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European Journal of Epidemiology
Erschienen in: European Journal of Epidemiology 5/2017

16.05.2017 | CANCER

Body mass index and risk of colorectal carcinoma subtypes classified by tumor differentiation status

verfasst von: Akiko Hanyuda, Yin Cao, Tsuyoshi Hamada, Jonathan A. Nowak, Zhi Rong Qian, Yohei Masugi, Annacarolina da Silva, Li Liu, Keisuke Kosumi, Thing Rinda Soong, Iny Jhun, Kana Wu, Xuehong Zhang, Mingyang Song, Jeffrey A. Meyerhardt, Andrew T. Chan, Charles S. Fuchs, Edward L. Giovannucci, Shuji Ogino, Reiko Nishihara

Erschienen in: European Journal of Epidemiology | Ausgabe 5/2017

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Abstract

Previous studies suggest that abnormal energy balance status may dysregulate intestinal epithelial homeostasis and promote colorectal carcinogenesis, yet little is known about how host energy balance and obesity influence enterocyte differentiation during carcinogenesis. We hypothesized that the association between high body mass index (BMI) and colorectal carcinoma incidence might differ according to tumor histopathologic differentiation status. Using databases of the Nurses’ Health Study and Health Professionals Follow-up Study, and duplication-method Cox proportional hazards models, we prospectively examined an association between BMI and the incidence of colorectal carcinoma subtypes classified by differentiation features. 120,813 participants were followed for 26 or 32 years and 1528 rectal and colon cancer cases with available tumor pathological data were documented. The association between BMI and colorectal cancer risk significantly differed depending on the presence or absence of poorly-differentiated foci (Pheterogeneity = 0.006). Higher BMI was associated with a higher risk of colorectal carcinoma without poorly-differentiated foci (≥30.0 vs. 18.5–22.4 kg/m2: multivariable-adjusted hazard ratio, 1.87; 95% confidence interval, 1.49–2.34; Ptrend < 0.001), but not with risk of carcinoma with poorly-differentiated foci (Ptrend = 0.56). This differential association appeared to be consistent in strata of tumor microsatellite instability or FASN expression status, although the statistical power was limited. The association between BMI and colorectal carcinoma risk did not significantly differ by overall tumor differentiation, mucinous differentiation, or signet ring cell component (Pheterogeneity > 0.03, with the adjusted α of 0.01). High BMI was associated with risk of colorectal cancer subtype containing no poorly-differentiated focus. Our findings suggest that carcinogenic influence of excess energy balance might be stronger for tumors that retain better intestinal differentiation throughout the tumor areas.
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Metadaten
Titel
Body mass index and risk of colorectal carcinoma subtypes classified by tumor differentiation status
verfasst von
Akiko Hanyuda
Yin Cao
Tsuyoshi Hamada
Jonathan A. Nowak
Zhi Rong Qian
Yohei Masugi
Annacarolina da Silva
Li Liu
Keisuke Kosumi
Thing Rinda Soong
Iny Jhun
Kana Wu
Xuehong Zhang
Mingyang Song
Jeffrey A. Meyerhardt
Andrew T. Chan
Charles S. Fuchs
Edward L. Giovannucci
Shuji Ogino
Reiko Nishihara
Publikationsdatum
16.05.2017
Verlag
Springer Netherlands
Erschienen in
European Journal of Epidemiology / Ausgabe 5/2017
Print ISSN: 0393-2990
Elektronische ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-017-0254-y

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