Measured Body Mass Index in Adolescence and the Incidence of Colorectal Cancer in a Cohort of 1.1 Million Males

Abstract

Background and Aims: The increasing prevalence of adolescent obesity affects adult health. We investigated the association of adolescent overweight with colorectal cancer incidence in a large cohort of males.Methods: Body mass index (BMI) was measured in 1.1 million Jewish Israeli males who underwent a general health examination at ages 16 to 19 between 1967 and 2005. Overweight was defined as BMI ! 85th percentile of the standard U.S. distribution in adolescence. Colorectal cancer was identified by linkage with the Israel National Cancer Registry up to 2006. The mean follow-up period was 17.6 AE 10.9 years, reflecting 19.5 million person-years. Cox proportional hazards modeling was used.Results: The prevalence of adolescent overweight increased from 9.9% to 16.8% in the first 10 and last 10 annual examination cohorts. Colon (n ¼ 445) and rectal cancer (n ¼ 193) cases were detected. Overweight predicted an increased risk of colon cancer [HR ¼ 1.53; 95% confidence interval (CI), 1.17-2.02, P ¼ 0.002] but not of rectal cancer (HR ¼ 1.09; 95% CI, 0.38-1.73, P ¼ 0.72). The risk was greatest for nonmucinous adenocarcinoma of the colon (HR ¼ 1.68, 95% CI, 1.26-2.23, P ¼ 0.001). The association of BMI ! 85th percentile with colon cancer was even more pronounced in analyses that were restricted to men followed until at least 40 years of age [N ¼ 367,478; HR ¼ 1.75 (95% CI, 1.33-2.3, P < 0.001)].Conclusions: Adolescent overweight is substantially associated with colon cancer incidence in young to middle-aged adults.Impact: These long-term sequelae add to the urgency to seriously address increasing childhood and adolescent obesity with its attendant increasing population impact. Cancer Epidemiol Biomarkers Prev; 20(12); 2524-31. Ó2011 AACR.

Diabetes Mellitus and the Incidence of Colorectal Cancer: An Updated Systematic Review and Meta-Analysis

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