Relationship of prediagnostic body mass index with survival after colorectal cancer: Stage-specific associations.
Higher body mass index (BMI) is a well-established risk factor for colorectal cancer (CRC), but is inconsistently associated with CRC survival. In 6 prospective studies participating in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), 2,249 non-Hispanic white CRC cases were followed for a median 4.5 years after diagnosis, during which 777 died, 554 from CRC-related causes. Associations between prediagnosis BMI and survival (overall and CRC-specific) were evaluated using Cox regression models adjusted for age at diagnosis, sex, study and smoking status (current/former/never). The association between BMI category and CRC survival varied by cancer stage at diagnosis (I-IV) for both all-cause (p-interaction = 0.03) and CRC-specific mortality (p-interaction = 0.04). Compared to normal BMI (18.5-24.9 kg/m(2) ), overweight (BMI 25.0-29.9) was associated with increased mortality among those with Stage I disease, and decreased mortality among those with Stages II-IV disease. Similarly, obesity (BMI ≥30) was associated with increased mortality among those with Stages I-II disease, and decreased mortality among those with Stages III-IV disease. These results suggest the relationship between BMI and survival after CRC diagnosis differs by stage at diagnosis, and may emphasize the importance of adequate metabolic reserves for colorectal cancer survival in patients with late-stage disease.
Department of Epidemiology, University of Washington, Seattle, WA.|Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Jonathan M
0000-0001-8084-1608
JM
Kocarnik
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA.|Division of Gastroenterology, Massachusetts General Hospital, Boston, MA.
Andrew T
AT
Chan
Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT.
Martha L
ML
Slattery
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
John D
JD
Potter
Dana-Farber Cancer Institute, Boston, MA.|Brigham and Women's Hospital, Boston, MA.
Jeffrey
J
Meyerhardt
Department of Epidemiology, University of Washington, Seattle, WA.|Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Amanda
A
Phipps
Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN.|Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN.
Hongmei
H
Nan
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Tabitha
T
Harrison
Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY.
Thomas E
TE
Rohan
Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA.
Lihong
L
Qi
Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Lifang
L
Hou
Division of Research, Kaiser Permanente Northern California, Oakland, CA.
Bette
B
Caan
Division of Research, Kaiser Permanente Northern California, Oakland, CA.
Candyce H
CH
Kroenke
Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY.
Howard
H
Strickler
Division of Epidemiology, New York University School of Medicine, New York, NY.
Richard B
RB
Hayes
Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Robert E
RE
Schoen
Division of Gastroenterology, Massachusetts General Hospital, Boston, MA.|Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Dawn Q
DQ
Chong
Department of Epidemiology, University of Washington, Seattle, WA.|Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Emily
E
White
Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD.
Sonja I
SI
Berndt
Department of Epidemiology, University of Washington, Seattle, WA.|Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Ulrike
U
Peters
Department of Epidemiology, University of Washington, Seattle, WA.|Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Polly A
PA
Newcomb
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate
body mass index (BMI); cancer stage; colorectal cancer (CRC); mortality; survival