title: Adult weight change and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition.
abstract: OBJECTIVE
  Weight change during adult life may reflect metabolic changes and influence colorectal cancer (CRC) development, but such role is not well established. We aimed to explore the association between adult weight change (from age 20 to 50) and CRC risk. In particular, we investigated differences according to colon and rectal cancer, sex and measures of attained adiposity.
  
  
  METHODS
  We included 201,696 participants from six participating countries in the European Prospective Investigation into Cancer and Nutrition (1992-2010). During a mean follow-up of 11.2 years 2384 (1194 in men and 1190 in women) incident CRC cases occurred. Cox proportional hazard models adjusted for body mass index at age 20 and lifestyle factors at study recruitment were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  After multivariable adjustment, each kg of weight gained annually from age 20 to 50 was associated with a 60% higher risk of colon cancer (95% CI 1.20-2.09), but not rectal cancer (HR 1.13, 95% CI 0.79-1.62, P(interaction)=0.04). The higher risk of colon cancer was restricted to people with high attained waist circumference at age 50 (HR 1.82, 95%CI 1.14-2.91, P(interaction)=0.02). Results were not different in men and women (P(interaction)=0.81).
  
  
  CONCLUSIONS
  Adult weight gain, as reflected by attained abdominal obesity at age 50, increases colon cancer risk in both men and women. These data underline the importance of weight management and metabolic health maintenance in early adult life years for colon cancer prevention.
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. Electronic address: krasimira.aleksandrova@dife.de.
authors.forename: Krasimira
authors.initials: K
authors.lastname: Aleksandrova
authors.forename: Tobias
authors.initials: T
authors.lastname: Pischon
authors.forename: Brian
authors.initials: B
authors.lastname: Buijsse
authors.forename: Anne M
authors.initials: AM
authors.lastname: May
authors.forename: Petra H
authors.initials: PH
authors.lastname: Peeters
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Mazda
authors.initials: M
authors.lastname: Jenab
authors.forename: Veronika
authors.initials: V
authors.lastname: Fedirko
authors.forename: Christina C
authors.initials: CC
authors.lastname: Dahm
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Heinz
authors.initials: H
authors.lastname: Freisling
authors.forename: Pietro
authors.initials: P
authors.lastname: Ferrari
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.forename: Androniki
authors.initials: A
authors.lastname: Naska
authors.forename: Valeria
authors.initials: V
authors.lastname: Pala
authors.forename: Amalia
authors.initials: A
authors.lastname: Mattiello
authors.forename: Bodil
authors.initials: B
authors.lastname: Ohlsson
authors.forename: Karin
authors.initials: K
authors.lastname: Jirström
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
mesh_terms: D050154:Adiposity; D000328:Adult; D000367:Age Factors; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D055105:Waist Circumference; D015430:Weight Gain
keywords: Abdominal obesity; Body weight change; Cancer prevention; Colorectal neoplasms