? 2013 American Society for Nutrition.
Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study1, 2, 3, 4.
Charlotte N Steins Bisschop , .
Carla H van Gils , .
Marleen J Emaus , .
H Bas Bueno-de-Mesquita , .
Evelyn M Monninkhof , .
Heiner Boeing , .
Krasmira Aleksandrova , .
Mazda Jenab , .
Teresa Norat , .
Elio Riboli , .
Marie-Christine Boutron-Rualt , .
Guy Fagherazzi , .
Antoine Racine , .
Domenico Palli , .
Vittorio Krogh , .
Rosario Tumino , .
Alessio Naccarati , .
Amalia Mattiello , .
Marcial Vicente Arg锟斤拷elles , .
Maria Jos锟斤拷 Sanchez , .
Maria Jos锟斤拷 Tormo , .
Eva Ardanaz , .
Miren Dorronsoro , .
Catalina Bonet , .
Kay-Tee Khaw , .
Tim Key , .
Antonia Trichopoulou , .
Philippos Orfanos , .
Androniki Naska , .
Rudolph R Kaaks , .
Annekatrin Lukanova , .
Tobias Pischon , .
Ingrid Ljuslinder , .
Karin Jirstr?m , .
Bodil Ohlsson , .
Kim Overvad , .
Tina Landsvig Berentzen , .
Jytte Halkjaer , .
Anne Tjonneland , .
Elisabete Weiderpass , .
Guri Skeie , .
Tonje Braaten , .
Peter D Siersema , .
Heinz Freisling , .
Pietro Ferrari , .
Petra HM Peeters , and .
Anne M May .
1From the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands (CNSB, CHvG, EMM, PHMP, and AMM); the National Institute for Public Health and the Environment, Bilthoven, Netherlands (HBB-d-M); the Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands (HBB-d-M); the Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbr锟斤拷cke, Nuthetal, Germany (HB and KA); the International Agency for Research on Cancer, WHO, Lyon, France (MJ, HF, and PF); the Division of Epidemiology, Public Health and Primary Care, Imperial College, London, United Kingdom (HBB-d-M, TN, ER, and PHMP); INSERM, Centre for Research in Epidemiology and Population Health, Nutrition, Hormones and Women's Health Team, Villejuif, France (MB-R, GF, and AR); University of Paris, Sud, Villejuif, France (MB-R, GF, and AR); IGR, Villejuif, France (MB-R, GF, and AR); Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute锟紺ISPO, Florence, Italy (DP); the Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (VK); the Cancer Registry and Histopathology Unit, 锟斤拷Civile M.P. Arezzo锟斤拷 Hospital, ASP Ragusa, Italy (RT); HuGeF锟紺Human Genetics Foundation锟紺Torino, Molecular and Genetic Epidemiology Unit, Torino, Italy (A Naccarati); Dipartimento di Medicina Clinica e Chirugia, FEDERICO II University, Naples, Italy (AM); Public Health Directorate, Asturias, Spain (MVA); the Andalusian School of Public Health, Granada, Spain (MS and MJT); CIBER de Epidemiolog锟斤拷a y Salud P锟斤拷blica, Spain (MS, MJT, and EA); the Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain (MJT); the Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain (MJT); the Navarre Public Health Institute, Pamplona, Spain (EA); Subdirecci锟斤拷n de Salud P锟斤拷blica de Gipuzkoa, Gobierno Vasco, San Sebastian, Spain (MD); the Department of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain (CB); Clinical Gerontology Unit University of Cambridge Cambridge, United Kingdom (KK); the Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom (TK); the Hellenic Health Foundation, Athens Greece (A Trichopoulou, PO, and A Naska); the WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (A Trichopoulou, PO, and A Naska); the Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany (RK); the Department of Radiation Sciences, Oncology, Ume? University Ume?, Sweden (IL); the Department of Clinical Sciences, Division of Pathology, Lund University, Lund, Sweden (KJ); the Department of Clinical Sciences, Division of Internal Medicine, Skane University Hospital, Malm?, Lund University, Lund, Sweden (BO); the Department of Epidemiology, Institute of Public Health, Aarhus University, Aarhus, Denmark (KO); the Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark (TL); the Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark (JH, A Tjonneland, EW, GS, and TB); the Department of Research, Cancer Registry of Norway, Oslo, Norway (EW); the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (EW); Samfundet Folkh?lsan, Helsinki, Finland (EW); the Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, Netherlands (PDS); the Max-Delbr锟斤拷ck-Centrum f锟斤拷r Molekulare Medizin Berlin-Buch, Molecular Epidemiology Group, Berlin, Germany (TP); the Hormones and Cancer Group, Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany (AL); and the Department of Medical Biosciences, Pathology, Ume? University, Ume?, Sweden (AL). .
