Anthropometric risk factors for colorectal polyps in African-American women.
OBJECTIVE
Colorectal adenomas are thought to be precursor lesions to colorectal cancer, a leading cause of cancer incidence and mortality in African-American women. Studies suggest that obesity is associated with risk of adenomas in white women, but little is known about the relation in African-American women. We prospectively examined the association between selected anthropometric factors and colorectal polyps in African-American women.


METHODS
Data were obtained from the Black Women's Health Study (BWHS), a prospective cohort study of African-American women. From 1997 to 2003, we followed 33,403 women aged > or =30 years with no prior diagnosis of cancer or polyps. Cox regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for risk of polyps, with adjustment for potential confounders.


RESULTS
After 211,797 person-years of follow-up, 1,189 cases of colorectal polyps were reported. The IRR comparing women with a current BMI > or =35 to <25 kg/m(2) was 1.35 (95% CI = 1.12-1.62), after adjustment for covariates including waist-to-hip ratio (WHR). Women who gained > or =30 kg since age 18 were 1.76 times as likely as those who gained <5 kg to report polyps (95% CI = 1.33-2.33). The IRR comparing the highest (>or =0.87) to lowest (<0.71) quintiles of WHR was 1.26 (95% CI = 1.04-1.54), after adjustment for covariates including BMI. BMI at age 18, adult height, and waist circumference (BMI-adjusted) were not materially associated with risk. Results were similar among women with a recent endoscopy.


CONCLUSIONS
Weight gain and obesity in adulthood may increase the risk of colorectal polyps in African-American women.
Wise
Lauren A
LA
Slone Epidemiology Center at Boston University, Boston, Massachusetts, USA. lwise@slone.bu.edu
Rosenberg
Lynn
L
Palmer
Julie R
JR
Adams-Campbell
Lucile L
LL
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000886:Anthropometry; D001827:Body Height; D015992:Body Mass Index; D003111:Colonic Polyps / Q000208:ethnology*; D015179:Colorectal Neoplasms / Q000208:ethnology*; D005192:Family Health; D005500:Follow-Up Studies; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D049629:Waist-Hip Ratio; D015430:Weight Gain