Body mass index and risk of colorectal cancer in women (United States)
Body mass index and risk of colorectal cancer in women (United States)
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DOI：
10.1023/b:caco.0000036168.23351.f1
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发表时间：
2004-08-01
影响因子：
2.3
通讯作者：
Buring, JE
中科院分区：
文献类型：
--
作者：
Lin, J;Zhang, SM;Buring, JE
目的：有关肥胖与女性结直肠癌风险的流行病学数据尚无定论。最近的两项研究表明，雌激素状态可能会改变这种关联。在雌激素暴露量高的女性[绝经前女性和目前接受绝经后激素治疗 (PMH) 的绝经后女性]中，BMI 与结直肠癌风险呈正相关。我们前瞻性地调查了 BMI 在结直肠癌风险中的作用以及雌激素在女性健康研究的一个大队列中的改变作用。方法：在 39,876 名基线年龄大于或等于 45 岁、表面上健康的女性中（其中 54% 为绝经后），其中 37,671 人符合本研究的资格。在平均 8.7 年的随访中，202 名女性被确诊患有结直肠癌。基线BMI的计算方法是用自我报告的体重（公斤）除以身高（米）的平方。结果：结直肠癌的多变量相对风险（RR）和95％置信区间（CI）对于27-29.9 kg/m（2）为1.72（1.12-2.66），对于大于或等于30 kg/m（2）为1.67（1.08-2.59），与 BMI < 23 kg/m(2) 相比（趋势 p = 0.02）。这种正相关主要见于近端结肠（趋势 p = 0.004）。当根据绝经后妇女的 PMH 使用情况进一步检查这种关联时，我们发现 BMI 较高的当前使用者和从未使用者都面临更大的结直肠癌风险（BMI 和 PMH 使用之间的交互作用 p = 0.33）。与BMI<23 kg/m(2)相比，当前用户中27-29.9和大于或等于30 kg/m(2)的多变量RR和95% CI分别为1.98(0.98-3.99)和1.41(0.65-3.06)，以及1.05(0.42-2.65)和2.91 (1.40-6.06) 在从未使用者中。结论：这些数据表明，较高的 BMI 与结直肠癌风险升高相关，并且绝经后妇女中雌激素暴露并未改变这种正相关关系。
Objective: Epidemiologic data relating obesity to risk of colorectal cancer in women have been inconclusive. Two recent studies have suggested that the association may be modified by estrogen status; BMI was positively associated with colorectal cancer risk among women with high estrogen exposures [premenopausal women, and postmenopausal women who currently received postmenopausal hormone therapy (PMH)]. We prospectively investigated the role of BMI in colorectal cancer risk along with the modifying effects of estrogen in a large cohort from the Women's Health Study.Methods: Among 39,876 apparently healthy women aged greater than or equal to45 years at baseline (54% of them were postmenopausal), 37,671 were eligible for the present study. During an average of 8.7 years of follow-up, 202 women had a confirmed diagnosis of colorectal cancer. Baseline BMI was calculated by dividing self-reported weight in kilograms by height in meters squared.Results: The multivariate relative risks (RRs) and 95% confidence interval (CI) of colorectal cancer were 1.72 (1.12-2.66) for 27-29.9 kg/m(2), and 1.67 (1.08-2.59) for greater than or equal to30 kg/m(2), as compared with BMI < 23 kg/m(2) (p for trend = 0.02). This positive association was seen primarily in the proximal colon (p for trend = 0.004). When the association was further examined according to PMH use among postmenopausal women, we found that both current and never users with higher BMI were at a greater risk of colorectal cancer (p for interaction between BMI and PMH use = 0.33). As compared with BMI < 23 kg/m(2), the multivariate RRs and 95% CI for 27-29.9 and greater than or equal to30 kg/m(2) were 1.98 (0.98-3.99) and 1.41 (0.65-3.06) among current users, and 1.05 (0.42-2.65) and 2.91 (1.40-6.06) among never users.Conclusions: These data suggest that higher BMI was associated with an elevated risk of colorectal cancer, and the positive relationship was not altered by estrogen exposure among postmenopausal women.