Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study.
BACKGROUND
A moderate association exists between body mass index (BMI) and colorectal cancer. Less is known about the effect of weight change.


OBJECTIVE
We investigated the relation between BMI and weight change and subsequent colon and rectal cancer risk.


METHODS
This was studied among 328,781 participants in the prospective European Prospective Investigation into Cancer-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating study (mean age: 50 y). Body weight was assessed at recruitment and on average 5 y later. Self-reported weight change (kg/y) was categorized in sex-specific quintiles, with quintiles 2 and 3 combined as the reference category (men: -0.6 to 0.3 kg/y; women: -0.4 to 0.4 kg/y). In the subsequent years, participants were followed for the occurrence of colon and rectal cancer (median period: 6.8 y). Multivariable Cox proportional hazards regression analyses were used to study the association.


RESULTS
A total of 1261 incident colon cancer and 747 rectal cancer cases were identified. BMI at recruitment was statistically significantly associated with colon cancer risk in men (HR: 1.04; 95% CI: 1.02, 1.07). Moderate weight gain (quintile 4) in men increased risk further (HR: 1.32; 95% CI: 1.04, 1.68), but this relation did not show a clear trend. In women, BMI or weight gain was not related to subsequent risk of colon cancer. No statistically significant associations for weight loss and colon cancer or for BMI and weight changes and rectal cancer were found.


CONCLUSIONS
BMI attained at adulthood was associated with colon cancer risk. Subsequent weight gain or loss was not related to colon or rectal cancer risk in men or women.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands (CNSB, CHvG, EMM, PHMP, and AMM); the National Institute for Public Health and the Environment, Bilthoven, Netherlands (HBB-d-M); the Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands (HBB-d-M); the Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany (HB and KA); the International Agency for Research on Cancer, WHO, Lyon, France (MJ, HF, and PF); the Division of Epidemiology, Public Health and Primary Care, Imperial College, London, United Kingdom (HBB-d-M, TN, ER, and PHMP); INSERM, Centre for Research in Epidemiology and Population Health, Nutrition, Hormones and Women's Health Team, Villejuif, France (MB-R, GF, and AR); University of Paris, Sud, Villejuif, France (MB-R, GF, and AR); IGR, Villejuif, France (MB-R, GF, and AR); Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy (DP); the Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (VK); the Cancer Registry and Histopathology Unit, "Civile M.P. Arezzo" Hospital, ASP Ragusa, Italy (RT); HuGeF-Human Genetics Foundation-Torino, Molecular and Genetic Epidemiology Unit, Torino, Italy (A Naccarati); Dipartimento di Medicina Clinica e Chirugia, FEDERICO II University, Naples, Italy (AM); Public Health Directorate, Asturias, Spain (MVA); the Andalusian School of Public Health, Granada, Spain (MS and MJT); CIBER de Epidemiología y Salud Pública, Spain (MS, MJT, and EA); the Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain (MJT); the Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain (MJT); the Navarre Public Health Institute, Pamplona, Spain (EA); Subdirección de Salud Pública de Gipuzkoa, Gobierno Vasco, San Sebastian, Spain (MD); the Department of Epidemiology, Catalan I
Charlotte N
CN
Steins Bisschop
Carla H
CH
van Gils
Marleen J
MJ
Emaus
H Bas
HB
Bueno-de-Mesquita
Evelyn M
EM
Monninkhof
Heiner
H
Boeing
Krasmira
K
Aleksandrova
Mazda
M
Jenab
Teresa
T
Norat
Elio
E
Riboli
Marie-Christine
MC
Boutron-Rualt
Guy
G
Fagherazzi
Antoine
A
Racine
Domenico
D
Palli
Vittorio
V
Krogh
Rosario
R
Tumino
Alessio
A
Naccarati
Amalia
A
Mattiello
Marcial Vicente
MV
Argüelles
Maria José
MJ
Sanchez
Maria José
MJ
Tormo
Eva
E
Ardanaz
Miren
M
Dorronsoro
Catalina
C
Bonet
Kay-Tee
KT
Khaw
Tim
T
Key
Antonia
A
Trichopoulou
Philippos
P
Orfanos
Androniki
A
Naska
Rudolph R
RR
Kaaks
Annekatrin
A
Lukanova
Tobias
T
Pischon
Ingrid
I
Ljuslinder
Karin
K
Jirström
Bodil
B
Ohlsson
Kim
K
Overvad
Tina
T
Landsvig Berentzen
Jytte
J
Halkjaer
Anne
A
Tjonneland
Elisabete
E
Weiderpass
Guri
G
Skeie
Tonje
T
Braaten
Peter D
PD
Siersema
Heinz
H
Freisling
Pietro
P
Ferrari
Petra H M
PH
Peeters
Anne M
AM
May
D000328:Adult; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009752:Nutritional Status; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D015430:Weight Gain; D015431:Weight Loss