This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stürmer, T. Articles by Glynn, R. J. Search for Related Content PubMed PubMed Citation Articles by Stürmer, T. Articles by Glynn, R. J.

Metabolic Abnormalities and Risk for Colorectal Cancer in the Physicians' Health Study

Divisions of ¹ Preventive Medicine, ² Pharmacoepidemiology and Pharmacoeconomics, and ³ Aging, Brigham and Women's Hospital and ⁴ Department of Ambulatory Care and Prevention, Harvard Medical School; Departments of ⁵ Epidemiology and ⁶ Biostatistics, Harvard School of Public Health; and ⁷ Massachusetts Veterans Epidemiology Research and Information Center, Boston Veterans Affairs Health Care System, Boston, Massachusetts

Requests for reprints: Til Stürmer, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue East, Boston, MA 02215. Phone: 617-278-0627; Fax: 617-731-3843. E-mail: til.sturmer{at}post.harvard.edu

Background: Obesity and diabetes are established risk factors for colorectal cancer but have mainly been assessed independently. There are few data about whether the metabolic syndrome, which refers to a clustering of cardiovascular disease risk factors thought to be related to insulin resistance, including obesity, type 2 diabetes, hyperlipidemia, and hypertension, is associated with colorectal cancer risk.

Methods: During and after the randomized trial of aspirin and ß-carotene, 22,071 healthy male physicians, initially ages 40 to 84 years, reported overweight (body mass index, 27 kg/m²), diabetes, elevated blood pressure (130/85 mmHg or use of antihypertensive medication), hypercholesterolemia (240 mg/dL or use of lipid-lowering medication), and occurrence of cancer on annual questionnaires. Adjusted relative risks (RR) and 95% confidence intervals (95% CI) for time-varying metabolic abnormalities and colorectal cancer were estimated using a multivariable proportional hazards model.

Results: During 369,966 person-years of follow-up (median, 19 years), 494 physicians developed colorectal cancer. With aging of the cohort, the prevalence of having two or more abnormalities increased from 13% to 35%. Overweight (RR, 1.4; 95% CI, 1.1-1.7) and diabetes (RR, 1.5; 95% CI, 1.1-2.0) were associated with increased risk for colorectal cancer, whereas elevated blood pressure (RR, 1.1; 95% CI, 0.9-1.3) and hypercholesterolemia (RR, 0.9; 95% CI, 0.7-1.1) were not. This model assessing metabolic abnormalities independently was more predictive for colorectal cancer than a model based on the number of abnormalities (each additional abnormality RR, 1.16; 95% CI, 1.05-1.29).

Conclusions: Out of the markers of the metabolic syndrome assessed, overweight and diabetes are risk factors for colorectal cancer, whereas, in contrast to their role in cardiovascular disease, elevated blood pressure and hypercholesterolemia are not. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2391–7)

This article has been cited by other articles:

				S. Sookoian, C. Gemma, T. F. Gianotti, A. Burgueno, G. Castano, and C. J. Pirola Genetic variants of Clock transcription factor are associated with individual susceptibility to obesity Am. J. Clinical Nutrition, June 1, 2008; 87(6): 1606 - 1615. [Abstract] [Full Text] [PDF]