Cancer Causes & Control

, Volume 25, Issue 10, pp 1407–1418

Postdiagnosis body mass index and risk of mortality in colorectal cancer survivors: a prospective study and meta-analysis

  • Sabrina Schlesinger
  • Sabine Siegert
  • Manja Koch
  • Jessica Walter
  • Nils Heits
  • Sebastian Hinz
  • Gunnar Jacobs
  • Jochen Hampe
  • Clemens Schafmayer
  • Ute Nöthlings
Original paper

DOI: 10.1007/s10552-014-0435-x

Cite this article as:
Schlesinger, S., Siegert, S., Koch, M. et al. Cancer Causes Control (2014) 25: 1407. doi:10.1007/s10552-014-0435-x

Abstract

Purpose

Aim of this study was to investigate the association between postdiagnosis body mass index (BMI) and all-cause mortality in colorectal cancer (CRC) survivors in a prospective study and meta-analysis.

Methods

We conducted a prospective cohort study on 2,143 CRC survivors in Germany. Participants were recruited to the study on average 4 years after diagnosis, and postdiagnosis BMI was assessed at recruitment using a self-administered questionnaire. CRC survivors were followed up for a mean time of 3.5 years. The association between BMI and all-cause mortality was investigated using multivariable Cox proportional hazards models. Additionally, we performed a meta-analysis of studies on postdiagnosis BMI and all-cause mortality (n = 5, including this study) by applying random-effects models.

Results

In the prospective analysis, 349 participants died. BMI was not statistically significantly associated with all-cause mortality. Compared to normal weight survivors, the hazard ratios (HRs) [95 % confidence interval (CI)] for all-cause mortality in underweight, overweight and obese survivors were 1.65 (0.79–3.45), 0.80 (0.62–1.03) and 0.84 (0.62–1.14), respectively. In the meta-analysis, individuals with underweight were at increased risk for all-cause mortality [HR (95 % CI) 1.72 (1.18–2.49)], whereas individuals with overweight had a lower risk [HR (95 % CI) 0.79 (0.71–0.88)], compared to normal weight subjects. For obesity, the risk of mortality was also reduced with only borderline significance [HR (95 % CI) 0.88 (0.77–1.00)].

Conclusions

While the present study as well as single previously published studies showed that overweight was associated with a non-significant reduced risk for all-cause mortality, our meta-analysis indicated a decreased mortality risk among overweight CRC survivors.

Keywords

Body mass index Colorectal neoplasms Mortality Survivors 

Supplementary material

10552_2014_435_MOESM1_ESM.docx (220 kb)
Supplementary material 1 (DOCX 219 kb)

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Sabrina Schlesinger
    • 1
  • Sabine Siegert
    • 1
  • Manja Koch
    • 1
  • Jessica Walter
    • 2
  • Nils Heits
    • 2
  • Sebastian Hinz
    • 2
  • Gunnar Jacobs
    • 3
  • Jochen Hampe
    • 4
  • Clemens Schafmayer
    • 2
  • Ute Nöthlings
    • 5
    • 6
  1. 1.Institute of EpidemiologyChristian-Albrechts University of KielKielGermany
  2. 2.Department of General and Thoracic SurgeryUniversity Hospital Schleswig-HolsteinKielGermany
  3. 3.PopGen BiobankUniversity Hospital Schleswig-HolsteinKielGermany
  4. 4.Department of General Internal MedicineUniversity Hospital Schleswig-HolsteinKielGermany
  5. 5.Nutritional Epidemiology, Department of Nutrition and Food ScienceUniversity BonnBonnGermany
  6. 6.Section of Epidemiology, Institute for Experimental MedicineChristian-Albrechts University of KielKielGermany

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