Prospective weight change and colon cancer risk in male US health professionals
Open accessAbstract
Epidemiological studies are remarkably consistent, especially among men, in showing that overweight and obesity [body mass index (BMI) >25] are associated with increased risk of colon cancer. However, no prospective studies address the influence of weight change in adulthood on subsequent colon cancer risk. In this study, we investigated whether weight change influences colon cancer risk utilizing prospectively collected weight data. We included 46,349 men aged 40–75 participating in the Health Professionals Follow‐Up Study. Questionnaires including items on weight were completed every second year during follow‐up from 1986 to 2004. Updated weight change between consecutive questionnaires during follow‐up and recalled weight gain since age 21 was evaluated. All eligible men were cancer‐free at baseline. Proportional hazard and restricted spline regression models were implemented. Over an 18‐year period, we documented 765 cases of colon cancer. Cumulative mean BMI >22.5 was associated with significantly increased risk of colon cancer. The short‐term weight change in the prior 2 to 4 years was positively and significantly associated with risk [HR = 1.14 (95% confidence interval, 1.00–1.29) for 4.54 kg (10 pounds) increment, p = 0.04 for overall trend]. Weight gain per 10 years since age 21 was associated with significantly increased risk [HR = 1.33 (1.12–1.58) for 4.54 kg increase per 10 years, p = 0.001]. We estimated that 29.5% of all colon cancer cases was attributable to BMI above 22.5. Our results add support that overweight and obesity are modifiable risk factors for colon cancer among men and suggest that weight has an important influence on colon cancer risk even in later life. © 2008 Wiley‐Liss, Inc.
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In these cohorts, body measurements and weight change are strong predictors of disease outcomes.
“Anthropometric measurements and weight changes strongly predict disease outcomes in these cohorts.20–26”
From Changes in diet and lifestyle and long-term weight gain in women and men (2011) · cites this paper as [25]
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“Consistent with findings from the Health Professionals Follow-up Study (22), we found no significant association with weight loss, though numbers of cancers were small.”
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“Three studies (22,55,56) investigated colon can-cer (CC) only, while the remaining one (54) examined both CC and CRC.”
BackgroundSelf-citationGibson, T. M., Park, Y., Robien, K., Shiels, M. S., Black, A., Sampson, J. N., Purdue, M. P., Freeman, L. E. B., Andreotti, G., Weinstein, S. J., et al. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2014.56.8444 · Cited by 80 · see citing works
Aleksandrova, K. (2012) · Frontiers in Bioscience-Elite · doi:10.2741/e596 · Cited by 74 · see citing works
“More recently, positive associations between adult weight gain and colon cancer risk have been reported by several cohort (53, 57, 60) and case-control studies (49, 61-63).”
BackgroundResultLaake, I., Thune, I., Selmer, R. M., Tretli, S., Slattery, M. L., & Veierød, M. B. (2010) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-09-0813 · Cited by 74 · see citing works
“The third study, also in men, found a positive trend for weight change and total colon cancer risk (36), but a positive association was found in the proximal colon only.”
BackgroundResultAn association between colonic adenoma and abdominal obesity: a cross-sectional study
Kim, Y., Kim, Y. J., & Lee, S. Y. (2009) · BMC Gastroenterology · doi:10.1186/1471-230x-9-4 · Cited by 72 · see citing works
Aleksandrova, K., Pischon, T., Buijsse, B., May, A. M., Peeters, P. H. M., Bueno-de-Mesquita, H. B., Jenab, M., Fedirko, V., Dahm, C. C., Siersema, P. D., et al. (2013) · European Journal of Cancer · doi:10.1016/j.ejca.2013.06.021 · Cited by 70 · see citing works
Kawashima, K., Maeda, K., Saigo, C., Kito, Y., Yoshida, K., & Takeuchi, T. (2017) · International Journal of Molecular Sciences · doi:10.3390/ijms18040866 · Cited by 65 · see citing works
“Data from HPFS (US Health Professionals Follow-Up Study) indicate that overweight is a modifiable risk factor for colon cancer among men [3].”
BackgroundLi, H., Yang, G., Xiang, Y.-B., Gao, J., Zhang, X., Zheng, W., Yt, G., & Shu, X.-O. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.152 · Cited by 63 · see citing works
“It has been suggested that menopausal status (21) and hormonal replacement therapy (HRT) (15, 41) may modify the association of body fatness and CRC.”
