Skip to main content

Advertisement

SpringerLink
Log in

A prospective study of waist circumference and body mass index in relation to colorectal cancer incidence

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objectives

To study the association between waist circumference and colorectal cancer, and whether it is independent of body mass index (BMI).

Methods

Between 1997 and 2005, 953 incident colorectal cancer cases (546 men and 407 women) were identified among 95,151 participants (44,068 men and 51,083 women) from the Cancer Prevention Study-II Nutrition Cohort.

Results

Waist circumference was associated with increased colorectal cancer incidence in both men (multivariable adjusted rate ratio (RR) 1.68, 95% confidence interval (CI) 1.12–2.53 for waist circumference ≥120 cm compared to <95 cm, p trend = 0.006) and women (RR 1.75, 95% CI 1.20–2.54 for ≥110 compared to <85 cm, p trend = 0.003). High levels of BMI were also associated with increased risk. After adjustment for BMI, waist circumference remained associated with a nonstatistically significant increase in colorectal cancer incidence in both men (RR 1.41, 95% CI 0.81–2.45 for ≥120 compared to <95 cm, p trend = 0.10) and women (RR 1.48, 95% CI 0.89–2.48 for ≥110 compared to <85 cm, p trend = 0.13).

Conclusions

Our results confirm that waist circumference is associated with increased colorectal cancer incidence, possibly partially independent of BMI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4(8):579–591

    Article  PubMed  CAS  Google Scholar 

  2. Gupta K, Krishnaswamy G, Karnad A, Peiris AN (2002) Insulin: a novel factor in carcinogenesis. Am J Med Sci 323(3):140–145

    Article  PubMed  CAS  Google Scholar 

  3. Gunter MJ, Leitzmann MF (2006) Obesity and colorectal cancer: epidemiology, mechanisms and candidate genes. J Nutr Biochem 17(3):145–156

    Article  PubMed  CAS  Google Scholar 

  4. Tran TT, Naigamwalla D, Oprescu AI, Lam L, McKeown-Eyssen G, Bruce WR et al (2006) Hyperinsulinemia, but not other factors associated with insulin resistance, acutely enhances colorectal epithelial proliferation in vivo. Endocrinology 147(4):1830–1837

    Article  PubMed  CAS  Google Scholar 

  5. Jenab M, Riboli E, Cleveland RJ, Norat T, Rinaldi S, Nieters A, et al (2007) Serum C-peptide, IGFBP-1 and IGFBP-2 and risk of colon and rectal cancers in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer, 19 Mar 2007

  6. Ma J, Giovannucci E, Pollak M, Leavitt A, Tao Y, Gaziano JM et al (2004) A prospective study of plasma C-peptide and colorectal cancer risk in men. J Natl Cancer Inst 96(7):546–553

    PubMed  CAS  Google Scholar 

  7. Frezza EE, Wachtel MS, Chiriva-Internati M (2006) Influence of obesity on the risk of developing colon cancer. Gut 55(2):285–291

    Article  PubMed  CAS  Google Scholar 

  8. Farin HM, Abbasi F, Reaven GM (2005) Body mass index and waist circumference correlate to the same degree with insulin-mediated glucose uptake. Metabolism 54(10):1323–1328

    Article  PubMed  CAS  Google Scholar 

  9. Bosy-Westphal A, Geisler C, Onur S, Korth O, Selberg O, Schrezenmeir J et al (2006) Value of body fat mass vs anthropometric obesity indices in the assessment of metabolic risk factors. Int J Obes (Lond) 30(3):475–483

    Article  CAS  Google Scholar 

  10. Farin HM, Abbasi F, Reaven GM (2006) Comparison of body mass index versus waist circumference with the metabolic changes that increase the risk of cardiovascular disease in insulin-resistant individuals. Am J Cardiol 98(8):1053–1056

    Article  PubMed  CAS  Google Scholar 

  11. Racette SB, Evans EM, Weiss EP, Hagberg JM, Holloszy JO (2006) Abdominal adiposity is a stronger predictor of insulin resistance than fitness among 50–95 year olds. Diabetes Care 29(3):673–678

    Article  PubMed  Google Scholar 

  12. Prentice AM, Jebb SA (2001) Beyond body mass index. Obes Rev 2(3):141–147

    Article  PubMed  CAS  Google Scholar 

  13. Moghaddam AA, Woodward M, Huxley R (2007) Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomarkers Prev 16:2533–2547

    Article  PubMed  Google Scholar 

  14. Larsson SC, Wolk A (2007) Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr 86(3):556–565

    PubMed  CAS  Google Scholar 

  15. Pischon T, Lahmann PH, Boeing H, Friedenreich C, Norat T, Tjonneland A et al (2006) Body size and risk of colon and rectal cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC). J Natl Cancer Inst 98(13):920–931

    Article  PubMed  Google Scholar 

  16. Macinnis RJ, English DR, Hopper JL, Gertig DM, Haydon AM, Giles GG (2006) Body size and composition and colon cancer risk in women. Int J Cancer 118(6):1496–1500

    Article  PubMed  CAS  Google Scholar 

  17. Moore LL, Bradlee ML, Singer MR, Splansky GL, Proctor MH, Ellison RC et al (2004) BMI and waist circumference as predictors of lifetime colon cancer risk in Framingham Study adults. Int J Obes Relat Metab Disord 28(4):559–567

