title: Pre-diagnostic anthropometry and survival after colorectal cancer diagnosis in Western European populations.
abstract: General and abdominal adiposity are associated with a high risk of developing colorectal cancer (CRC), but the role of these exposures on cancer survival has been less studied. The association between pre-diagnostic anthropometric characteristics and CRC-specific and all-cause death was examined among 3,924 men and women diagnosed with CRC between 1992 and 2009 in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Over a mean follow-up period of 49 months, 1,309 deaths occurred of which 1,043 (79.7%) were due to CRC. In multivariable analysis, pre-diagnostic BMI ≥ 30 kg/m(2) was associated with a high risk for CRC-specific (HR = 1.26, 95% CI = 1.04-1.52) and all-cause (HR = 1.32, 95% CI = 1.12-1.56) death relative to BMI <25 kg/m(2). Every 5 kg/m(2) increase in BMI was associated with a high risk for CRC-specific (HR = 1.10, 95% CI = 1.02-1.19) and all-cause death (HR = 1.12, 95% CI = 1.05-1.20); and every 10 cm increase in waist circumference was associated with a high risk for CRC-specific (HR = 1.09, 95% CI = 1.02-1.16) and all-cause death (HR = 1.11, 95% CI = 1.05-1.18). Similar associations were observed for waist-to-hip and waist-to-height ratios. Height was not associated with CRC-specific or all-cause death. Associations tended to be stronger among men than in women. Possible interactions by age at diagnosis, cancer stage, tumour location, and hormone replacement therapy use among postmenopausal women were noted. Pre-diagnostic general and abdominal adiposity are associated with lower survival after CRC diagnosis.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Winship Cancer Institute, Emory University, Atlanta, GA, USA.
authors.forename: Veronika
authors.initials: V
authors.lastname: Fedirko
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
authors.forename: Krasimira
authors.initials: K
authors.lastname: Aleksandrova
authors.forename: Tobias
authors.initials: T
authors.lastname: Pischon
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: Petra H
authors.initials: PH
authors.lastname: Peeters
authors.forename: Dora
authors.initials: D
authors.lastname: Romaguera-Bosch
authors.forename: H B As
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Christina C
authors.initials: CC
authors.lastname: Dahm
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Maria-Dolores
authors.initials: MD
authors.lastname: Chirlaque
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
authors.forename: Pernille E
authors.initials: PE
authors.lastname: Bidstrup
authors.forename: Susanne O
authors.initials: SO
authors.lastname: Dalton
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gunter
authors.forename: Petra A
authors.initials: PA
authors.lastname: Wark
authors.forename: Teresa
authors.initials: T
authors.lastname: Norat
authors.forename: Jytte
authors.initials: J
authors.lastname: Halkjaer
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Vincent K
authors.initials: VK
authors.lastname: Dik
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Laure
authors.initials: L
authors.lastname: Dossus
authors.forename: Nadia
authors.initials: N
authors.lastname: Bastide
authors.forename: Tilman
authors.initials: T
authors.lastname: Kühn
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Eleni
authors.initials: E
authors.lastname: Klinaki
authors.forename: Michalis
authors.initials: M
authors.lastname: Katsoulis
authors.forename: Valeria
authors.initials: V
authors.lastname: Pala
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.forename: Guri
authors.initials: G
authors.lastname: Skeie
authors.forename: Carlos A
authors.initials: CA
authors.lastname: González
authors.forename: María-José
authors.initials: MJ
authors.lastname: Sánchez
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.forename: J Ramon
authors.initials: JR
authors.lastname: Quiros
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.forename: Karin
authors.initials: K
authors.lastname: Jirström
authors.forename: Ingrid
authors.initials: I
authors.lastname: Ljuslinder
authors.forename: Richard
authors.initials: R
authors.lastname: Palmqvist
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nick
authors.initials: N
authors.lastname: Wareham
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Bradbury
authors.forename: Magdalena
authors.initials: M
authors.lastname: Stepien
authors.forename: Talita
authors.initials: T
authors.lastname: Duarte-Salles
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Mazda
authors.initials: M
authors.lastname: Jenab
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D005060:Europe; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000473:pathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017678:Sex Distribution; D055105:Waist Circumference; D049629:Waist-Hip Ratio
keywords: abdominal obesity; body composition; colorectal neoplasms; obesity; survival