compared to those with BMI at 18.5-23 kg/m 2 , the relative risk of CRC increased to 17% equally in those with BMI 23-25 kg/m 2 and those with BMI 25-30 kg/m 2 (Shin et al, 2017).…”

Section: Discussionmentioning

confidence: 85%

“…Another study from Korea supports that there was no difference between using the cutoff level of BMI 23 kg/m 2 and BMI 25 kg/ m 2 on the risk of CRC (Shin et al, 2017). The authors showed that when compared to those with BMI at 18.5-23 kg/m 2 , the relative risk of CRC increased to 17% equally in those with BMI 23-25 kg/m 2 and those with BMI 25-30 kg/m 2 (Shin et al, 2017).…”

Section: Discussionmentioning

confidence: 97%

Overweight as an Additional Risk Factor for Colorectal Neoplasia in Lean Population

Jangsirikul

Promratpan

Aniwan

et al. 2019

Asian Pac J Cancer Prev

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Background:Overweight in Thailand is not as common as in Western countries. We sought to evaluate overweight as the additional risk factor that can increase the prediction of colorectal neoplasia (CRN) detection in Thais apart from the Asia-Pacific Colorectal Screening (APCS) score. Methods: We prospectively enrolled asymptomatic 338 subjects who underwent screening colonoscopy between November 2016 and September 2017. All risk factors according to APCS, BMI and the presence of metabolic syndrome were collected. Overweight was defined as BMI ≥23 kg/m 2 . By APCS score, subjects were categorized into 1) high-risk and 2) average-risk. Using the combination of APCS score and overweight, subjects were stratified into 4 groups; high-risk with overweight (G1), average-risk with overweight (G2), high-risk with normal weight (G3) average-risk and with normal weight (G4). Logistic regression analysis was used to estimate the risk of detecting CRN. Results: The prevalence of CRN in the high-risk subjects was higher than that of in the average-risk subjects (49%vs.32%; OR, 2.00; 95%CI, 1.17-3.41). After adjustment for APCS risk factors and metabolic syndrome, overweight significantly increased the risk of detecting CRN (OR, 2.52; 95%CI, 1.57-4.05). Among the 4 groups, the detection rates of CRN were significantly different (G1=64%, G2=40%, G3=32% and G4=21%, p<0.01). The relative risk of detecting CRN increased when G1 (OR 6.49; 95%CI, 2.87-14.67), and G2 (2.42; 1.39-4.21) were compared with G4. Conclusions: In addition to the APCS score, overweight is an independent risk factor for detecting CRN. In Thai population, combining overweight and APCS score may be useful to improve the prediction for CRN.

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“…Recently, the subset of people with obesity and obesity‐related metabolic disturbances has become of interest. Several previous studies have reported the different risks of CRN between MHO and metabolically unhealthy non‐obese (MUNO) subgroups . Based on the results of the previous studies, they may also have different implications for the risk of developing metachronous CRN following polypectomy.…”

Section: Introductionmentioning

confidence: 96%

“…Several previous studies have reported the different risks of CRN between MHO and metabolically unhealthy non-obese (MUNO) subgroups. [19][20][21][22][23][24][25] Based on the results of the previous studies, they may also have different implications for the risk of developing metachronous CRN following polypectomy. However, there is a lack of data on the risk of metachronous CRN among subgroups according to obesity and metabolic status.…”

Section: Introductionmentioning

confidence: 99%

Impact of obesity and metabolic abnormalities on the risk of metachronous colorectal neoplasia after polypectomy in men

Kim

Jung

Park

et al. 2019

J of Gastro and Hepatol

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Background and Aim Obesity and metabolic syndrome are well‐known risk factors for the development of metachronous colorectal neoplasia (CRN). However, data on the risks of metachronous CRN among subgroups according to obesity and metabolic status are scarce. Therefore, we aimed to compare the risk of metachronous CRN among men with different obesity and metabolic status. Methods In total, 8059 asymptomatic men who underwent ≥ 1 adenoma removal between 2010 and 2014 and follow‐up colonoscopic surveillance until 2017 were categorized into four groups according to obesity and metabolic status: metabolically healthy non‐obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non‐obese (MUNO), and metabolically unhealthy obese (MUO). Results Of the 8059 men, 2389 (29.6%), 351 (4.4%), 1986 (24.6%), and 3333 (41.4%) subjects were assigned to the MHNO, MHO, MUNO, and MUO groups, respectively. The mean surveillance interval was 3.5 ± 1.4 years. Compared to the MHNO group, the risk of metachronous advanced CRN was significantly increased in the MUO group (adjusted hazard ratio [HR] = 1.50; 95% confidence interval [CI]: 1.02–2.19), but not in the MHO and MUNO groups, while the risk of metachronous overall CRN significantly increased in the MUNO (adjusted HR = 1.12; 95% CI: 1.01–1.24) and MUO groups (adjusted HR = 1.17; 95% CI: 1.07–1.29), but not in the MHO group. Conclusions Men who had both obesity and poor metabolic health were found to be at an increased risk of metachronous advanced CRN, suggesting that MUO men may need to undergo more intensive surveillance colonoscopy after polypectomy.

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Association Among Obesity, Metabolic Health, and the Risk for Colorectal Cancer in the General Population in Korea Using the National Health Insurance Service–National Sample Cohort

Cited by 49 publications

References 38 publications

Risk Factors for Colorectal Cancer in Korea: A Population-Based Retrospective Cohort Study

Risk Factors for Colorectal Cancer in Korea: A Population-Based Retrospective Cohort Study

Overweight as an Additional Risk Factor for Colorectal Neoplasia in Lean Population

Impact of obesity and metabolic abnormalities on the risk of metachronous colorectal neoplasia after polypectomy in men

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