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Obesity increases risk for young-onset colorectal cancer in women
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WASHINGTON — Researchers found that obesity and weight gain from adolescence correlated with an increased risk for young-onset colorectal cancer among women, according to a presentation at Digestive Disease Week 2018.
Po-Hong Liu, MD, MPH, from the clinical and translational epidemiology unit at Massachusetts General Hospital, noted in his presentation that while the incidence and mortality rates of colorectal cancer have been decreasing among both men and women aged 50 years and older, data has revealed a recent increase in colorectal cancer incidence and mortality among men and women aged 20 years to 49 years.
“Obesity can contribute to chronic inflammation as well as metabolic syndrome, insulin resistance and modifications of gut microbiota,” Liu said during his presentation. “Due to the parallel increase in obesity and young-onset and colorectal cancer, understanding the role of obesity in colorectal cancer may help us understand this epidemiology.”
Liu and colleagues conducted a prospective study of 85,256 women to examine the correlation between risk for young-onset CRC and the change in obesity and weight from age 18 years to baseline. During 22 years of follow-up, the researchers observed 121 incident cases of young-onset CRC in those aged younger than 50 years.
Young-onset CRC occurred significantly more often among women with BMI 30 kg/m2 or higher (HR = 1.92; 95% CI, 1.08-3.44), compared with women with BMI between 18.5 kg/m2 and 22.9 kg/m2.
Additionally, weight gain from adolescence correlated with an increased risk for young-onset CRC, especially among those who gained at least 40 kg between age 18 years and study baseline (HR = 1.96; 95% CI, 0.92-4.19).
“Obesity may play a substantial role in early-onset colorectal cancer carcinogenesis and may contribute to the age-specific difference in colorectal cancer trends,” Liu concluded. “Future studies could determine the role of body weight in screening strategies.” – by Talitha Bennett
Reference:
Liu PH, et al. Abstract 283. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.
Disclosure: Liu reports no relevant financial disclosures. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.
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Carol Burke, MD
The incidence and mortality from CRC in adults over the age of 50 has consistently diminished over the last 3 decades in the United States. While less than 10,000 cases of CRC occur in individuals less than the age of 50, a concerning rise in CRC is noted in individuals between 20 to 49 years of age.
It is estimate that there will be a 90% and 124% increase in the incidence of colon and rectal cancer, respectively, by 2030. The characteristics of young-onset CRC seems to favor white Americans, is left-sided and microsatellite stable. The epidemiologic factors leading to the increased incidence of young onset CRC are not well defined and have been conjectured to be related to lifestyle including low levels of physical activity, obesity, smoking, poor dietary choices and, potentially, alterations in the microbiome, to name a few. This study clearly shows in a cohort of women followed since 1989 in the Nurses’ Health Study that young-onset colon, not rectal, cancer is independently associated with a BMI of 30 kg/m2 or greater and CRC is associated with substantial weight gain since adolescence. This is important data that physicians can share with their patients to encourage them to adopt a healthy lifestyle which includes avoidance of obesity and implementation of measures to maintain a healthy body weight over their lifespan.
Reference: Bailey CE, et al. JAMA Surg. 2015;150(1):17-22
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Amy Foxx-Orenstein, DO, FACG
There’s now a large and consistent body of evidence that overweight and obesity in childhood and adolescence have adverse consequences and can lead to premature mortality and physical morbidity in early adulthood and beyond. Obesity can contribute to chronic inflammation as well as metabolic syndrome, insulin resistance and modification of gut microbiota.
Recently, obesity was linked to 12 types of cancer including breast, colon, esophagus, pancreas and ovarian. This abstract highlights colorectal cancer, but obesity itself is a growing epidemic. We’ve seen a rise in body mass for the past 35 years and the rates are not really slowing down.
The take-away from this presentation is that due to the parallel increase of obesity and young onset of colorectal cancer, understanding the role of obesity in colorectal cancer may help us to understand this epidemiology.
Mayo Clinic College of Medicine in Minnesota
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