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 Moghaddam, A. A. Articles by Huxley, R. Search for Related Content PubMed PubMed Citation Articles by Moghaddam, A. A. Articles by Huxley, R. Related Collections Epidemiology and Prevention Epidemiology and Prevention: Screening, Behavior, and Survivorship

Obesity and Risk of Colorectal Cancer: A Meta-analysis of 31 Studies with 70,000 Events

The George Institute for International Health, Sydney, Australia

Requests for reprints: Rachel Huxley, The George Institute for International Health, P.O. Box M201, Missenden Road, Sydney, NSW 2050 Australia. Phone: 61-2-9657-0358; Fax: 61-2-9657-0301. E-mail: rhuxley{at}thegeorgeinstitute.org

Background: Colorectal cancer is the second most common cause of death and illness in developed countries. Previous reviews have suggested that obesity may be associated with 30% to 60% greater risk of colorectal cancer, but little consideration was given to the possible effect of publication bias on the reported association.

Methods: Relevant studies were identified through EMBASE and MEDLINE. Studies were included if they had published quantitative estimates of the association between general obesity [defined here as body mass index (BMI) 30 kg/m²] and central obesity (measured using waist circumference) and colorectal cancer. Random-effects meta-analyses were done, involving 70,000 cases of incident colorectal cancer from 31 studies, of which 23 were cohort studies and 8 were case-control studies.

Results: After pooling and correcting for publication bias, the estimated relative risk of colorectal cancer was 1.19 [95% confidence interval (95% CI), 1.11-1.29], comparing obese (BMI 30 kg/m²) with normal weight (BMI <25 kg/m²) people; and 1.45 (95% CI, 1.31-1.61), comparing those with the highest, to the lowest, level of central obesity. After correcting for publication bias, the risk of colorectal cancer was 1.41 (95% CI, 1.30-1.54) in men compared with 1.08 (95% CI, 0.98-1.18) for women (P_{heterogeneity} <0.001). There was evidence of a dose-response relationship between BMI and colorectal cancer: for a 2 kg/m² increase in BMI, the risk of colorectal cancer increased by 7% (4-10%). For a 2-cm increase in waist circumference, the risk increased by 4% (2-5%).

Conclusions: Obesity has a direct and independent relationship with colorectal cancer, although the strength of the association with general obesity is smaller than previously reported. (Cancer Epidemiol Biomarkers Prev 2007;16(12):2533–47)

This article has been cited by other articles:

				S. Pechlivanis, J. L. Bermejo, B. Pardini, A. Naccarati, L. Vodickova, J. Novotny, K. Hemminki, P. Vodicka, and A. Forsti Genetic variation in adipokine genes and risk of colorectal cancer Eur. J. Endocrinol., June 1, 2009; 160(6): 933 - 940. [Abstract] [Full Text] [PDF]

				L. G. Carvajal-Carmona, S. Spain, The CORGI Consortium, D. Kerr, R. Houlston, J.-B. Cazier, and I. Tomlinson Common variation at the adiponectin locus is not associated with colorectal cancer risk in the UK Hum. Mol. Genet., May 15, 2009; 18(10): 1889 - 1892. [Abstract] [Full Text] [PDF]

				E. L. Ashbeck, E. T. Jacobs, M. E. Martinez, E. W. Gerner, P. Lance, and P. A. Thompson Components of Metabolic Syndrome and Metachronous Colorectal Neoplasia Cancer Epidemiol. Biomarkers Prev., April 1, 2009; 18(4): 1134 - 1143. [Abstract] [Full Text] [PDF]

				E. T. Jacobs, D. J. Ahnen, E. L. Ashbeck, J. A. Baron, E. R. Greenberg, P. Lance, D. A. Lieberman, G. McKeown-Eyssen, A. Schatzkin, P. A. Thompson, et al. Association Between Body Mass Index and Colorectal Neoplasia at Follow-Up Colonoscopy: A Pooling Study Am. J. Epidemiol., March 15, 2009; 169(6): 657 - 666. [Abstract] [Full Text] [PDF]

				H. G Mulholland, L. J Murray, C. R Cardwell, and M. M Cantwell Glycemic index, glycemic load, and risk of digestive tract neoplasms: a systematic review and meta-analysis Am. J. Clinical Nutrition, February 1, 2009; 89(2): 568 - 576. [Abstract] [Full Text] [PDF]

				T. V. Clendenen, K. L. Koenig, R. E. Shore, M. Levitz, A. A. Arslan, and A. Zeleniuch-Jacquotte Postmenopausal Levels of Endogenous Sex Hormones and Risk of Colorectal Cancer Cancer Epidemiol. Biomarkers Prev., January 1, 2009; 18(1): 275 - 281. [Abstract] [Full Text] [PDF]

				G. C. Prendergast Metastasis, miRNAs, Multiple Myeloma, and More Cancer Reviews Online Content, January 1, 2008; 2008(1): 1 - 1. [Full Text] [PDF]