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. 2023 Sep;129(5):829-837.
doi: 10.1038/s41416-023-02351-6. Epub 2023 Jul 13.

The underestimated impact of excess body weight on colorectal cancer risk: Evidence from the UK Biobank cohort

Fatemeh Safizadeh  1   2 , Marko Mandic  1   2 , Dianne Pulte  1 , Tobias Niedermaier  1 , Michael Hoffmeister  1 , Hermann Brenner  3   4   5
Affiliations

The underestimated impact of excess body weight on colorectal cancer risk: Evidence from the UK Biobank cohort

Fatemeh Safizadeh et al. Br J Cancer. 2023 Sep.

Abstract

Background: The association between excess weight and colorectal cancer (CRC) risk may have been underestimated due to potential weight loss during pre-clinical sojourn time of CRC. We aimed to investigate this association and the corresponding population attributable fraction (PAF), accounting for prediagnostic weight loss.

Methods: Data from the UK Biobank prospective cohort were used. Multivariable adjusted hazard ratios (HR) and their 95% confidence intervals (CI) for various periods of follow-up and the corresponding PAF of excess weight were calculated.

Results: During a median of 10.0 years of follow-up, of 453,049 participants, 4794 developed CRC. The excess weight-CRC association became substantially stronger with including increasing lengths of follow-up in the analyses and further excluding the initial years of follow-up. HRs (95% CIs) for overweight and obesity were 1.06 (0.97-1.16) and 1.14 (1.03-1.26) after 7 years of follow-up, 1.13 (1.05-1.21) and 1.23 (1.14-1.33) when including complete follow-up length, and 1.26 (1.12-1.43) and 1.42 (1.24-1.63) when excluding the initial 7 years of follow-up. The corresponding PAFs of excess weight were estimated as 6.8%, 11.3%, and 19.0%, respectively.

Conclusions: Comprehensive consideration of the potential effect of prediagnostic weight loss discloses a much stronger impact of excess body weight on CRC risk than previously assumed.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Study Flowchart.
Flowchart showing selection of the study population.
See this image and copyright information in PMC

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