BackgroundMethodResultInfluentialSchlesinger, S., Lieb, W., Koch, M., Fedirko, V., Dahm, C. C., Pischon, T., Nöthlings, U., Boeing, H., & Aleksandrova, K. (2015) · Obesity Reviews · doi:10.1111/obr.12286 · Cited by 70 · see citing works
“Data for several studies (11,18,19) were additionally adapted as described in the succeeding text.”
BackgroundMethodResultInfluentialNa, S., & Myung, S. (2012) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2012.59.1.16 · Cited by 54 · see citing works
“2%의 대장암 환자가 과체중(BMI≥25 kg/m(2))에 원인 이 있다고 보고하였다.(13) Moghaddam 등(14)이 31개의 연구를 분석하여 2007년 발표한 메타-분석연구에서는 남자의 경우 정상 BMI 사람들에 비하여 비만(BMI≥30 kg/m(2)) 환자들에 서 대장암의 발생이 1.”
Sperrin, M., Marshall, A. D., Higgins, V., Buchan, I. E., & Renehan, A. G. (2013) · International Journal of Obesity · doi:10.1038/ijo.2013.161 · Cited by 54 · see citing works
Gribovskaja‐Rupp, I., Kosinski, L. A., & Ludwig, K. (2011) · Clinics in Colon and Rectal Surgery · doi:10.1055/s-0031-1295686 · Cited by 48 · see citing works
Obesity management — An opportunity for cancer prevention
Anderson, A. S., & Caswell, S. (2009) · The Surgeon · doi:10.1016/s1479-666x(09)80005-x · Cited by 46 · see citing works
Sun, W., Nie, W., Wang, Z., Zhang, H., Li, Y., & Fang, X. (2020) · OncoTargets and Therapy · doi:10.2147/ott.s246092 · Cited by 46 · see citing works
Impact of Obesity and Bariatric Surgery on Survival
Christou, N. V. (2009) · World Journal of Surgery · doi:10.1007/s00268-009-0050-2 · Cited by 46 · see citing works
“Obesity contributes to reduced life span because of several associated diseases including cardiovascular conditions [11], cancer [12–15], and diabetes [16–20].”
BackgroundSong, M., Hu, F. B., Spiegelman, D. L., Chan, A. T., Wu, K., Ogino, S., Fuchs, C. S., Willett, W. C., & Giovannucci, E. L. (2015) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-15-0061 · Cited by 45 · see citing works
“the HPFS, we observed a positive association between weight gain and colon cancer (3); however, that analysis was focused on late adulthood weight gain among only men, and did not examine associations with rectal cancer.”
BackgroundSelf-citationMorois, S., Mesrine, S., Josset, M., Clavel‐Chapelon, F., & Boutron‐Ruault, M. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwq258 · Cited by 45 · see citing works
Bisschop, C. N. S., van Gils, C. H., Emaus, M. J., Bueno-de-Mesquita, H. B., Monninkhof, E. M., Boeing, H., Aleksandrova, K., Jenab, M., Norat, T., Ríboli, E., et al. (2013) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.066530 · Cited by 44 · see citing works
“In addition, in line with our findings, most studies did not find an effect of weight loss on colon or rectal cancer risk in men (12), or in men and women (15).”
BackgroundResultShi, X., Deng, G., Wen, H., Lin, A., Wang, H., Zhu, L., Mou, W., Liu, Z., Li, X., Zhang, J., et al. (2024) · Journal of Global Health · doi:10.7189/jogh.14.04067 · Cited by 43 · see citing works
Seo, J. Y., Jin, E. H., Chung, G. E., Kim, Y. S., Bae, J. H., Yim, J. Y., Han, K., & Yang, S. Y. (2023) · Scientific Reports · doi:10.1038/s41598-023-36111-6 · Cited by 41 · see citing works
Park, J. Y., Mitrou, P. N., Keogh, R. H., Luben, R., Wareham, N. J., & Khaw, K. (2011) · International Journal of Obesity · doi:10.1038/ijo.2011.61 · Cited by 41 · see citing works
Simmen, F. A., & Simmen, R. C. M. (2011) · European Journal of Cancer Prevention · doi:10.1097/cej.0b013e328348fc21 · Cited by 36 · see citing works
“Maternal obesity and colorectal cancers Overweight and obesity are positively associated with increased colorectal cancer risk in men and to a lesser degree in women (Frezza et al., 2006; Dai et al., 2007; Kim et al., 2007; Nock et al., 2008; Thygesen et al., 2008).”
BackgroundInfluentialIs obesity an advantage in patients with colorectal cancer?
