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1 Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria, Australia; 2 Centre for Genetic Epidemiology, University of Melbourne, Melbourne, Victoria, Australia; and 3 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Requests for reprints Graham G. Giles, Cancer Epidemiology Centre, Cancer Control Research Institute, The Cancer Council Victoria, 1 Rathdowne Street, Carlton South, Victoria 3053, Australia. Phone: +61-3-9635-5155; Fax: +61-3-9635-5330. E-mail: Graham.Giles{at}cancervic.org.au
Background: Several studies of male colon cancer have found positive associations with body size and composition. It is uncertain whether this relationship is due to non-adipose mass, adipose mass, distribution of adipose mass such as central adiposity, or all three. Methods: In a prospective cohort study of men aged 27–75 at recruitment in 1990–1994, body measurements were taken by interviewers. Fat mass and fat-free mass (FFM) were estimated from bioelectrical impedance analysis. Waist circumference and waist-to-hips ratio (WHR) estimated central adiposity. Incident colon cancers were ascertained via the population cancer registry. Altogether, 16,556 men contributed 145,433 person-years and 153 colon cancers. Results: Rate ratios (RRs) comparing men in the fourth quartile with those in the first quartile were as follows: FFM 2.3 [95% confidence interval (CI) 1.4–3.7]; height 1.9 (95% CI 1.1–3.1); waist circumference 2.1 (95% CI 1.3–3.5); WHR 2.1 (95% CI 1.3–3.4); fat mass 1.8 (95% CI 1.1–3.0); and body mass index 1.7 (95% CI 1.1–2.8). When continuous measures of FFM and WHR were modeled together, the RR for FFM per 10 kg was 1.37 (95% CI 1.04–1.80) and the RR for WHR per 0.1 unit was 1.65 (95% CI 1.28–2.13). After adjustment for FFM and WHR, the RRs for fat mass and body mass index were no longer statistically significant. Conclusion: Male colon cancer appears to be related to body size and composition by two different pathways, via central adiposity and via non-adipose mass.
Key Words: Colon cancer • anthropometry • bioelectrical impedance analysis • cohort study • Australia
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