title: Excess body weight and colorectal cancer survival: the multiethnic cohort.
abstract: OBJECTIVE
  Excess body weight is a risk factor for colorectal cancer (CRC) and may also adversely affect survival in CRC patients.
  
  
  METHODS
  This study examined the relation of body mass index (BMI), which was self-reported at cohort entry and after 5.7 ± 0.8 years, with CRC-specific and all-cause survival among 4,204 incident cases of invasive CRC in the multiethnic cohort. Cox regression analysis with age as time metric and BMI as time-varying exposure was applied to estimate hazard ratios (HR) and 95% confidence intervals (CIs) while adjusting for relevant covariates.
  
  
  RESULTS
  Over 6.0 ± 4.7 years of follow-up, 1,976 all-cause and 1,095 CRC-specific deaths were recorded. The mean time interval between cohort entry and diagnosis was 7.6 ± 4.7 years. No association with CRC-specific survival was detected in men (HR5units = 0.94; 95%CI 0.84-1.04) or women (HR5units = 0.98; 95%CI 0.89-1.08). In men, all-cause survival also showed no relation with BMI (HR5unit = 0.97; 95%CI 0.90-1.06), whereas it was reduced in women (HR5units = 1.10; 95%CI 1.03-1.18). Interactions of BMI with ethnicity were only significant for obesity. Obese Latino and overweight Native Hawaiian men as well as overweight African-American women experienced significantly better CRC-specific survival than whites. Overweight Japanese men and African-American women had better all-cause survival and obese Latino women had the lowest all-cause survival (HRobese = 1.74; 95%CI 1.08-2.80).
  
  
  CONCLUSIONS
  This analysis detected little evidence for an adverse effect of excess body weight on CRC-specific survival, but all-cause survival was reduced in women. These findings suggest that adiposity may be less important for CRC survival than as an etiologic factor.
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA. gertraud@cc.hawaii.edu.
authors.forename: Gertraud
authors.initials: G
authors.lastname: Maskarinec
authors.affiliation: School of Public Health, University of Memphis, 200 Robison Hall, Memphis, TN, USA.
authors.forename: Brook E
authors.initials: BE
authors.lastname: Harmon
authors.affiliation: Health Science Center, University of Tennessee, Memphis, TN, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Little
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Ollberding
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
authors.forename: Laurence N
authors.initials: LN
authors.lastname: Kolonel
authors.affiliation: University of Southern California, Health Sciences Campus, Los Angeles, CA, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Henderson
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
authors.forename: Loic
authors.initials: L
authors.lastname: Le Marchand
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
mesh_terms: D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000208:ethnology / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D057566:Self Report
keywords: Colorectal cancer; Ethnicity; Obesity; Survival