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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Research Article

Fetal Growth and Subsequent Maternal Risk of Colorectal Cancer

Casey Crump, Jan Sundquist, Weiva Sieh, Marilyn A. Winkleby and Kristina Sundquist
Casey Crump
1Department of Medicine, Stanford University, Stanford, California.
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  • For correspondence: kccrump@stanford.edu
Jan Sundquist
2Center for Primary Health Care Research, Lund University, Malmö, Sweden.
3Stanford Prevention Research Center, Stanford University, Stanford, California.
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Weiva Sieh
4Department of Health Research and Policy, Stanford University, Stanford, California.
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Marilyn A. Winkleby
3Stanford Prevention Research Center, Stanford University, Stanford, California.
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Kristina Sundquist
2Center for Primary Health Care Research, Lund University, Malmö, Sweden.
3Stanford Prevention Research Center, Stanford University, Stanford, California.
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DOI: 10.1158/1055-9965.EPI-15-0202
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Abstract

Background: High birth weight has been associated with subsequent increased risk of breast cancer in the infant's mother, possibly related to maternal estrogen and growth factor pathways. However, its association with maternal risk of colorectal cancer, the third most common cancer among women, is unknown.

Methods: We conducted a national cohort study of 1,838,509 mothers who delivered 3,590,523 babies in Sweden in 1973–2008, followed up for colorectal cancer incidence through 2009.

Results: There were 7,318 mothers diagnosed with colorectal cancer in 36.8 million person-years of follow-up. After adjusting for maternal age, body mass index, diabetes, and other potential confounders, high fetal growth was associated with a subsequent increased risk of colorectal cancer in the mother [incidence rate ratio (IRR) per additional 1 SD relative to mean birth weight for gestational age and sex, 1.05; 95% confidence intervals (CI), 1.03–1.07; P < 0.0001]. Each 1,000 g increase in the infant's birth weight was associated with a 12% increase in the mother's subsequent risk of colorectal cancer (IRR, 1.12; 95% CI, 1.07–1.17; P < 0.0001). Multiple gestation was also independently associated with increased maternal risk of colorectal cancer (IRR for twin or higher order vs. singleton, 1.22; 95% CI, 1.04–1.44; P = 0.02).

Conclusion: In this large cohort study, high fetal growth and multiple gestation were independently associated with subsequent higher maternal risk of colorectal cancer. These findings warrant further investigation of maternal growth factor and estrogen pathways in the etiology of colorectal cancer.

Impact: If confirmed, our findings may help identify subgroups of women at high risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev; 24(8); 1–6. ©2015 AACR.

  • Received February 25, 2015.
  • Revision received May 6, 2015.
  • Accepted May 18, 2015.
  • ©2015 American Association for Cancer Research.
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This OnlineFirst version was published on July 15, 2015
doi: 10.1158/1055-9965.EPI-15-0202

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Fetal Growth and Subsequent Maternal Risk of Colorectal Cancer
Casey Crump, Jan Sundquist, Weiva Sieh, Marilyn A. Winkleby and Kristina Sundquist
Cancer Epidemiol Biomarkers Prev July 15 2015 DOI: 10.1158/1055-9965.EPI-15-0202

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Fetal Growth and Subsequent Maternal Risk of Colorectal Cancer
Casey Crump, Jan Sundquist, Weiva Sieh, Marilyn A. Winkleby and Kristina Sundquist
Cancer Epidemiol Biomarkers Prev July 15 2015 DOI: 10.1158/1055-9965.EPI-15-0202
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