Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis

Abstract

A sedentary lifestyle, obesity, and a Westernized diet have been implicated in the aetiology of both colorectal cancer and non-insulin dependent diabetes mellitus, leading to the hypothesis that hyperinsulinaemia may promote colorectal cancer. We prospectively examined the association between colorectal cancer risk and factors related to insulin resistance and hyperinsulinaemia, including BMI, physical activity, diabetes mellitus, and blood glucose, in a cohort of 75 219 Norwegian men and women. Information on incident cases of colorectal cancer was made available from the Norwegian Cancer Registry. Reported P values are two-sided. During 12 years of follow up, 730 cases of colorectal cancer were registered. In men, but not in women, we found a negative association with leisure-time physical activity ( P for trend = 0.002), with an age-adjusted RR for the highest versus the lowest category of activity of 0.54 (95% CI = 0.37–0.79). Women, but not men, with a history of diabetes were at increased risk of colorectal cancer (age-adjusted RR = 1.55; 95% CI = 1.04–2.31), as were women with non-fasting blood glucose ≥8.0 mmol l −1 (age-adjusted RR = 1.98; 95% CI = 1.31–2.98) compared with glucose <8.0 mmol l −1 . Overall, we found no association between BMI and risk of colorectal cancer. Additional adjustment including each of the main variables, marital status, and educational attainment did not materially change the results. We conclude that the inverse association between leisure-time physical activity and colorectal cancer in men, and the positive association between diabetes, blood glucose, and colorectal cancer in women, at least in part, support the hypothesis that insulin may act as a tumour promoter in colorectal carcinogenesis. © 2001 Cancer Research Campaign http://www.bjcancer.com

Physical Inactivity, Water Intake and Constipation as Risk Factors for Colorectal Cancer among Adults in Jordan

“…Campbell et al (2007) concluded that obesity is associated with colon and rectal cancer only in women but not men. Nilsen and Vatten (2001) study revealed that no association was found between BMI and CRC neither in males nor females of the study. However, the lower BMI among cases which has been detected in this study may reflect the effect of chemotherapy and other therpies that were used to treat cancer patients (DobrilaDintinjana et al, 2012).…”

“…Lifestyle characterized by low physical activity may result in a positive energy balance and weight gain (Marchand et al, 1997). The role of physical inactivity and obesity in CRC prevention have been shown CRC in several studies (Whittemore et al, 1990;Marchand et al, 1997;Nilsen and Vatten, 2001).…”

Physical activity, sedentary behavior, and the risk of colon and rectal cancer in the NIH-AARP Diet and Health Study

“…Findings from available epidemiologic studies of women have been less conclusive, with results from several prospective studies observing no association [6,8,15,32] and others reporting statistically nonsignificant risk reductions [33,34]. Few studies found a statistically significant inverse association between physical activity and colorectal cancer in women [13,16,35].…”

Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

“…Breast, colon, uterine, and ovarian cancer incidence have also been shown to increase with BMI (19,20). Obesity is associated with comorbidities that include type 2 diabetes, hyperlipidemia, HTN, OSA, stroke, asthma, and back and lower extremity weight-bearing degenerative problems (2,14,(21)(22)(23).…”