Body Size, Weight Change, and Risk of Colon Cancer

Julie K. Bassett; Gianluca Severi; Dallas R. English; Laura Baglietto; Kavitha Krishnan; John L. Hopper; Graham G. Giles

doi:10.1158/1055-9965.EPI-10-0543

DOI: 10.1158/1055-9965.EPI-10-0543 Published November 2010

Article Figures & Data

Tables

Table 1.

Distribution of demographic and anthropometric characteristics by weight change

	Weight change since age 18 (kg)
	≤−3	>−3 to <3	3 to <10	10 to <20	≥20
Men (n = 16,188)
No. participants, n (%)	631 (4)	1,717 (11)	4,093 (25)	5,846 (36)	3,901 (24)
Age at study entry, mean (SD)	56.8 (9.2)	56.1 (9.1)	55.2 (9.0)	55.5 (8.7)	56.2 (8.5)
Weight change (kg), mean (SD)	−7.9 (5.8)	0.4 (1.6)	6.7 (2.0)	14.6 (2.8)	27.7 (7.3)
Weight at 18 y (kg), mean (SD)	78.9 (13.4)	70.8 (9.1)	68.6 (8.2)	66.7 (8.4)	63.8 (9.7)
Weight at study entry (kg), mean (SD)	71.0 (11.3)	71.3 (9.2)	75.3 (8.3)	81.4 (8.6)	91.5 (11.7)
Height at study entry (cm), mean (SD)	172.6 (7.5)	172.1 (7.4)	172.1 (7.3)	172.5 (7.3)	173.1 (7.4)
BMI at 18 y (kg/m²), mean (SD)	26.4 (4.0)	23.9 (2.7)	23.2 (2.3)	22.4 (2.4)	21.3 (2.8)
BMI at study entry (kg/m²), mean (SD)	23.8 (3.3)	24.1 (2.7)	25.4 (2.4)	27.4 (2.5)	30.6 (3.6)
Country of birth, n (%)
Australia	474 (75)	1,211 (71)	2,833 (69)	3,833 (66)	2,311 (59)
United Kingdom	45 (7)	166 (10)	351 (9)	487 (8)	294 (8)
Italy	60 (10)	182 (11)	517 (13)	888 (15)	614 (16)
Greek	52 (8)	158 (9)	392 (10)	638 (11)	682 (18)
Education, n (%)
≤Primary	87 (14)	233 (14)	620 (15)	1,028 (18)	950 (24)
Some high/technical	212 (34)	517 (30)	1,147 (28)	1,838 (31)	1,325 (34)
Completed high/technical	161 (26)	409 (24)	1,046 (26)	1,503 (26)	955 (25)
Degree/diploma	171 (27)	558 (33)	1,280 (31)	1,477 (25)	671 (17)
Women (n = 23,438)
No. participants, n (%)	1,198 (5)	2,633 (11)	6,068 (26)	7,950 (34)	5,589 (24)
Age at study entry, mean (SD)	55.0 (9.1)	54.1 (9.2)	54.1 (8.7)	55.2 (8.5)	55.9 (8.0)
Weight change (kg), mean (SD)	−7.4 (4.7)	0.5 (1.6)	6.6 (2.0)	14.6 (2.8)	28.6 (8.1)
Weight at 18 y (kg), mean (SD)	64.4 (10.9)	57.6 (7.7)	54.9 (6.9)	53.6 (7.1)	53.5 (8.0)
Weight at study entry (kg), mean (SD)	57.0 (9.1)	58.1 (7.6)	61.5 (7.0)	68.2 (7.6)	82.1 (11.7)
Height at study entry (cm), mean (SD)	160.3 (6.7)	160.5 (6.7)	160.1 (6.7)	159.8 (6.7)	160 (6.5)
BMI at 18 y (kg/m²), mean (SD)	25.1 (4.0)	22.4 (2.8)	21.4 (2.5)	21.0 (2.6)	21.0 (2.9)
BMI at study entry (kg/m²), mean (SD)	22.2 (3.3)	22.6 (2.8)	24.0 (2.7)	26.8 (3.0)	32.3 (4.6)
Country of birth, n (%)
Australia	936 (78)	2,048 (78)	4,619 (76)	5,679 (71)	3,528 (63)
United Kingdom	93 (8)	205 (8)	426 (7)	510 (6)	335 (6)
Italy	81 (7)	213 (8)	578 (10)	959 (12)	947 (17)
Greek	88 (7)	167 (6)	445 (7)	802 (10)	779 (14)
Education, n (%)
≤Primary	159 (13)	314 (12)	875 (14)	1,567 (20)	1,582 (28)
Some high/technical	491 (41)	1,066 (41)	2,530 (42)	3,598 (45)	2,468 (44)
Completed high/technical	231 (19)	520 (20)	1,169 (19)	1,387 (17)	887 (16)
Degree/diploma	317 (27)	733 (28)	1,494 (25)	1,398 (18)	652 (12)

