title: Adolescent body mass index and erythrocyte sedimentation rate in relation to colorectal cancer risk.
abstract: Adult obesity and inflammation have been associated with risk of colorectal cancer (CRC); however, less is known about how adolescent body mass index (BMI) and inflammation, as measured by erythrocyte sedimentation rate (ESR), relate to CRC risk. We sought to evaluate these associations in a cohort of 239 658 Swedish men who underwent compulsory military enlistment examinations in late adolescence (ages 16-20 years).
  
  
  
  At the time of the conscription assessment (1969-1976), height and weight were measured and ESR was assayed. By linkage to the national cancer registry, these conscripts were followed for CRC through 1 January 2010. Over an average of 35 years of follow-up, 885 cases of CRC occurred, including 501 colon cancers and 384 rectal cancers. Cox regression was used to estimate adjusted HRs and corresponding 95% CIs.
  
  
  
  Compared with normal weight (BMI 18.5 to <25 kg/m(2)) in late adolescence, upper overweight (BMI 27.5 to <30 kg/m(2)) was associated with a 2.08-fold higher risk of CRC (95% CI 1.40 to 3.07) and obesity (BMI 30+ kg/m(2)) was associated with a 2.38-fold higher risk of CRC (95% CI 1.51 to 3.76) (p-trend: <0.001). Male adolescents with ESR (15+ mm/h) had a 63% higher risk of CRC (HR 1.63; 95% CI 1.08 to 2.45) than those with low ESR (<10 mm/h) (p-trend: 0.006). Associations did not significantly differ by anatomic site.
  
  
  
  Late-adolescent BMI and inflammation, as measured by ESR, may be independently associated with future CRC risk. Further research is needed to better understand how early-life exposures relate to CRC.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Kantor
authors.affiliation: Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Ruzan
authors.initials: R
authors.lastname: Udumyan
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Signorello
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
authors.affiliation: Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden Research Department of Epidemiology and Public Health, University College London, London, UK Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Scott
authors.initials: S
authors.lastname: Montgomery
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Katja
authors.initials: K
authors.lastname: Fall
mesh_terms: D000293:Adolescent; D000328:Adult; D001799:Blood Sedimentation; D015992:Body Mass Index; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
keywords: COLORECTAL CANCER; COLORECTAL NEOPLASM; INFLAMMATION; OBESITY