Prediagnosis body mass index and waist-hip circumference ratio in association with colorectal cancer survival

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• 作者：Nan Wang ; Nikhil K. Khankari ; Hui Cai ; Hong-Lan Li ; Gong Yang ; Yu-Tang Gao ; Yong-Bing Xiang ; Xiao-Ou Shu and Wei Zheng
• 刊名：International Journal of Cancer
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：140
• 期：2
• 页码：292-301
• 全文大小：319K
• ISSN：1097-0215

文摘

The association of obesity on survival among patients with colorectal cancer (CRC) has not been well characterized. We investigated the association of prediagnostic body mass index (BMI)/waist–hip ratio (WHR) and total/cause-specific mortality in CRC patients. Our study included 1,452 patients who participated in two large cohort studies and were diagnosed with CRC during follow-up period. Participants were measured for anthropometrics and interviewed to collect relevant information at baseline, prior to any cancer diagnosis. Data on site-specific cancer incidence and cause-specific mortality were obtained via in-person surveys and annual record linkage with cancer and vital statistics registries. Cox proportional hazard models were used to evaluate the associations of BMI and WHR with survival. A total of 547 participants died during the follow-up period, including 499 who died of CRC. Relative to normal BMI (18.5 to <25.0 kg/m²), obesity (BMI ≥ 30 kg/m²) was associated with increased mortality resulting from all causes [hazard ratio (HR) = 1.5, 95% confidence interval (CI): 1.1–2.1] and CRC (HR = 1.5, 95% CI: 1.1–2.1). Elevated risk of death was also found among underweight patients (BMI < 18.5 kg/m²), although not all risk estimates were statistically significant. Overweight BMI (25.0 to <30.0 kg/m²) was not associated with risk of death among CRC patients, nor was WHR. In conclusion, prediagnostic BMI was associated with survival among CRC patients following a U-shape pattern; obesity was associated with high mortality after CRC diagnosis. These findings provide support for maintaining healthy weight to improve the survival of CRC patients.