Lack of evidence for effect modification by estrogen of association between body mass index and colorectal cancer risk among postmenopausal women

Wang, Yiting; Jacobs, Eric J.; Teras, Lauren R.; Pavluck, Alexandre L.; Rodríguez, Carmen; Thun, Michael J.; Calle, Eugenia E.

doi:10.1007/s10552-007-9009-5

Cited by 12 publications

(11 citation statements)

References 29 publications

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“…Contrary to our results, these studies have found a stronger association in premenopausal or estrogen-positive women than in postmenopausal or estrogen-negative women. Other studies have, however, not found the effect of BMI to be modified by use of hormone replacement therapy (HRT) in postmenopausal women (42,43). We could not study effect modification by HRT.…”

Section: Discussionmentioning

confidence: 79%

A Prospective Study of Body Mass Index, Weight Change, and Risk of Cancer in the Proximal and Distal Colon

Laake¹,

Thune²,

Selmer³

et al. 2010

Cancer Epidemiol Biomarkers Prev

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Background: Body mass index (BMI) is an established risk factor for colon cancer, but risks may differ between genders and colon subsites. Moreover, whether weight change influences risk is not yet clarified. We investigated these issues in a large, Norwegian, population-based cohort study.Methods: Participants' weight was measured at examinations up to three times between 1974 and 1988. Hazard ratios (HR) and confidence intervals (CI) were estimated using Cox regression.Results: During follow-up of 38,822 men and 37,357 women, we identified 228 proximal and 174 distal colon cancer cases in men and 237 and 159 cases, respectively, in women. The association between BMI and colon cancer risk differed between subsites in men (P = 0.02) but not in women (P = 0.95). In men, HRs (95% CIs) per 5 kg/m 2 were 1.07 (0.86-1.33) and 1.49 (1.19-1.87) for proximal and distal colon, respec-

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Section: Discussionmentioning

confidence: 79%

A Prospective Study of Body Mass Index, Weight Change, and Risk of Cancer in the Proximal and Distal Colon

Laake¹,

Thune²,

Selmer³

et al. 2010

Cancer Epidemiol Biomarkers Prev

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“…(25, 26) While similar associations have also been reported for endometrial cancer (27, 28), evidence for effect modification for colorectal cancer is inconsistent across studies. (29, 30)…”

Section: Discussionmentioning

confidence: 99%

Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States

et al. 2016

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Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing different forms of cancer. Study participants from seven European and one US cohort study with two or more weight assessments during follow-up were included (n=329,576). Trajectories of body mass index (BMI) across ages were estimated using a quadratic growth model; overweight duration (BMI≥25) and cumulative weighted overweight years were calculated. In multivariate Cox models and random effects analyses, a longer duration of overweight was significantly associated with the incidence of obesity-related cancer (overall Hazard Ratio (HR) per 10-yr increment: 1.36; 95%CI: 1.12-1.60), but also increased the risk of postmenopausal breast and colorectal cancer. Additionally accounting for the degree of overweight further increased the risk of obesity-related cancer. Risks associated with a longer overweight duration were higher in men than in women and were attenuated by smoking. For postmenopausal breast cancer, increased risks were confined to women who never used hormone therapy. Overall, 8.4% of all obesity-related cancers could be attributed to overweight at any age. These findings provide further insights into the role of overweight duration in the etiology of cancer and indicate that weight control is relevant at all ages. This knowledge is vital for the development of effective and targeted cancer prevention strategies.

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“…A positive association of BMI and CRC risk was not found among HRT users (Po0.01). Recently, another large cohort study from the United States including 814 incident cases with CRC observed a statistically significant increase in CRC risk among nonusers of hormones with BMIX30 kg m À2 (HR 1.36, 1.04 -1.79), but not among users, when compared to women with BMIo25 kg m À2 (Wang et al, 2007). However, despite the size of the study, no significant effect modification of the BMI -CRC association was found for never, former, and current use of HRT (P ¼ 0.5).…”

Section: Discussionmentioning

confidence: 99%

“…However, despite the size of the study, no significant effect modification of the BMI -CRC association was found for never, former, and current use of HRT (P ¼ 0.5). Except for the WHS and the study by Wang et al (2007), all other previous studies differentiating between users and nonusers of HRT were mainly reporting on colon cancer risk (Slattery et al, 2003;Hou et al, 2006;Pischon et al, 2006;Adams et al, 2007), so we repeated the analysis after exclusion of patients with rectum cancer (32% of cases). Despite the limited power, ORs were similar for all BMI groups and risk of CRC was still significantly increased in the two highest BMI groups among those with no HRT use.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have previously reported on the modifying effect of HRT on the association of BMI and CRC risk among postmenopausal women, and provided conflicting results (Table 1) (Slattery et al, 2003;Lin et al, 2004;Hou et al, 2006;Pischon et al, 2006;Adams et al, 2007;Wang et al, 2007). Thus, we investigated the association of postmenopausal hormone therapy and BMI with CRC risk in a large population-based study from Germany.…”

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confidence: 98%

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Hormone replacement therapy, body mass, and the risk of colorectal cancer among postmenopausal women from Germany

et al. 2007

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Previous studies have reported inconsistent results regarding the modifying effect of hormone replacement therapy (HRT) on the association of body mass index (BMI) and the risk of colorectal cancer (CRC) among postmenopausal women. We assessed the use of HRT and BMI in 208 postmenopausal women with histologically confirmed incident CRC and 246 controls in a population-based case -control study in Germany (DACHS study). Ever use of HRT was strongly associated with reduction of CRC risk (adjusted odds ratio 0.41, 95% confidence interval 0.25 -0.67). Among nonusers of HRT, risk of CRC was strongly increased in women with BMI 27 to o30 kg m À2 (2.76, 1.07 -7.12) and obese women (3.30, 1.25 -8.72), when compared with women with BMI o23 kg m À2 (P for trend o0.01). BMI was not associated with risk of CRC among HRT users (P for interaction o0.01). In contrast to most other studies, a positive association of BMI and CRC risk was found among nonusers of HRT, but not among users of HRT. The reasons for the inconsistency of results regarding the potential risk modifying effect of postmenopausal hormones in the association of BMI with CRC remain inconclusive and require further study.

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Lack of evidence for effect modification by estrogen of association between body mass index and colorectal cancer risk among postmenopausal women

Abstract: Our results do not support the hypothesis that BMI increases risk of colorectal cancer more strongly among women with higher levels of estrogen.

Cited by 12 publications

References 29 publications

A Prospective Study of Body Mass Index, Weight Change, and Risk of Cancer in the Proximal and Distal Colon

A Prospective Study of Body Mass Index, Weight Change, and Risk of Cancer in the Proximal and Distal Colon

Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States

Hormone replacement therapy, body mass, and the risk of colorectal cancer among postmenopausal women from Germany

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