Change in Body Size and the Risk of Colorectal Adenomas

Abstract

Adiposity has been recognized as a risk factor for colorectal adenoma, but the influence of weight gain, adipose tissue distribution, and possible differences between ethnic/racial and gender groups remains unanswered. The aim of this prospective study was to examine the association between adiposity and weight change and colorectal adenoma risk. Over f10-year period, anthropometric measures and other risk factors were measured at three time points in the multicenter multiethnic Insulin Resistance Atherosclerosis Study cohort. Colonoscopies were then conducted on 600 cohort participants regardless of symptoms whose mean age at colonoscopy was 64 years. Multivariate logistic regression analyses were used to assess the association between colorectal adenomas and measures of adiposity and weight change over the f10-year period before colonoscopy. Obesity was positively associated with risk of colorectal adenomas at the time of colonoscopy [adjusted odds ratio (OR adj ), 2.16; 95% confidence interval (95% CI), 1.13-4.14] and was stronger in women (OR adj , 4.42; 95% CI, 1.53-12.78) than in men (OR adj , 1.26; 95% CI, 0.52-3.07). The risk of adenomas increased among participants who gained weight compared with those who maintained weight over the f5 years (OR adj , 2.30; 95% CI, 1.25-4.22) and f10 years (OR adj , 2.12; 95% CI, 1.25-3.62). These associations were similar for both advanced and nonadvanced adenomas. These results suggest a positive association between obesity, weight gain, and colorectal adenoma risk. Stronger associations were observed when obesity was measured at the time of colonoscopy, suggesting that obesity may be a promoting factor in the growth of colorectal adenomas. (Cancer Epidemiol Biomarkers Prev 2007;16(3):526-31)

Cutoff value determines the performance of a semi-quantitative immunochemical faecal occult blood test in a colorectal cancer screening programme

“…This is in line with other studies (Manus et al, 1997;Betes et al, 2003;Sedjo et al, 2007). Thus, the diagnostic yield increases with age and male gender.…”

Body Size, Weight Change, and Risk of Colon Cancer

“…Sedjo et al (38) reported a nonsignificant weight change by sex interaction in their study of colorectal adenoma risk and recent weight change; thus, results were presented for men and women combined. Other studies have fit separate models for men and women or stratified by sex (11, 13, 19, 23-25, 39, 40).…”

“…It is possible that increases in abdominal obesity over adulthood could convey higher risks than those we have observed for weight increases. To our knowledge, only one study examined the relationship between change in waist circumference or waist-hip ratio and risk of colorectal adenomas, but they reported no associations between 5-or 10-year change in either measure of abdominal obesity (38). A recent review concluded that colon cancer risk is related to determinants of the metabolic syndrome (obesity, abdominal obesity, and physical inactivity), its clinical consequences (type 2 diabetes and hypertension), its plasma or serum components (hypertriglyceridemia, hyperglycemia, and low high-density lipoprotein cholesterol), and markers of hyperinsulinemia or insulin resistance (insulin and C-peptide; ref.…”

“…We are aware of only one other study that formally tested for sex differences in the association between weight change and colon cancer or adenoma risk (38). Sedjo et al (38) reported a nonsignificant weight change by sex interaction in their study of colorectal adenoma risk and recent weight change; thus, results were presented for men and women combined.…”

Impact of Project SCOPE on Racial/Ethnic Disparities in Screening Colonoscopies

“…In addition to insurance, other covariates such as age, gender, smoking, diabetes mellitus, obesity, aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), and personal and family history of colonic neoplasia have been identified as a risk factor for colonic neoplasia [15][16][17][18][19][20][21][22][23]; therefore, these covariates were also abstracted from the medicals records. Smoking history and family history of colonic neoplasia were self-defined in the medical records.…”