Kasi, P. M., Zafar, S. Y., & Grothey, A. (2015) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/17474124.2015.1089170 · Cited by 34 · see citing works
Giovannucci, E. L. (2018) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djy091 · Cited by 34 · see citing works
Self-citationGoday, A., Barneto, I., García‐Almeida, J. M., Blasco, A., Lecube, A., Grávalos, C., de Icaya, P. M., Peñas, R. D. L., Monereo, S., Vázquez, L., et al. (2015) · Clinical & Translational Oncology · doi:10.1007/s12094-015-1306-y · Cited by 28 · see citing works
Effects of high‐fat diet‐induced adipokines and cytokines on colorectal cancer development
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The role of the lipidome in obesity-mediated colon cancer risk
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“Waist circumference is an established marker for measuring obesity and the association between waist circumference measured at a single point in time and the risk of colorectal cancer is well established [20-25].”
BackgroundTran, T. P. T., Luu, N. M., Bui, T. T., Han, M., Lim, M. K., & Oh, J. (2022) · Obesity · doi:10.1002/oby.23464 · Cited by 19 · see citing works
“For men, a study in the US among 46,349 40- to 75-year-old individuals demonstrated that weight gain per 10-year intervals after age 21 years was associated with increased colon cancer risk (44), which was consistent with another study in Europe that showed moderate weight gain (0.”
ResultHenn, M., Glenn, A. J., Willett, W. C., Martínez‐González, M. Á., Sun, Q., & Hu, F. B. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.09.023 · Cited by 18 · see citing works
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Meng, M., Guo, M., Wang, P., Han, R., Zhou, J., & Wang, C. (2019) · Journal of Functional Foods · doi:10.1016/j.jff.2019.103578 · Cited by 16 · see citing works
Diet-induced weight loss leads to a switch in gene regulatory network control in the rectal mucosa
Vargas, A. J., Quackenbush, J. F., & Glass, K. (2016) · Genomics · doi:10.1016/j.ygeno.2016.08.001 · Cited by 14 · see citing works
“Although there are several reports of an association of intentional weight loss with reduced colorectal cancer [12] [13][14], many studies have been unable to find this association [15] [16] [17] [18].”
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“Conclusions about weight change and colon cancer from long-term retrospective and prospective epidemiological studies are unclear because of conflicting results among studies, which have found the incidence of colon cancer increases or does not change with weight gain, and decreases or does not change with weight loss…”
The Future Colorectal Cancer Burden Attributable to Modifiable Behaviors: A Pooled Cohort Study
Vajdic, C. M., MacInnis, R. J., Canfell, K., Hull, P., Arriaga, M. E., Hirani, V., Cumming, R. G., Mitchell, P., Byles, J., Giles, G. G., et al. (2018) · JNCI Cancer Spectrum · doi:10.1093/jncics/pky033 · Cited by 13 · see citing works
Molecular Biologic and Epidemiologic Insights for Preventability of Colorectal Cancer
Giovannucci, E. L. (2021) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djab229 · Cited by 12 · see citing works
Self-citationExpression of Genes Related to Lipid Handling and the Obesity Paradox in Melanoma: Database Analysis
Giampietri, C., Tomaipitinca, L., Scatozza, F., & Facchiano, A. (2020) · JMIR Cancer · doi:10.2196/16974 · Cited by 12 · see citing works
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Önal, A. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.73958 · Cited by 9 · see citing works
Ki-67 and Bcl-2 Antigen Expression in Adenomatous Colorectal Polyps from Women with Breast Cancer
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“Although some authors have shown that overweight and obesity, especially among men, are associated with increased risk of colon cancer, in the present study, both groups of women had normal BMI.18 The size of polyps has been shown in some studies to represent an important risk factor for the development of dysplasia a…”
BackgroundCiocan, A., Ciocan, R. A., Hajjar, N. A., Benea, A., Pandrea, S. L., Cătană, C.-S., Drugan, C., Oprea, V. C., Dîrzu, D. S., & Bolboaca, S. D. (2023) · Biomedicines · doi:10.3390/biomedicines11030894 · Cited by 6 · see citing works
“Data regarding body mass index (BMI) and blood type, known risk factors for CRC [30,31], were used to characterize the subjects included in the study.”
MethodFwelo, P., Adekunle, T. E., Adekunle, T. B., Garza, E. R., Huang, E. S., Lawrence, W. R., & Ewing, A. P. (2025) · Cancer Medicine · doi:10.1002/cam4.70612 · Cited by 5 · see citing works
“These disparities are driven by late-stage presentation, socioeconomic barriers, limited access to timely and comprehensive care, and systemic inequities in healthcare delivery [4, 16, 52].”
