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Obesity is an initiator of colon adenomas but not a promoter of colorectal cancer in the Black Women’s Health Study

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Abstract

Purpose

Evidence for the association of anthropometrics with colorectal neoplasms is limited for African Americans.

Methods

We examined anthropometric measures with both colorectal adenoma and colorectal cancer (CRC) risk in the ongoing Black Women's Health Study. In a nested case–control analysis, 954 cases of colorectal adenoma were compared with 3,816 polyp-free controls, matched on age and follow-up time. For the CRC analyses, 413 incident CRC cases were identified over a 16-year follow-up (802,783 person-years). Adenoma cases and CRC were verified by medical record review. We used multivariable conditional logistic regression analyses (for adenoma) and Cox proportional hazards analyses (for CRC) that included anthropometric exposures and selected confounders.

Results

Overall body mass index (BMI) and other anthropometric factors were not associated with colorectal adenoma or cancer risk in Black women. However, increased risk of adenoma (but not CRC) was observed among especially related to adenomas in the proximal colon. Among women ≥ 50 years of age, risk of proximal adenoma increased 14% (95% CI 1.00, 1.31), 35% (95% CI 1.12, 1.63), and 25% (0.93, 1.68) with each standard deviation increase in BMI, waist circumference, and waist-to-hip ratio, respectively. None of the anthropometric factors were associated with young onset CRC or adenoma risk.

Conclusion

Our results suggest that obesity might be an initiator for colon adenomas but not a promoter for colorectal cancer among Black women.

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Acknowledgments

Data on colorectal cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, and VA), and results reported do not necessarily represent their views. The authors are grateful to the participants and staff of the BWHS.

Funding

This work was supported by National Cancer Institute grants R01 CA058420 (L. Rosenberg), UO1 CA164974 (L. Rosenberg). CD is supported by National Cancer Institute training grant K07 CA197112 (C.Dash). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

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Authors and Affiliations

  1. Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA

    Chiranjeev Dash, Sarah Nomura, Jiachen Lu & Lucile L. Adams-Campbell

  2. Slone Epidemiology Center at Boston University, Boston, MA, USA

    Jeffrey Yu, Lynn Rosenberg & Julie R. Palmer

  3. Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, 1000 New Jersey Ave SE, Washington, DC, 20003, USA

    Chiranjeev Dash & Lucile L. Adams-Campbell

Authors
  1. Chiranjeev Dash
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  2. Jeffrey Yu
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  3. Sarah Nomura
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  4. Jiachen Lu
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  5. Lynn Rosenberg
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  7. Lucile L. Adams-Campbell
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Correspondence to Lucile L. Adams-Campbell.

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Dash, C., Yu, J., Nomura, S. et al. Obesity is an initiator of colon adenomas but not a promoter of colorectal cancer in the Black Women’s Health Study. Cancer Causes Control 31, 291–302 (2020). https://doi.org/10.1007/s10552-020-01283-3

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  • DOI: https://doi.org/10.1007/s10552-020-01283-3

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