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. 2016 Aug;65(8):1289-95.
doi: 10.1136/gutjnl-2014-309007. Epub 2015 May 18.

Adolescent body mass index and erythrocyte sedimentation rate in relation to colorectal cancer risk

Elizabeth D Kantor  1 , Ruzan Udumyan  2 , Lisa B Signorello  1 , Edward L Giovannucci  3 , Scott Montgomery  4 , Katja Fall  5
Affiliations

Adolescent body mass index and erythrocyte sedimentation rate in relation to colorectal cancer risk

Elizabeth D Kantor et al. Gut. 2016 Aug.

Abstract

Objective: Adult obesity and inflammation have been associated with risk of colorectal cancer (CRC); however, less is known about how adolescent body mass index (BMI) and inflammation, as measured by erythrocyte sedimentation rate (ESR), relate to CRC risk. We sought to evaluate these associations in a cohort of 239 658 Swedish men who underwent compulsory military enlistment examinations in late adolescence (ages 16-20 years).

Design: At the time of the conscription assessment (1969-1976), height and weight were measured and ESR was assayed. By linkage to the national cancer registry, these conscripts were followed for CRC through 1 January 2010. Over an average of 35 years of follow-up, 885 cases of CRC occurred, including 501 colon cancers and 384 rectal cancers. Cox regression was used to estimate adjusted HRs and corresponding 95% CIs.

Results: Compared with normal weight (BMI 18.5 to <25 kg/m(2)) in late adolescence, upper overweight (BMI 27.5 to <30 kg/m(2)) was associated with a 2.08-fold higher risk of CRC (95% CI 1.40 to 3.07) and obesity (BMI 30+ kg/m(2)) was associated with a 2.38-fold higher risk of CRC (95% CI 1.51 to 3.76) (p-trend: <0.001). Male adolescents with ESR (15+ mm/h) had a 63% higher risk of CRC (HR 1.63; 95% CI 1.08 to 2.45) than those with low ESR (<10 mm/h) (p-trend: 0.006). Associations did not significantly differ by anatomic site.

Conclusions: Late-adolescent BMI and inflammation, as measured by ESR, may be independently associated with future CRC risk. Further research is needed to better understand how early-life exposures relate to CRC.

Keywords: COLORECTAL CANCER; COLORECTAL NEOPLASM; INFLAMMATION; OBESITY.

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Conflict of interest statement

COMPETING INTERESTS:

Study authors have no conflict of interest to declare.

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