Anderson, L. N., Álvarez, E., Incze, T., Tarride, J., KWAN, M. Y. W., & Mbuagbaw, L. C. E. (2023) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01385-0 · Cited by 5 · see citing works
[Retracted] Female Colon Cancer Metastasis Pattern and Prognosis: A SEER‐Based Study
Liu, Y., Kang, R., Zheng, H., Wang, P., Jiang, W., Xiong, B., Chen, J., & Xu, J. (2022) · BioMed Research International · doi:10.1155/2022/3865601 · Cited by 5 · see citing works
RetractedBody Mass Index and Colorectal Cancer
Aykan, N. F., Artaç, M., & Özatlı, T. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.78617 · Cited by 4 · see citing works
Consequences and comorbidities associated with obesity
Ghouri, N., Clifton, P. M., Craigie, A. M., Anderson, A. S., Christensen, P., Waters, L., Williams, C., Coco, G. L., & Ricciardelli, L. A. (2017) · Wiley eBooks · doi:10.1002/9781118857991.ch2 · Cited by 4 · see citing works
Diet and Nutrition in the Etiology and Prevention of Cancer
Clinton, S. K., Grainger, E. M., & Giovannucci, E. L. (2017) · Holland‐Frei Cancer Medicine · doi:10.1002/9781119000822.hfcm037 · Cited by 3 · see citing works
Self-citationSaber, A., Alghamdi, A., Raggam, A. J., Alamoudi, L. O., Aljahdali, A., Bakheet, R., Algethmi, A. M., Khan, M. A., & Zaidi, S. F. (2022) · Cureus · doi:10.7759/cureus.32216 · Cited by 1 · see citing works
“5 notably increases the risk of colon cancer [28].”
BackgroundEnergy Imbalance and Cancer Risk
Keum, N. (2015) · Digital Access to Scholarship at Harvard (DASH) (Harvard University)
Adiposity and Cancer Risk: A Life Course Approach
Chan, H. T. H. (2016)
(2009) · Obesity Management · doi:10.1089/obe.2009.0101
Diet and Nutrition in the Etiology and Prevention of Cancer
Clinton, S. K., Giovannucci, E. L., Tabung, F. K., & Grainger, E. M. (2022) · Holland‐Frei Cancer Medicine · doi:10.1002/9781119000822.hfcm037.pub2
Self-citationMorois, S. (2011) · doi:10.70675/2dbb9b88z1e80z4a7bz9b96z14202d8acbe0
“Pour les cancers, les études sont plus nombreuses, et ont généralement décrit une augmentation de risque associée à une prise de poid s ou une augmentation d’IMC à l’âge adulte (151-155;155;156;158-161) (Annexe F).”
Background
- Authors
- Thygesen, L. C., Grønbæk, M., Johansen, C., Fuchs, C. S., Willett, W. C., & Giovannucci, E.
- Affiliations
- Harvard University (US)
- Danish National Institute of Public Health (DK)
- Danish Cancer Society (DK)
- Brigham and Women's Hospital (US)
- Corresponding author
- Thygesen, Lau Caspar
- ORCID
- Venue
- International Journal of Cancer
- Publisher
- Wiley
- Published
- 2008-06-10
- Volume
- 123
- Issue
- 5
- Pages
- 1160-1165
- ISSN
- 0020-7136 (ISSN-L)
- 1097-0215
- PMC
- PMC3965300
- OpenAlex
- W2046899109
- Cited by
- 78
- References
- 48
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 4 · 2022: 5 · 2021: 1 · 2020: 2 · 2019: 4 · 2018: 4 · 2017: 6 · 2016: 2 · 2015: 9 · 2014: 3 · 2013: 5 · 2012: 6
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Funders
- National Cancer Institute (CA-55075, P01CA055075)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK040561)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- colon cancer, weight change, weight gain, obesity, overweight, body mass index, men, Health Professionals Follow-up Study, cancer risk, attributable fraction, modifiable risk factors
- MeSH terms
- Adult, Aged, Colonic Neoplasms, Health Personnel, Humans, Life Style, Male, Middle Aged, Obesity, Prospective Studies, Surveys and Questionnaires, Regression Analysis, Risk Factors, United States, Weight Gain, Weight Loss, Body Mass Index, Proportional Hazards Models, Risk Assessment, Overweight
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