NOTE: Percentages may not add up to 100% due to rounding.

Table 2.

HRs and 95% CIs for colon cancer in relation to weight and BMI

	Men		Women
	Cases (PY)	HR (95% CI)^*	Cases (PY)	HR (95% CI)^*
Weight at age 18 y (quartiles)
<61 kg/<50 kg	73 (56,370)	1.00	60 (72,766)	1.00
61 to <67 kg/50 to <54 kg	61 (58,551)	0.79 (0.55-1.11)	81 (80,481)	1.24 (0.88-1.73)
67 to <73 kg/54 to <59 kg	70 (52,479)	1.00 (0.70-1.41)	62 (85,169)	0.93 (0.64-1.34)
≥73/≥59 kg	73 (54,206)	1.05 (0.72-1.51)	89 (94,561)	1.25 (0.88-1.79)
Linear model (per 5 kg)^†	277 (221,606)	1.03 (0.94-1.12)	292 (332,977)	1.03 (0.94-1.14)
P for trend (linear model)		0.54		0.50
Weight at study entry (quartiles)
<73.0 kg/<59.8 kg	50 (55,504)	1.00	67 (83,762)	1.00
73.0 to <79.8 kg/59.8 to <66.3 kg	63 (55,853)	1.23 (0.84-1.80)	81 (83,009)	1.24 (0.89-1.72)
79.8 to <87.6 kg/66.3 to <74.7 kg	78 (55,662)	1.56 (1.08-2.28)	61 (83,311)	0.93 (0.65-1.33)
≥87.6 kg/≥74.7 kg	86 (54,587)	1.81 (1.22-2.68)	83 (82,896)	1.32 (0.93-1.86)
Linear model (per 5 kg)^†	277 (221,606)	1.12 (1.04-1.21)	292 (332,977)	1.04 (0.98-1.11)
P for trend (linear model)		<0.01		0.22
BMI at age 18 y
<18.5 kg/m²	18 (11,012)	1.46 (0.89-2.40)	28 (42,291)	0.79 (0.53-1.18)
18.5 to <23 kg/m² (reference)	135 (118,562)	1.00	180 (205,695)	1.00
23 to <25 kg/m²	70 (53,675)	1.08 (0.81-1.45)	53 (50,366)	1.18 (0.87-1.61)
≥25 kg/m²	54 (38,358)	1.21 (0.88-1.67)	31 (34,625)	1.07 (0.73-1.58)
Linear model (per 5 kg/m²)^†	277 (221,606)	1.05 (0.80-1.37)	292 (332,977)	1.19 (0.93-1.52)
P for trend (linear model)		0.73		0.16
BMI at study entry
<23 kg/m²	13 (22,766)	0.60 (0.32-1.13)	64 (75,853)	0.95 (0.67-1.36)
23 to <25 kg/m² (reference)	38 (38,972)	1.00	59 (63,349)	1.00
25 to <30 kg/m²	160 (118,719)	1.31 (0.91-1.87)	102 (121,574)	0.84 (0.61-1.17)
≥30 kg/m²	66 (41,150)	1.51 (1.00-2.28)	67 (72,201)	1.00 (0.70-1.44)
Linear model (per 5 kg/m²)^†	277 (221,606)	1.39 (1.12-1.71)	292 (332,977)	1.01 (0.86-1.18)
P for trend (linear model)		<0.01		0.90

Abbreviation: PY, person-years.

