title: Survival of women with colon cancer in relation to precancer anthropometric characteristics: the Iowa Women's Health Study.
abstract: BACKGROUND
  We hypothesized that precancer anthropometric variables are associated with mortality among women who developed colon cancer in a prospective cohort, the Iowa Women's Health Study (IWHS).
  
  
  METHODS
  From 1986 to 2005, 1,096 incident cases of colon cancer were identified (mean age at diagnosis, 73 years). Anthropometric characteristics were self-measured before colon cancer diagnosis (in 1986). Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for all-cause and colon-cancer mortality, adjusted for age at cancer diagnosis, stage, education, smoking status, and pack-years of smoking.
  
  
  RESULTS
  During the follow-up of up to 20 years, 493 women died; 289 had colon cancer as the underlying cause. The HRs of all-cause death were increased for the highest versus lowest tertile for weight (HR, 1.39; 95% CI, 1.10-1.76; P trend = 0.005); waist to hip ratio (WHR; HR, 1.36; 95% CI, 1.08-1.72; P trend = 0.008), and waist (HR, 1.45; 95% CI, 1.15-1.82; P trend = 0.001). Compared with that for body mass index (BMI) of 18.5 to 24.9 kg/m(2), HRs were increased for BMI >or=30 kg/m(2) (HR, 1.45; 95% CI, 1.14-1.85) and for the few women with BMI <18.5 kg/m(2) (HR, 1.89; 95% CI, 1.01-3.53). Colon cancer mortality was positively associated with WHR and waist: HR, 1.37 (95% CI, 1.02;1.85; P trend = 0.04) and 1.34 (95% CI, 1.01-1.80; P trend = 0.05), respectively, for the highest versus lowest tertile.
  
  
  CONCLUSIONS
  Greater precancer anthropometric measures and BMI <18.5 kg/m(2) predicted poorer survival among colon cancer patients. Higher abdominal adiposity measured by WHR and waist was associated with increased risk of colon cancer death.
  
  
  CONCLUSIONS
  Prediagnostic obesity may be a modifiable risk factor for death in colon cancer patients.
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota 55455, USA. prizm001@mail.umn.edu
authors.forename: Anna E
authors.initials: AE
authors.lastname: Prizment
authors.forename: Andrew
authors.initials: A
authors.lastname: Flood
authors.forename: Kristin E
authors.initials: KE
authors.lastname: Anderson
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
mesh_terms: D000368:Aged; D000886:Anthropometry / Q000379:methods*; D015992:Body Mass Index; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D007484:Iowa / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome; D016387:Women's Health
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