The underestimated impact of excess body weight on colorectal cancer risk: Evidence from the UK Biobank cohort

医学 危险系数 超重 生命银行 减肥 结直肠癌 队列 队列研究 置信区间 前瞻性队列研究 人口 肥胖 内科学 癌症 环境卫生 生物信息学 生物
作者
Fatemeh Safizadeh,Marko Mandic,Dianne Pulte,Tobias Niedermaier,Michael Hoffmeister,Hermann Brenner
出处
期刊:British Journal of Cancer [Springer Nature]
标识
DOI:10.1038/s41416-023-02351-6
摘要

Abstract Background The association between excess weight and colorectal cancer (CRC) risk may have been underestimated due to potential weight loss during pre-clinical sojourn time of CRC. We aimed to investigate this association and the corresponding population attributable fraction (PAF), accounting for prediagnostic weight loss. Methods Data from the UK Biobank prospective cohort were used. Multivariable adjusted hazard ratios (HR) and their 95% confidence intervals (CI) for various periods of follow-up and the corresponding PAF of excess weight were calculated. Results During a median of 10.0 years of follow-up, of 453,049 participants, 4794 developed CRC. The excess weight–CRC association became substantially stronger with including increasing lengths of follow-up in the analyses and further excluding the initial years of follow-up. HRs (95% CIs) for overweight and obesity were 1.06 (0.97–1.16) and 1.14 (1.03–1.26) after 7 years of follow-up, 1.13 (1.05–1.21) and 1.23 (1.14–1.33) when including complete follow-up length, and 1.26 (1.12–1.43) and 1.42 (1.24–1.63) when excluding the initial 7 years of follow-up. The corresponding PAFs of excess weight were estimated as 6.8%, 11.3%, and 19.0%, respectively. Conclusions Comprehensive consideration of the potential effect of prediagnostic weight loss discloses a much stronger impact of excess body weight on CRC risk than previously assumed.

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