↵*Models adjusted for country of birth, education, processed and fresh meat consumption, fruit and vegetable consumption, fat intake, daily energy intake, smoking status, and alcohol consumption and stratified by sex. Models with weight at age 18 y or weight at study entry were also adjusted for height at study entry.
↵^†Test for heterogeneity in the HRs between men and women, for weight at age 18 y (P = 0.92), weight at study entry (P = 0.12), BMI at age 18 y (P = 0.49), and BMI at study entry (P = 0.02).

Table 3.

HRs and 95% CIs for colon cancer in relation to weight change

Weight change category	Men		Women
Weight change category	Cases (PY)	HR (95% CI)^*	Cases (PY)	HR (95% CI)^*
≤−3 kg	8 (8,370)	0.68 (0.31-1.50)	17 (16,651)	0.90 (0.50-1.62)
>−3 to <3 kg (reference)	29 (23,271)	1.00	37 (36,968)	1.00
3 to <10 kg	58 (56,260)	0.92 (0.59-1.44)	73 (86,306)	0.88 (0.59-1.31)
10 to <20 kg	94 (80,478)	1.05 (0.68-1.60)	91 (113,454)	0.81 (0.55-1.20)
≥20 kg	88 (53,228)	1.47 (0.94-2.31)	74 (79,598)	0.96 (0.64-1.44)
Linear model (per 5 kg)^†	277 (221,606)	1.11 (1.03-1.20)	292 (332,977)	1.00 (0.94-1.07)
P for trend (linear model)		<0.01		0.95

↵*Adjusted for country of birth, weight at age 18 and height at study entry, education, processed and fresh meat consumption, fruit and vegetable consumption, fat intake, daily energy intake, smoking status, and alcohol consumption and stratified by sex.
↵^†Test for heterogeneity in the HRs for weight change between men and women (P = 0.04).

Table 4.

HRs and 95% CIs for colon cancer in relation to weight change by tumor subsite

Weight change category	Men		Women
Weight change category	Cases	HR (95% CI)^*	Cases	HR (95% CI)^*
Proximal
≤−3 kg	5	1.04 (0.35-3.08)	9	0.72 (0.32-1.59)
>−3 to <3 kg (reference)	11	1.00	24	1.00
3 to <10 kg	31	1.37 (0.69-2.71)	39	0.73 (0.44-1.20)
10 to <20 kg	50	1.63 (0.85-3.10)	54	0.73 (0.46-1.18)
≥20 kg	41	2.12 (1.10-4.10)	44	0.86 (0.53-1.40)
Linear model (per 5 kg)^†	138	1.14 (1.03-1.25)	170	1.01 (0.92-1.10)
P for trend (linear model)		<0.01		0.89
Distal
≤−3 kg	2	0.36 (0.09-1.53)	7	1.31 (0.49-3.52)
>−3 to <3 kg (reference)	15	1.00	11	1.00
3 to <10 kg	24	0.69 (0.36-1.32)	29	1.17 (0.59-2.33)
10 to <20 kg	41	0.78 (0.42-1.44)	30	0.92 (0.46-1.82)
≥20 kg	41	1.11 (0.58-2.11)	24	1.07 (0.53-2.18)
Linear model (per 5 kg)^†	123	1.09 (0.97-1.22)	101	0.98 (0.88-1.10)
P for trend (linear model)		0.14		0.72

↵*Adjusted for country of birth, weight at age 18 and height at study entry, education, processed and fresh meat consumption, fruit and vegetable consumption, fat intake, daily energy intake, smoking status, and alcohol consumption and stratified by tumor subsite.
↵^†Test for heterogeneity in the HRs for weight change between proximal and distal subsite: P = 0.59 (men) and P = 0.72 (women).