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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Measured Body Mass Index in Adolescence and the Incidence of Colorectal Cancer in a Cohort of 1.1 Million Males

Zohar Levi, Jeremy D. Kark, Micha Barchana, Irena Liphshitz, Ofir Zavdi, Dorit Tzur, Estela Derazne, Moshe Furman, Yaron Niv, Barak Gordon, Arnon Afek and Ari Shamiss
Zohar Levi
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Jeremy D. Kark
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Micha Barchana
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Irena Liphshitz
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Ofir Zavdi
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Dorit Tzur
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Estela Derazne
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Moshe Furman
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Yaron Niv
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Barak Gordon
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Arnon Afek
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Ari Shamiss
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DOI: 10.1158/1055-9965.EPI-11-0531 Published December 2011
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Abstract

Background and Aims: The increasing prevalence of adolescent obesity affects adult health. We investigated the association of adolescent overweight with colorectal cancer incidence in a large cohort of males.

Methods: Body mass index (BMI) was measured in 1.1 million Jewish Israeli males who underwent a general health examination at ages 16 to 19 between 1967 and 2005. Overweight was defined as BMI ≥ 85th percentile of the standard U.S. distribution in adolescence. Colorectal cancer was identified by linkage with the Israel National Cancer Registry up to 2006. The mean follow-up period was 17.6 ± 10.9 years, reflecting 19.5 million person-years. Cox proportional hazards modeling was used.

Results: The prevalence of adolescent overweight increased from 9.9% to 16.8% in the first 10 and last 10 annual examination cohorts. Colon (n = 445) and rectal cancer (n = 193) cases were detected. Overweight predicted an increased risk of colon cancer [HR = 1.53; 95% confidence interval (CI), 1.17–2.02, P = 0.002] but not of rectal cancer (HR = 1.09; 95% CI, 0.38–1.73, P = 0.72). The risk was greatest for nonmucinous adenocarcinoma of the colon (HR = 1.68, 95% CI, 1.26–2.23, P = 0.001). The association of BMI ≥ 85th percentile with colon cancer was even more pronounced in analyses that were restricted to men followed until at least 40 years of age [N = 367,478; HR = 1.75 (95% CI, 1.33–2.3, P < 0.001)].

Conclusions: Adolescent overweight is substantially associated with colon cancer incidence in young to middle-aged adults.

Impact: These long-term sequelae add to the urgency to seriously address increasing childhood and adolescent obesity with its attendant increasing population impact. Cancer Epidemiol Biomarkers Prev; 20(12); 2524–31. ©2011 AACR.

  • Received June 6, 2011.
  • Revision received October 6, 2011.
  • Accepted October 6, 2011.
  • ©2011 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 20 (12)
December 2011
Volume 20, Issue 12
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Measured Body Mass Index in Adolescence and the Incidence of Colorectal Cancer in a Cohort of 1.1 Million Males
Zohar Levi, Jeremy D. Kark, Micha Barchana, Irena Liphshitz, Ofir Zavdi, Dorit Tzur, Estela Derazne, Moshe Furman, Yaron Niv, Barak Gordon, Arnon Afek and Ari Shamiss
Cancer Epidemiol Biomarkers Prev December 1 2011 (20) (12) 2524-2531; DOI: 10.1158/1055-9965.EPI-11-0531

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Measured Body Mass Index in Adolescence and the Incidence of Colorectal Cancer in a Cohort of 1.1 Million Males
Zohar Levi, Jeremy D. Kark, Micha Barchana, Irena Liphshitz, Ofir Zavdi, Dorit Tzur, Estela Derazne, Moshe Furman, Yaron Niv, Barak Gordon, Arnon Afek and Ari Shamiss
Cancer Epidemiol Biomarkers Prev December 1 2011 (20) (12) 2524-2531; DOI: 10.1158/1055-9965.EPI-11-0531
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