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Cited by 554Cancer Risks and FactorsColorectal Cancer Screening and DetectionObesity, Physical Activity, Diet

Body size and risk of colon and rectal cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Pischon, Tobias, Lahmann, Petra H., Boeing, Heiner, Friedenreich, Christine, Norat, Teresa, Tjønneland, Anne, Halkjaer, Jytte, Overvad, Kim +33 more·2006·JNCI Journal of the National Cancer Institute
DOI 10.1093/jnci/djj246
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Abstract

BACKGROUND: Body weight and body mass index (BMI) are positively related to risk of colon cancer in men, whereas weak or no associations exist in women. This discrepancy may be related to differences in fat distribution between sexes or to the use of hormone replacement therapy (HRT) in women. METHODS: We used multivariable adjusted Cox proportional hazards models to examine the association between anthropometric measures and risks of colon and rectal cancer among 368 277 men and women who were free of cancer at baseline from nine countries of the European Prospective Investigation Into Cancer and Nutrition. All statistical tests were two-sided. RESULTS: During 6.1 years of follow-up, we identified 984 and 586 patients with colon and rectal cancer, respectively. Body weight and BMI were statistically significantly associated with colon cancer risk in men (highest versus lowest quintile of BMI, relative risk [RR] = 1.55, 95% confidence interval [CI] = 1.12 to 2.15; P(trend) = .006) but not in women. In contrast, comparisons of the highest to the lowest quintile showed that several anthropometric measures, including waist circumference (men, RR = 1.39, 95% CI = 1.01 to 1.93; P(trend) = .001; women, RR = 1.48, 95% CI = 1.08 to 2.03; P(trend) = .008), waist-to-hip ratio (WHR; men, RR = 1.51, 95% CI = 1.06 to 2.15; P(trend) = .006; women, RR = 1.52, 95% CI = 1.12 to 2.05; P(trend) = .002), and height (men, RR = 1.40, 95% CI = 0.99 to 1.98; P(trend) = .04; women, RR = 1.79, 95% CI = 1.30 to 2.46; P(trend)<.001) were related to colon cancer risk in both sexes. The estimated absolute risk of developing colon cancer within 5 years was 203 and 131 cases per 100,000 men and 129 and 86 cases per 100,000 women in the highest and lowest quintiles of WHR, respectively. Upon further stratification, no association of waist circumference and WHR with risk of colon cancer was observed among postmenopausal women who used HRT. None of the anthropometric measures was statistically significantly related to rectal cancer. CONCLUSIONS: Waist circumference and WHR, indicators of abdominal obesity, were strongly associated with colon cancer risk in men and women in this population. The association of abdominal obesity with colon cancer risk may vary depending on HRT use in postmenopausal women; however, these findings require confirmation in future studies.

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  • For type 2 diabetes and certain cancers (e.g., colon), some studies suggest that waist circumference, waist-to-hip ratio, or direct measures of visceral adiposity are associated with risk independently of BMI.

    “For type 2 diabetes (20) as well as certain cancers (e.g., colon) (21), some studies suggest that waist circumference, waist-to-hip ratio, or direct measures of visceral adiposity are associated with risk independently of BMI.”

    From Diabetes and Cancer (2010) · cites this paper as [21]

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Authors
Pischon, T., Lahmann, P. H., Boeing, H., Friedenreich, C., Norat, T., Tjønneland, A., Halkjaer, J., Overvad, K., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Guernec, G., Bergmann, M. M., Linseisen, J., Becker, N., Trichopoulou, A., Trichopoulos, D., Sieri, S., Palli, D., Tumino, R., Vineis, P., Panico, S., Peeters, P. H. M., Bueno-de-Mesquita, H. B., Boshuizen, H. C., Van Guelpen, B., Palmqvist, R., Berglund, G., Gonzalez, C. A., Dorronsoro, M., Barricarte, A., Navarro, C., Martinez, C., Quirós, J. R., Roddam, A., Allen, N., Bingham, S., Khaw, K.-T., Ferrari, P., Kaaks, R., Slimani, N., & Riboli, E.
Affiliations
  • German Institute of Human Nutrition (DE)
  • Centre international de recherche sur le cancer (FR)
  • Danish Cancer Society (DK)
  • Aalborg University (DK)
  • German Cancer Research Center (DE)
  • National and Kapodistrian University of Athens (GR)
  • Fondazione IRCCS Istituto Nazionale dei Tumori (IT)
  • Istituto per lo Studio e la Prevenzione Oncologica (IT)
  • Imperial College London (GB)
  • University of Naples Federico II (IT)
  • Utrecht University (NL)
  • National Institute for Public Health and the Environment (NL)
  • Umeå University (SE)
  • Institut d'Investigació Biomédica de Bellvitge (ES)
  • Instituto de Salud Pública de Navarra (ES)
  • University of Oxford (GB)
  • Medical Research Council (GB)
  • University of Cambridge (GB)
Corresponding author
Pischon, Tobias
ORCID
Venue
JNCI Journal of the National Cancer Institute
Publisher
Oxford University Press (OUP)
Published
2006-07-05
Volume
98
Issue
13
Pages
920-931
ISSN
  • 0027-8874 (ISSN-L)
  • 1460-2105
DOI
10.1093/jnci/djj246
OpenAlex
W2146554041
Cited by
554
References
85
Citations by year
2026: 2 · 2025: 8 · 2024: 15 · 2023: 10 · 2022: 17 · 2021: 15 · 2020: 24 · 2019: 17 · 2018: 21 · 2017: 24 · 2016: 24 · 2015: 34 · 2014: 36 · 2013: 46 · 2012: 48
FWCI
21.89
Type
journal article
Language
en
Open access
closed
Locations
  • JNCI Journal of the National Cancer Institute (publishedVersion)
  • PubMed (publishedVersion)
  • Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
  • Rivm Repository (Netherlands National Institute for Public Health and the Environment) (submittedVersion)
  • OPUS (Augsburg University) (submittedVersion)
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, rectal cancer, body size, body mass index, body weight, waist circumference, waist-to-hip ratio, height, anthropometric measures, sex differences, hormone replacement therapy, body fat distribution, cancer risk, EPIC cohort, European Prospective Investigation into Cancer and Nutrition, abdominal obesity, diet and cancer risk
MeSH terms
Adult, Aged, Colonic Neoplasms, Europe, Feeding Behavior, Female, Follow-Up Studies, Humans, Life Style, Male, Middle Aged, Obesity, Prospective Studies, Rectal Neoplasms, Risk Factors, Sex Factors, Estrogen Replacement Therapy, Confounding Factors, Epidemiologic, Body Mass Index, Multivariate Analysis, Proportional Hazards Models, Sex Distribution, Postmenopause, Risk Assessment, Body Size, Waist-Hip Ratio, Abdominal Fat, Body Fat Distribution

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