Obesity and colorectal cancer risk in women
Obesity and colorectal cancer risk in women
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DOI：
10.1136/gut.51.2.191
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发表时间：
2002-08-01
期刊：
影响因子：
24.5
通讯作者：
Rohan, TE
中科院分区：
文献类型：
--
作者：
Terry, PD;Miller, AB;Rohan, TE
背景：几项关于肥胖和结直肠癌风险的大型研究发现，女性之间没有关联，但男性之间存在合理一致的正关联。在女性中，按年龄分层分析的研究表明，在绝经前的女性中存在更强的或仅限于绝经前的正向关联，尽管之前没有研究根据绝经状态来检验这种关联。方法：我们使用比例风险分析来估计在加拿大国家乳房筛查研究中招募的89 835名年龄在40-59岁之间的女性中肥胖与结直肠癌风险相关的风险比，该研究是一项多中心乳房X光检查乳腺癌筛查的随机对照试验。在平均10.6年(936 433人年)的随访中，共有527名女性被诊断为结直肠癌(363例结肠癌和164例直肠癌)。结果：我们发现肥胖(体重指数大于或等于30 kg/m(2))与绝经前女性患结直肠癌的风险增加了近两倍(风险比1.88，95%可信区间1.24-2.86)。在绝经后女性中没有相关性(交互作用=0.01)，并且在整个队列中只有微弱的正相关。结论：我们的数据表明，肥胖与绝经前女性结直肠癌风险增加两倍相关，但与绝经后女性风险改变无关。更年期状态的影响修正可能更好地解释了先前研究中不一致或薄弱的结果，而不是假定女性之间缺乏联系。
Background: Several large studies of obesity and colorectal cancer risk have found no association among women but a reasonably consistent positive association among men. In women, a positive association that is stronger among, or limited to, those who are premenopausal has been suggested by studies that stratified analyses by age, although no previous study has examined the association by menopausal status.Methods: We used proportional hazards analyses to estimate hazard ratios relating obesity to colorectal cancer risk among 89 835 women aged 40-59 years at recruitment into the Canadian National Breast Screening Study, a multicentre randomised controlled trial of mammography screening for breast cancer. During an average 10.6 years of follow up (936 433 person years), a total of 527 women were diagnosed with incident colorectal cancer (363 colon and 164 rectal).Results: We found that obesity (body mass index greater than or equal to30 kg/m(2)) was associated with an approximately twofold increased risk of colorectal cancer among women who were premenopausal at baseline (hazard ratio 1.88, 95% confidence interval 1.24-2.86). There was no association among postmenopausal women (p for interaction=0.01), and there was only a weak positive association in the entire cohort.Conclusions: Our data suggest that obesity is associated with a twofold increased risk of colorectal cancer in premenopausal women but is not associated with altered risk in postmenopausal women. Effect modification by menopausal status may better explain the inconsistent or weak findings in previous studies than the presumed lack of an association among women.