Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec;11(6):3445-3456.
doi: 10.1007/s40615-023-01797-x. Epub 2023 Sep 21.

Associations of Albumin and BMI with Colorectal Cancer Risk in the Southern Community Cohort Study: a Prospective Cohort Study

Zoe Walts  1   2 , Lisa Parlato  1   2 , Ronni Brent  1   2 , Qiuyin Cai  3 , Mark Steinwandel  4 , Wei Zheng  3 , Shaneda Warren Andersen  5   6   7
Affiliations

Associations of Albumin and BMI with Colorectal Cancer Risk in the Southern Community Cohort Study: a Prospective Cohort Study

Zoe Walts et al. J Racial Ethn Health Disparities. 2024 Dec.

Abstract

Background: Obesity may increase colorectal cancer (CRC) risk through mechanisms of increased inflammation. Although BMI is the most used adiposity indicator, it may less accurately measure adiposity in Black populations. Herein, we investigate associations between BMI, low albumin as an inflammation biomarker, and CRC risk in a racially diverse cohort.

Methods: Participant data arise from 71,141 participants of the Southern Community Cohort Study, including 724 incident CRC cases. Within the cohort, 69% are Black. Blood serum albumin concentrations, from samples taken at enrollment, were available for 235 cases and 567 controls. Controls matched by age, sex, and race were selected through incidence density sampling. Cox proportional hazards calculated BMI and CRC risk associations (hazard ratios [HRs]; 95% confidence intervals [CIs]. Conditional logistic regression calculated albumin and CRC risk associations (odds ratios [ORs]; 95%CIs).

Results: Underweight, but not overweight or obese, compared to normal BMI was associated with increased CRC risk (HR:1.75, 95%CI:1.00-3.09). Each standard deviation increase of albumin was associated with decreased CRC risk, particularly for those who self-identified as non-Hispanic Black (OR: 0.56, 95%CI:0.34-0.91), or female (OR:0.54, 95%CI:0.30-0.98), but there was no evidence for interaction by these variables (p-interactions > 0.05). Moreover, albumin concentration was lower in Black than White participants. Mediation analysis suggested that the relation between albumin and CRC was not mediated by BMI.

Conclusions: Null associations of overweight/obesity with CRC risk demonstrates limited utility of BMI, especially among Black populations. Low albumin may indicate CRC risk. In Black individuals, albumin may better predict adiposity related risks than BMI.

Keywords: Adiposity; Albumin; BMI; Biomarkers; Colorectal cancer risk; Inflammation.

PubMed Disclaimer

Conflict of interest statement

Declarations Ethics Approval All study activities conformed to the tenets of the Declaration of Helsinki, and all participants provided written informed consent. Institutional Review Board (IRB) approval for this study was provided by Meharry Medical College and Vanderbilt University Medical Center. Consent to Participate All participants included in the study provided informed consent. Competing Interests The authors have no relevant financial or non-financial interests to disclose.

Similar articles

See all similar articles

Cited by

References

    1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin 2023;73:17–48. 10.3322/caac.21763. - DOI - PubMed
    1. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017–2018. NCHS Data Brief 2020:8. - PubMed
    1. Ogden CL. Prevalence of Obesity Among Adults, by Household Income and Education — United States, 2011–2014. MMWR Morb Mortal Wkly Rep 2017;66. 10.15585/mmwr.mm6650a1. - DOI - PMC - PubMed
    1. Hruby A, Hu FB. The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics 2015;33:673–89. 10.1007/s40273-014-0243-x. - DOI - PMC - PubMed
    1. Coughlin SS, Blumenthal DS, Seay SJ, Smith SA. Toward the Elimination of Colorectal Cancer Disparities Among African Americans. J Racial Ethn Health Disparities 2016;3:555–64. 10.1007/s40615-015-0174-z. - DOI - PMC - PubMed

LinkOut - more resources