    Article  PubMed  CAS  Google Scholar 

  18. MacInnis RJ, English DR, Hopper JL, Haydon AM, Gertig DM, Giles GG (2004) Body size and composition and colon cancer risk in men. Cancer Epidemiol Biomarkers Prev 13(4):553–559

    PubMed  Google Scholar 

  19. Schoen RE, Tangen CM, Kuller LH, Burke GL, Cushman M, Tracy RP et al (1999) Increased blood glucose and insulin, body size, and incident colorectal cancer. J Natl Cancer Inst 91(13):1147–1154

    Article  PubMed  CAS  Google Scholar 

  20. Martinez ME, Giovannucci E, Spiegelman D, Hunter DJ, Willett WC, Colditz GA (1997) Leisure-time physical activity, body size, and colon cancer in women. Nurses’ Health Study Research Group. J Natl Cancer Inst 89(13):948–955

    Article  PubMed  CAS  Google Scholar 

  21. Giovannucci E, Ascherio A, Rimm EB, Colditz GA, Stampfer MJ, Willett WC (1995) Physical activity, obesity, and risk for colon cancer and adenoma in men. Ann Intern Med 122(5):327–334

    PubMed  CAS  Google Scholar 

  22. Folsom AR, Kushi LH, Anderson KE, Mink PJ, Olson JE, Hong CP et al (2000) Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women’s Health Study. Arch Intern Med 160(14):2117–2128

    Article  PubMed  CAS  Google Scholar 

  23. Larsson SC, Rutegård J, Bergkvist L, Wolk A (2006) Physical activity, obesity, and risk of colon and rectal cancer in a cohort of Swedish men. Eur J Cancer 42:2590–2597

    Article  PubMed  Google Scholar 

  24. Calle EE, Rodriguez C, Jacobs EJ, Almon ML, Chao A, McCullough ML et al (2002) The American Cancer Society Cancer Prevention Study II Nutrition Cohort: rationale, study design, and baseline characteristics. Cancer 94(9):2490–2501

    Article  PubMed  Google Scholar 

  25. Stellman SD, Garfinkel L (1986) Smoking habits and tar levels in a new American Cancer Society prospective study of 1.2 million men and women. J Natl Cancer Inst 76(6):1057–1063

    PubMed  CAS  Google Scholar 

  26. Rimm EB, Stampfer MJ, Colditz GA, Chute CG, Litin LB, Willett WC (1990) Validity of self-reported waist and hip circumferences in men and women. Epidemiology 1(6):466–473

    Article  PubMed  CAS  Google Scholar 

  27. Kushi LH, Kaye SA, Folsom AR, Soler JT, Prineas RJ (1988) Accuracy and reliability of self-measurement of body girths. Am J Epidemiol 128(4):740–748

    PubMed  CAS  Google Scholar 

  28. Cox D (1972) Regression models and life tables (with discussion). J R Stat Soc 32:187–220

    Google Scholar 

  29. (1998) Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med 158(17):1855–1867

  30. Li C, Ford ES, McGuire LC, Mokdad AH (2007) Increasing trends in waist circumference and abdominal obesity among US adults. Obesity (Silver Spring) 15(1):216–224

    Article  Google Scholar 

  31. Després JP (2006) Is visceral obesity the cause of the metabolic syndrome? Ann Med 38:52–63

    Article  PubMed  CAS  Google Scholar 

  32. Kuk JL, Janiszewski PM, Ross R (2007) Body mass index and hip and thigh circumferences are negatively associated with visceral adipose tissue after control for waist circumference. Am J Clin Nutr 85(6):1540–1544

    PubMed  CAS  Google Scholar 

  33. Macinnis RJ, English DR, Haydon AM, Hopper JL, Gertig DM, Giles GG (2006) Body size and composition and risk of rectal cancer (Australia). Cancer Causes Control 17(10):1291–1297

    Article  PubMed  Google Scholar 

  34. Spencer EA, Roddam AW, Key TJ (2004) Accuracy of self-reported waist and hip measurements in 4492 EPIC-Oxford participants. Public Health Nutr 7(6):723–727

    Article  PubMed  Google Scholar 

  35. Han TS, Lean ME (1998) Self-reported waist circumference compared with the ‘Waist Watcher’ tape-measure to identify individuals at increased health risk through intra-abdominal fat accumulation. Br J Nutr 80(1):81–88

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors acknowledge the help of Elizabeth Barry Bain in reviewing the SAS programs, Peter Briggs and Daniela Dudas in updating the datasets. We thank all CPS-II participants for their continued support.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA, 30303-1002, USA

    Yiting Wang, Eric J. Jacobs, Alpa V. Patel, Carmen Rodríguez, Marjorie L. McCullough, Michael J. Thun & Eugenia E. Calle

Authors
  1. Yiting Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eric J. Jacobs
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alpa V. Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carmen Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marjorie L. McCullough
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael J. Thun
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eugenia E. Calle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eric J. Jacobs.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, Y., Jacobs, E.J., Patel, A.V. et al. A prospective study of waist circumference and body mass index in relation to colorectal cancer incidence. Cancer Causes Control 19, 783–792 (2008). https://doi.org/10.1007/s10552-008-9141-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-008-9141-x

Keywords

Search

Navigation