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Excess body weight and colorectal cancer survival: the multiethnic cohort

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Abstract

Purpose

Excess body weight is a risk factor for colorectal cancer (CRC) and may also adversely affect survival in CRC patients.

Methods

This study examined the relation of body mass index (BMI), which was self-reported at cohort entry and after 5.7 ± 0.8 years, with CRC-specific and all-cause survival among 4,204 incident cases of invasive CRC in the multiethnic cohort. Cox regression analysis with age as time metric and BMI as time-varying exposure was applied to estimate hazard ratios (HR) and 95 % confidence intervals (CIs) while adjusting for relevant covariates.

Results

Over 6.0 ± 4.7 years of follow-up, 1,976 all-cause and 1,095 CRC-specific deaths were recorded. The mean time interval between cohort entry and diagnosis was 7.6 ± 4.7 years. No association with CRC-specific survival was detected in men (HR5units = 0.94; 95 %CI 0.84–1.04) or women (HR5units = 0.98; 95 %CI 0.89–1.08). In men, all-cause survival also showed no relation with BMI (HR5unit = 0.97; 95 %CI 0.90–1.06), whereas it was reduced in women (HR5units = 1.10; 95 %CI 1.03–1.18). Interactions of BMI with ethnicity were only significant for obesity. Obese Latino and overweight Native Hawaiian men as well as overweight African-American women experienced significantly better CRC-specific survival than whites. Overweight Japanese men and African-American women had better all-cause survival and obese Latino women had the lowest all-cause survival (HRobese = 1.74; 95 %CI 1.08–2.80).

Conclusions

This analysis detected little evidence for an adverse effect of excess body weight on CRC-specific survival, but all-cause survival was reduced in women. These findings suggest that adiposity may be less important for CRC survival than as an etiologic factor.

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Acknowledgments

The Multiethnic Cohort Study has been supported by grants R37CA54281 and UM1CA164973 from the National Cancer Institute. Drs. Harmon and Little were supported by postdoctoral fellowships on grant R25CA90956. The tumor registries are supported by NCI contracts N01 PC 35137 and N01 PC 35139.

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Authors and Affiliations

  1. University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA

    Gertraud Maskarinec, Laurence N. Kolonel, Loic Le Marchand & Lynne R. Wilkens

  2. School of Public Health, University of Memphis, 200 Robison Hall, Memphis, TN, USA

    Brook E. Harmon

  3. Health Science Center, University of Tennessee, Memphis, TN, USA

    Melissa A. Little

  4. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Nicholas J. Ollberding

  5. University of Southern California, Health Sciences Campus, Los Angeles, CA, USA

    Brian E. Henderson

Authors
  1. Gertraud Maskarinec
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  2. Brook E. Harmon
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  3. Melissa A. Little
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  4. Nicholas J. Ollberding
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  5. Laurence N. Kolonel
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  6. Brian E. Henderson
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  7. Loic Le Marchand
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  8. Lynne R. Wilkens
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Corresponding author

Correspondence to Gertraud Maskarinec.

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The authors of this paper have no conflict of interest to report.

Additional information

Brian E. Henderson—Deceased.

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Maskarinec, G., Harmon, B.E., Little, M.A. et al. Excess body weight and colorectal cancer survival: the multiethnic cohort. Cancer Causes Control 26, 1709–1718 (2015). https://doi.org/10.1007/s10552-015-0664-7

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  • DOI: https://doi.org/10.1007/s10552-015-0664-7

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