title: Body weight, fat distribution and colorectal cancer risk: a report from cohort studies of 134255 Chinese men and women.
abstract: OBJECTIVE
  The objective was to evaluate the association of body size and fat distribution with the risk of colorectal cancer (CRC) in Chinese men and women.
  
  
  METHODS
  This was a population-based, prospective cohort study.
  
  
  METHODS
  The analysis included 134,255 Chinese adults enrolled in the Shanghai Women's Health Study and the Shanghai Men's Health Study, with an average follow-up of 11.0 and 5.5 years, respectively.
  
  
  METHODS
  Waist circumference (WC), body mass index (BMI) and waist-to-hip ratio (WHR) were measured by trained interviewers at baseline. Multivariable Cox models were used to calculate adjusted hazard ratios (HRs) for incident CRC.
  
  
  RESULTS
  A total of 935 incident CRC cases were identified. Both measures of general adiposity (measured by BMI) and central adiposity (measured by WHR and WC) were significantly associated with an increased risk of colon cancer in men but not in women. Multivariable-adjusted HRs for colon cancer in men in the highest compared with the lowest quintiles were 2.15 (95% confidence interval (CI): 1.35-3.43; P for trend=0.0006) for BMI, 1.97 (95% CI: 1.19-3.24; P for trend=0.0004) for WHR and 2.00 (95% CI: 1.21-3.29; P for trend=0.0002) for WC. The BMI-associated risk was attenuated in analyses stratified by WHR, whereas the WHR-associated risk remained significant in the high BMI stratum (HR for comparison of extreme tertiles of WHR: 3.38, 95% CI: 1.47-7.75; P for trend =0.0002). None of these anthropometric measures were significantly associated with rectal cancer.
  
  
  CONCLUSIONS
  Obesity, particularly central obesity, was associated with an increased risk of colon cancer in men.
authors.affiliation: Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.forename: G
authors.initials: G
authors.lastname: Yang
authors.forename: Y-B
authors.initials: YB
authors.lastname: Xiang
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: W
authors.initials: W
authors.lastname: Zheng
authors.forename: Y-T
authors.initials: YT
authors.lastname: Gao
authors.forename: X-O
authors.initials: XO
authors.lastname: Shu
mesh_terms: D050154:Adiposity; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D001835:Body Weight; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D014505:Urban Population; D055105:Waist Circumference; D049629:Waist-Hip Ratio