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; Ari Shamiss

doi:10.1158/1055-9965.EPI-11-0531

DOI: 10.1158/1055-9965.EPI-11-0531 Published December 2011

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Figure 1.
Cumulative incidence of colon (A) or rectal cancer (B), according to adolescent BMI (≥85th or <85th percentile). A, cumulative incidence of colon cancer according to BMI in adolescence. B, cumulative incidence curves of rectal cancer according to BMI in adolescence.

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Table 1.

Baseline characteristics of the study cohort of Israeli males examined between 1967 and 2005 and followed up to 2006

Total cohort
N	1,109,864
Age at BMI measurement
Mean age ± SD, y	17.3 ± 0.43
16 y, n (%)	90,714 (8.2)
17 y, n (%)	939,471 (84.6)
18 y, n (%)	63,536 (5.7)
19 y, n (%)	16,143 (1.5)
BMI at measurement
BMI < 85th percentile
n (%)	971,393 (87.5)
Mean BMI, kg/m²	20.6 ± 2.05
BMI ≥ 85th percentile
n (%)	138,471 (12.5)
Mean BMI, kg/m²	26.9 ± 2.87
BMI by quintiles
Q1 (≤19.01 kg/m²)	17.9 ± 0.86
Q2 (19.02–20.33 kg/m²)	19.7 ± 0.38
Q3 (20.34–21.67 kg/m²)	21.0 ± 0.38
Q4 (21.68–23.62 kg/m²)	22.5 ± 0.56
Q5 (≥ 23.63 kg/m²)	26.4 ± 2.87
Place of residence (%)
Urban	88.4
Rural	12.5
Immigration (%)
Israeli born	82.6
Immigrants	17.4
Origin (%)
Europe	41.7
Asia	26.6
Africa	26.1
Israel	5.2
Years of follow-up
Mean ± SD (range)	17.6 ± 10.9 (0.5–40)
Cumulative (person-years)	19,564,191

Table 2.

Cox proportional HRs for CRC, according to baseline BMI (<85th or >85th percentile) in 1,109,864 males examined between 1967 and 2005 and followed up through 2006

Cancer (n)	Adjusted HR (95% CI)^a	P
Colon (445)
BMI < 85th (380)	1.0 (referent)	0.002
BMI ≥ 85th (65)	1.53 (1.17–2.00)
Rectum (193)
BMI < 85th (173)	1.0	0.723
BMI ≥ 85th (20)	1.09 (0.68–1.73)
Colorectal, nonmucinous (537)
BMI < 85th (461)	1.0	0.002
BMI ≥ 85th (76)	1.49 (1.16–1.90)
Colon, nonmucinous (368)
BMI < 85th (310)	1.0	0.001
BMI ≥ 85th (58)	1.68 (1.26–2.23)
Colorectal, mucinous (101)
BMI < 85th (92)	1.0	0.869
BMI ≥ 85th (9)	0.94 (0.47–1.88)

↵^aCox proportional analysis adjusted for year of birth, age at BMI measurement, country of origin, residence (rural or urban), immigration status, socioeconomic status, and height.

Table 3.

Cox proportional HRs for CRC, according to baseline BMI (divided into quintiles) in 1,109,864 males examined in 1967 to 2005 and followed up through 2006

Cancer (n)	Adjusted HR (95% CI)^a	P
Colon (445)
Quintile 1 (68)	1.0 (referent)
Quintile 2 (89)	1.10 (0.80–1.53)	0.534
Quintile 3 (97)	1.14 (0.93–1.57)	0.412
Quintile 4 (78)	0.96 (0.69–1.33)	0.798
Quintile 5 (113)	1.69 (1.24–2.29)	0.001
Test for trend by quintile		0.001
Rectum (193)
Quintile 1 (42)	1.0
Quintile 2 (43)	0.82 (0.53–1.27)	0.367
Quintile 3 (44)	0.86 (0.56–1.32)	0.488
Quintile 4 (29)	0.52 (0.32–0.85)	0.009
Quintile 5 (35)	0.86 (0.54–1.34)	0.491
Test for trend by quintile		0.125
Colorectal, nonmucinous (537)
Quintile 1 (89)	1.0
Quintile 2 (113)	1.10 (0.83–1.46)	0.509
Quintile 3 (117)	1.07 (0.80–1.14)	0.652
Quintile 4 (93)	0.85 (0.63–13.1)	0.278
Quintile 5 (125)	1.43 (1.09–1.89)	0.011
Test for trend by quintile		0.004
Colorectal, mucinous (101)
Quintile 1 (21)	1.0
Quintile 2 (19)	0.57 (0.29–1.13)	0.109
Quintile 3 (24)	0.90 (0.50–1.63)	0.741
Quintile 4 (14)	0.55 (0.28–1.09)	0.088
Quintile 5 (23)	1.12 (0.62–2.02)	0.708
Test for trend by quintile		0.132

↵^aCox proportional analysis adjusted for year of birth, age at BMI measurement, country of origin, residence (rural or urban), immigration status, socioeconomic status, and height.

Table 4.

Cox proportional HRs for CRC, according to baseline BMI (<85th or >85th percentile) in 367,478 males born between 1947 and 1966 and followed up through 2006

Cancer (n)	Adjusted HR (95% CI)^a	P
Colon (390)
BMI < 85th (328)	1.0 (referent)	<0.001
BMI ≥ 85th (62)	1.75 (1.33–2.3.)
Rectum (171)
BMI < 85th (153)	1.0	0.580
BMI ≥ 85th (18)	1.14 (0.70–1.87)
Colorectal, nonmucinous (476)
BMI < 85th (417)	1.0	<0.001
BMI ≥ 85th (60)	1.66 (1.29–2.14)
Colon, nonmucinous (327)
BMI < 85th (275)	1.0	<0.001
BMI ≥ 85th (52)	1.86 (1.38–2.50)
Colorectal, mucinous (85)
BMI < 85th (77)	1.0	0.943
BMI ≥ 85th (8)	1.02 (0.49–2.13)

↵^aCox proportional analysis adjusted for year of birth, age at BMI measurement, country of origin, residence (rural or urban), immigration status, socioeconomic status, and height.