Digestive Diseases and Sciences

, Volume 62, Issue 11, pp 3177–3185 | Cite as

Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia

  • Wambui G. Gathirua-Mwangi
  • Patrick Monahan
  • Yiqing Song
  • Terrell W. Zollinger
  • Victoria L. Champion
  • Timothy E. Stump
  • Thomas F. Imperiale
Original Article



Waist circumference (WC) is a stronger predictor of colon cancer (CRC) risk than body mass index (BMI). However, how well change in either WC or BMI predicts risk of advanced colorectal neoplasia (AN) is unclear.


To determine the relationship between change in BMI and WC from early adulthood to later age and the risk of AN and which change measure is a stronger predictor.


In 4500 adults, ages 50–80, with no previous neoplasia and undergoing screening colonoscopy, BMI and WC at age 21 and at time of screening were reported. Changes in BMI and WC were defined using universal risk cutoffs. Known CRC risk factors were controlled in the logistic models.


Overall, model statistics showed WC change (omnibus test χ 2 = 10.15, 2 DF, p value = 0.006) was a statistically stronger predictor of AN than BMI change (omnibus test χ 2 = 5.66, 5 DF, p value = 0.34). Independent of BMI change, participants who increased WC (OR 1.44; 95% CI 1.05–1.96) or maintained a high-risk WC (OR 2.50; 95% CI 1.38–4.53) at age 21 and at screening had an increased risk of AN compared to those with a low-risk WC. Study participants who were obese at age 21 and at screening had an increased risk of AN (OR 1.87; 95% CI 1.08–3.23) compared to those who maintained a healthy BMI. Maintaining an overweight BMI or increasing BMI was not associated with AN.


Maintaining an unhealthy BMI and WC throughout adult life may increase risk of AN. WC change may be a better predictor of AN than BMI change.


Obesity BMI change Waist circumference change Colorectal neoplasia Cancer Precancerous polyps 


Financial support

Dr. Gathirua-Mwangi is a postdoctoral appointee funded by a supplemental grant under R01CA196243 (PIs: Drs. Champion and Paskett). Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Numbers 3R01CA196243-02S1, R25 CA117865-07S1 and K05CA175048. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with ethical standards

Conflict of interest

The authors declare no potential conflicts of interest.

Supplementary material

10620_2017_4778_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 kb)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Epidemiology, Richard M. Fairbanks School of Public HealthIndiana UniversityIndianapolisUSA
  2. 2.Center for Nursing Research, School of NursingIndiana UniversityIndianapolisUSA
  3. 3.Department of BiostatisticsIndiana University School of MedicineIndianapolisUSA
  4. 4.Division of Gastroenterology and Hepatology, Departments of MedicineIndiana University School of MedicineIndianapolisUSA
  5. 5.Regenstrief Institute, Inc.IndianapolisUSA
  6. 6.Center for Innovation, Health Services Research and DevelopmentRichard L. Roudebush VA Medical CenterIndianapolisUSA

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