?2 CNSB received funding from the Dutch Cancer Society (UU 2009-4473). The EPIC-PANACEA project received funding from the Public Health Programme of the European Union (2005328). 锟斤拷Europe Against Cancer Programme锟斤拷 of the European Commission; French League against Cancer; National Institute for Health and Medical Research, France; Mutuelle Ge0ne0rale de l'Education Nationale, France; 3 M Co, France; Gustave Roussy Institute, France; and the General Councils of France; German Cancer Aid; German Cancer Research Centre; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund of the Spanish Ministry of Health (Exp P10710130), Regional Governments of Andaluc??a, Asturias, Basque Country, Murcia (no. 6236), Navarra, and the Catalan Institute of Oncology, La Caixa (BM 06-130), RTICC-RD06/0020 (Spain); Cancer Research UK; Medical Research Council, United Kingdom; Stroke Association, United Kingdom; British Heart Foundation; Department of Health, United Kingdom; Food Standards Agency, United Kingdom; Wellcome Trust, United Kingdom; the Hellenic Health Foundation, Greece; Italian Association for Research on Cancer; Italian National Research Council; Fondazione-Istituto Banco Napoli, Italy; Compagnia di San Paolo; Dutch Ministry of Public Health, Welfare and Sports; Dutch Prevention Funds; LK Research Funds; Dutch Zorg Onderzoek Nederland; World Cancer Research Fund; Statistics Netherlands, The Netherlands; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; and Nordforsk Centre of Excellence Programme in Food, Nutrition and Health (Helga), Norway.
?3 Address reprint requests to AM May, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands. E-mail: a.m.may{at}umcutrecht.nl .
?4 Address correspondence to CN Steins Bisschop, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands. E-mail: cnsteinsbisschop{at}gmail.com .
Abstract.
Background: A moderate association exists between body mass index (BMI) and colorectal cancer. Less is known about the effect of weight change.
Objective: We investigated the relation between BMI and weight change and subsequent colon and rectal cancer risk.
Design: This was studied among 328,781 participants in the prospective European Prospective Investigation into Cancer锟紺Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating study (mean age: 50 y). Body weight was assessed at recruitment and on average 5 y later. Self-reported weight change (kg/y) was categorized in sex-specific quintiles, with quintiles 2 and 3 combined as the reference category (men: ?0.6 to 0.3 kg/y; women: ?0.4 to 0.4 kg/y). In the subsequent years, participants were followed for the occurrence of colon and rectal cancer (median period: 6.8 y). Multivariable Cox proportional hazards regression analyses were used to study the association.
Results: A total of 1261 incident colon cancer and 747 rectal cancer cases were identified. BMI at recruitment was statistically significantly associated with colon cancer risk in men (HR: 1.04; 95% CI: 1.02, 1.07). Moderate weight gain (quintile 4) in men increased risk further (HR: 1.32; 95% CI: 1.04, 1.68), but this relation did not show a clear trend. In women, BMI or weight gain was not related to subsequent risk of colon cancer. No statistically significant associations for weight loss and colon cancer or for BMI and weight changes and rectal cancer were found.
Conclusion: BMI attained at adulthood was associated with colon cancer risk. Subsequent weight gain or loss was not related to colon or rectal cancer risk in men or women.
Received May 14, 2013. .
Accepted October 30, 2013. .
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