Prospective Investigation of Body Mass Index, Colorectal Adenoma, and Colorectal Cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
Prospective Investigation of Body Mass Index, Colorectal Adenoma, and Colorectal Cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
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DOI：
10.1200/jco.2012.48.4691
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发表时间：
2013-07-01
影响因子：
45.3
通讯作者：
Huang, Wen-Yi
中科院分区：
文献类型：
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作者：
Kitahara, Cari M.;Berndt, Sonja I.;Huang, Wen-Yi
肥胖一直与结直肠癌的风险增加有关，特别是在男性中。体重指数（BMI）是否对结直肠癌发展各阶段的风险有不同的影响尚不清楚。我们在一项大型筛查试验中评估了BMI与结直肠腺瘤发病率、腺瘤复发和癌症的关系，在该试验中，病例和对照组有同等的疾病检测机会。（1，213例），复发性腺瘤（752例）和偶发性结直肠癌（966例）男性和女性，年龄55至74岁，随机分配接受乙状结肠镜检查，作为前列腺，肺，结直肠，卵巢癌筛查试验我们使用多变量校正模型计算腺瘤发病率和复发率的比值比（OR）和95%CI，以及结直肠癌发病率的风险比（HR）和95%CI。（18.5至24.9 kg/m2），肥胖男性（30 kg/m2）的患者发生腺瘤的风险显著增加（OR，1.32; 95%CI，1.06至1.65）和结直肠癌（HR，1.48; 95%CI，1.16至1.89）以及复发性腺瘤的临界风险增加（OR，1.50; 95%CI，0.98至2.30）。没有协会被观察到无论是腺瘤或癌症women.Conclusion数据从这个大的前瞻性研究表明，肥胖是重要的，在整个自然史的结直肠癌，至少在男性，结直肠癌的预防工作应鼓励实现和维护一个健康的体重，除了定期筛查。
Purpose Obesity has consistently been linked to an increased risk of colorectal cancer, particularly among men. Whether body mass index (BMI) differentially influences the risk across the stages of colorectal cancer development remains unclear. We evaluated the associations of BMI with colorectal adenoma incidence, adenoma recurrence, and cancer in the context of a large screening trial, in which cases and controls had an equal chance for disease detection.Methods We prospectively evaluated the association between baseline BMI and the risk of incident distal adenoma (1,213 cases), recurrent adenoma (752 cases), and incident colorectal cancer (966 cases) among men and women, ages 55 to 74 years, randomly assigned to receive flexible sigmoidoscopy screening as part of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. We calculated odds ratios (ORs) and 95% CIs for adenoma incidence and recurrence, and hazard ratios (HRs) and 95% CIs for colorectal cancer incidence, using multivariable-adjusted models.Results Compared with normal-weight men (18.5 to 24.9 kg/m(2)), obese men ( 30 kg/m(2)) had significantly higher risk of incident adenoma (OR, 1.32; 95% CI, 1.06 to 1.65) and colorectal cancer (HR, 1.48; 95% CI, 1.16 to 1.89) and a borderline increased risk of recurrent adenoma (OR, 1.50; 95% CI, 0.98 to 2.30). No associations were observed for either adenoma or cancer in women.Conclusion Data from this large prospective study suggest that obesity is important throughout the natural history of colorectal cancer, at least in men, and colorectal cancer prevention efforts should encourage the achievement and maintenance of a healthy body weight in addition to regular screenings.