Association between body size and colorectal adenoma recurrence.
OBJECTIVE
Obesity has been associated with increased risk for colorectal adenoma, although its role as a risk factor after polypectomy for recurrence is unclear. Therefore, we sought to evaluate the effect of anthropometric measures of obesity on adenoma after polypectomy.


METHODS
Subjects with baseline adenomas (n = 2465) and follow-up colonoscopy data were drawn from 2 randomized trials designed to prevent adenoma recurrence.


RESULTS
Over a mean follow-up period of 3.1 years presence of a body mass index (BMI) > or = 30 kg/m2 was associated with a nonsignificant 17% increase in the odds for any adenoma recurrence among all subjects (odds ratio [OR], 1.17; 95% confidence interval [CI], 0.92-1.48). This result was confined to men (OR, 1.36; 95% CI, 1.01-1.83) and not observed for women (OR, 0.90; 95% CI, 0.60-1.33). Results for waist circumference did not reach statistical significance, although trends were similar to those for BMI. Analyses of the effects of obesity on more clinically significant lesions demonstrated that high BMI was a slightly stronger risk factor for advanced adenoma recurrences in men (OR, 1.62; 95% CI, 1.04-2.53) when compared with non-advanced lesions (OR, 1.26; 95% CI, 0.91-1.75). In addition, we observed an association for obesity and odds of adenoma recurrence among participants reporting a family history of colorectal cancer (OR, 2.25; 95% CI, 1.32-3.84) but not for those without (OR, 1.00; 95% CI, 0.77 to 1.31; P(int) = P = .008).


CONCLUSIONS
Our results support obesity as a risk factor for subsequent short-interval (mean follow-up time 3.1 years) development of colorectal adenomas, particularly among men and persons with a family history of colorectal cancer. Furthermore, obesity in men appears to be strongly associated with the development of clinically advanced lesions.
Jacobs
Elizabeth T
ET
Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, Arizona 85724-5024, USA. jacobse@u.arizona.edu
Martínez
María Elena
ME
Alberts
David S
DS
Jiang
Ruiyun
R
Lance
Peter
P
Lowe
Kimberly A
KA
Thompson
Patricia A
PA
D000236:Adenoma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D000368:Aged; D015992:Body Mass Index; D003111:Colonic Polyps / Q000601:surgery; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology