1
|
Nam SY, Jo J, Chun H, Jeon SW. Effect modification in the impacts of body mass index change on the risk of colorectal cancer in middle-aged and older adults. Dig Liver Dis 2025:S1590-8658(25)00758-3. [PMID: 40383682 DOI: 10.1016/j.dld.2025.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2025] [Revised: 04/27/2025] [Accepted: 04/28/2025] [Indexed: 05/20/2025]
Abstract
BACKGROUND Effect modification by cofactors in the association between body mass index (BMI) change and colorectal cancer (CRC) risk has rarely been investigated. METHODS Cancer-free individuals who participated in the national health examinations and cancer screening at 2010 and underwent national health examination at 2014, were enrolled and followed through 2021 RESULTS: Among 3.8 million, 42,555 patients developed CRCs. Persistent high BMI increased CRC risk comparing to persistent normal BMI. Among overweight individuals, BMI loss reduced CRC risk (adjusted hazard ratios [aHR] 0.93; 95 % confidence intervals [CIs] 0.88-0.99) and marked BMI gain (overweight to obesity II) increased CRC risk (aHR 1.91; 95 % CI 1.11-3.29). The impact of BMI change on CRC risk was significant across sex, age, and smoking status, with stronger effects in women, especially postmenopausal women. Persistent underweight in individuals over 50 years increased CRC risk (aHR 1.19; 95 % CI 1.05-1.34). Marked BMI gain increased CRC risk in men (normal to obesity I; aHR 1.21; 95 % CI 1.02-1.44) and women (overweight to obesity II; aHR 2.08; 95 % CI 1.16-3.74). CONCLUSIONS These results highlight the hazardousness of persistent high BMI and further BMI gain with effect modification by cofactors.
Collapse
Affiliation(s)
- Su Youn Nam
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea; Division of Gastroenterology, Kyungpook National University Chilgok Hospital, Daegu, South Korea; Integrated Research and Medical Center, Kyungpook National University Hospital, Daegu, South Korea
| | - Junwoo Jo
- Department of Statistics, Kyungpook National University, Daegu, Korea
| | - Hyonho Chun
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea; Division of Gastroenterology, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
| |
Collapse
|
2
|
Wang P, Zheng Z, Wang K, Gu J, Li Y. The burden of colorectal cancer attributable to high body mass index in China: findings from 1990 to 2021 and prediction to 2035. Int J Colorectal Dis 2025; 40:108. [PMID: 40323366 PMCID: PMC12052793 DOI: 10.1007/s00384-025-04877-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2025] [Indexed: 05/08/2025]
Abstract
BACKGROUND Colorectal cancer (CRC) incidence and mortality are rising in China, with high body mass index (BMI) established as a significant risk factor. However, comprehensive evidence regarding the BMI-attributable CRC burden in the Chinese population remains limited. OBJECTIVE This study aims to analyze the trend of CRC burden attributable to high BMI (BMI ≥ 25 kg/m2) in China from 1990 to 2021 and to predict its development from 2022 to 2035, in order to provide a scientific foundation for the formulation of public health policies. METHODS We analyzed data from the Global Burden of Disease Study 2021 (GBD 2021) to assess the BMI-attributable CRC burden in China from 1990 to 2021. Temporal trends were analyzed using Joinpoint regression models. Future projections through 2035 were generated using Bayesian age-period-cohort (BAPC) modeling. The Das Gupta method was used to explore the contribution of population growth, aging, and epidemiologic factors to these burden changes. RESULTS From 1990 to 2021, China's BMI-attributable CRC burden increased substantially, with ASMR and ASDR rising at annual rates of 2.393% (95% CI 2.306-2.481) and 2.305% (95% CI 2.188-2.422), respectively. The mortality and disability-adjusted life years (DALYs) rate both increased with age. Males showed higher burden rates in most age groups. Projections indicate continued increases in ASMR (2.43% annually) and ASDR (2.44% annually) through 2035. Epidemiological factors were the primary drivers, contributing 99.73% to mortality changes and 44.81% to DALYs changes. CONCLUSIONS The BMI-attributable CRC burden in China shows a concerning upward trajectory that is predicted to continue, with epidemiologic factors playing a major role. Urgent public health interventions targeting obesity prevention, lifestyle modification, and expanded CRC screening are needed to mitigate this growing burden.
Collapse
Affiliation(s)
- Peizhu Wang
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Zhaolei Zheng
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Kui Wang
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jianhua Gu
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, China.
| | - Yanqing Li
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, Shandong, China.
| |
Collapse
|
3
|
Ren J, Tang C, Wang J, Wang Y, Yang D, Sheng J, Zhu S, Liu Y, Li X, Liu W. Association of overweight/obesity and digestive system cancers: A meta-analysis and trial sequential analysis of prospective cohort studies. PLoS One 2025; 20:e0318256. [PMID: 40168281 PMCID: PMC11960891 DOI: 10.1371/journal.pone.0318256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Accepted: 01/14/2025] [Indexed: 04/03/2025] Open
Abstract
BACKGROUND Previous researches have reported correlations between overweight/obesity and common digestive system cancers (DSCs), including gastric, liver, esophageal, colorectal, and pancreatic cancers. However, the inconsistency in defining overweight/obesity and the risk of recall bias from case-control and retrospective cohort studies may influence existing results. Therefore, we aimed to validate the relationship between overweight/obesity and common DSCs by combining prospective cohort studies based on the World Health Organization (WHO) criteria for defining overweight/obesity. METHODS A comprehensive literature search was conducted across PubMed, Embase, Web of Science, and Cochrane databases, covering all publications up to February 7, 2024. The inclusion criteria focused on prospective cohort studies that examined the link between overweight/obesity and risks of DSCs. R software 4.1.3 and STATA 12 were utilised to calculate the relative risk (RR), with 95% confidence interval (CI) and prediction interval (PI). TSA v0.9.5.10 Beta software was used for trial sequential analysis (TSA). RESULTS The meta-analysis encompassed 39 articles. The overall analysis showed that compared with normal weight, overweight/obesity increased the risks of liver cancer (overweight: RR [95% CI] = 1.237 [1.112-1.377]; 95% PI: 0.888-1.725; obesity: RR [95% CI] = 1.642 [1.466-1.839]; 95% PI: 1.143-2.358) and colorectal cancer (overweight: RR [95% CI] = 1.124 [1.056-1.197]; 95% PI: 0.931-1.357; obesity: RR [95% CI] = 1.366 [1.242-1.503]; 95% PI: 0.959-1.945) in the total population. Subgroup analysis revealed that overweight (RR [95% CI] = 1.237 [1.165-1.314]; 95% PI: 1.154-1.327) and obesity (RR [95% CI] = 1.306 [1.152-1.480]; 95% PI: 1.108-1.539) were associated with an increased risk of pancreatic cancer only in women, and overweight also increased the gastric cancer risk of women (RR [95% CI] = 1.041 [1.013-1.070], 95% PI: 0.806-1.230). No significant association of overweight/obesity and esophageal cancer was observed in both male and female. CONCLUSION Our study suggested that overweight/obesity elevated the risks of liver and colorectal cancer in both men and women. No significant association was found between overweight/obesity and the risk of developing esophageal cancer. Clinicians are advised to consider weight control as an effective measure for preventing pancreatic, liver, and colorectal cancers.
Collapse
Affiliation(s)
- Ji Ren
- Department of Medicine and Health, Dezhou University, Dezhou, China
| | - Chunyan Tang
- Department of Nursing, Dezhou Municipal Hospital (Dezhou University Affiliated Hospital), Dezhou, China
| | - Jinghe Wang
- Department of Medicine and Health, Dezhou University, Dezhou, China
| | - Yanan Wang
- Department of Medicine and Health, Dezhou University, Dezhou, China
| | - Dongying Yang
- Department of Medicine and Health, Dezhou University, Dezhou, China
| | - Jianming Sheng
- Department of Medicine and Health, Dezhou University, Dezhou, China
| | - Shili Zhu
- Department of Medicine and Health, Dezhou University, Dezhou, China
| | - Yunli Liu
- Department of Medicine and Health, Dezhou University, Dezhou, China
| | - Xiaoqi Li
- Department of Medicine and Health, Dezhou University, Dezhou, China
| | - Wei Liu
- Department of Medicine and Health, Dezhou University, Dezhou, China
| |
Collapse
|
4
|
Kapała A, Różycka K, Grochowska E, Gazi A, Motacka E, Folwarski M. Cancer, malnutrition and inflammatory biomarkers. Why do some cancer patients lose more weight than others? Contemp Oncol (Pozn) 2025; 29:45-54. [PMID: 40330451 PMCID: PMC12051885 DOI: 10.5114/wo.2025.147939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 01/05/2025] [Indexed: 05/08/2025] Open
Abstract
Introduction Malnutrition is highly prevalent in cancer patients, significantly influencing their clinical outcomes and prognosis. The study was conducted to investigate the association between inflammatory biomarkers, nutritional status and progression of the disease across various types of cancers. Material and methods Retrospective data from 200 consecutive Caucasian cancer patients admitted to a major oncology hospital for cancer treatment were analyzed according to age, sex, cancer type, nutritional status (percentage body weight loss - %BWL), body mass index (BMI), percentage of dietary intake from the calculated requirement for nutrients (%DI)), and laboratory results (albumin levels, total protein concentration, C-reactive protein - CRP). Inflammatory biomarkers such as prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were assessed. Results Prognostic nutritional index (ρ = -0.464, p < 0.001), PLR (ρ = 0.293, p = 0.019), albumin level (ρ = -0.490, p < 0.001), platelet count (ρ = 0.114, p = 0.370), neutrophil count (ρ = 0.273, p = 0.030), CRP (ρ = 0.293, p = 0.019) and lymphocyte count (ρ = -0.288, p = 0.021) were significantly associated with %BWL. No significant association was found with NLR. Cancer dissemination was significantly associated with PNI (OR: 0.93, 95% CI: 0.88-0.98), PLR (OR: 1.00, 95% CI: 1.00-1.01), albumin (OR: 0.86, 95% CI: 0.80-0.93), platelet count (OR: 1.01, 95% CI: 1.00-1.01), %BWL (OR: 1.06, 95% CI: 1.02-1.10) and %DI (OR: 0.97, 95% CI: 0.96-0.99) but not with NLR, total protein level, total lymphocyte count, or BMI. For patients with albumin levels below 35 g/l, the likelihood of disseminated cancer was more than five times higher (OR: 5.45, 95% CI: 2.05-14.48). Conclusions The intensity of inflammation may be responsible for the severity of malnutrition and cancer prognosis.
Collapse
Affiliation(s)
- Aleksandra Kapała
- Department of Oncology Diagnostics, Cardio-Oncology and Palliative Medicine, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
- Department of Clinical Nutrition, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Katarzyna Różycka
- Department of Clinical Nutrition, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Ewelina Grochowska
- Department of Clinical Nutrition, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Aleksandra Gazi
- Department of Clinical Nutrition, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Emilia Motacka
- Department of Clinical Nutrition, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Marcin Folwarski
- Department of Clinical Nutrition and Dietetics, Medical University of Gdańsk, Gdańsk, Poland
- Nicolaus Copernicus Hospital, Gdańsk, Poland
| |
Collapse
|
5
|
Kim JH, Ko Y, Kim HJ, Park SJ. Age and sex differences in the relationship of body weight changes with colon cancer risks: A nationwide cohort study. Sci Rep 2025; 15:678. [PMID: 39753614 PMCID: PMC11698967 DOI: 10.1038/s41598-024-74916-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 09/30/2024] [Indexed: 01/06/2025] Open
Abstract
Colon cancer is a significant health concern, and obesity is a well-established risk factor. However, previous studies have mainly focused on assessing body weight as a risk factor for colon cancer at a specific time point. This nationwide cohort study investigated the association between body weight changes, which can fluctuate throughout an individual's lifespan, and the incidence of colon cancer using the South Korean population database provided by the National Health Insurance Service (NHIS). Participants who underwent biennial health screenings between 2004 and 2006, and had follow-up health check-ups between 2014 and 2016, were included in this study. Body weight changes were categorized as follows: < 5%, decrease 5-20%, decrease > 20%, increase 5-20%, or > 20%. The primary outcome was the incidence of newly diagnosed colon cancer. Statistical analysis was used to examine the relationship between body weight changes and the incidence of colon cancer stratified according to age and sex. The Kaplan-Meier method estimated the cumulative incidence of colon cancer, and Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for confounding factors. The analysis included data from 10,332,397 individuals, with a mean (± SD) age of 45.5 ± 13.1 years, and 54.9% were male. In males with a body mass index (BMI) range of 18-30 kg/m2, both a weight gain of 5-20% (HR 1.07, P > z 0.01 [95% CI 1.02-1.13]) and weight gain > 20% (HR 1.27, P > z 0.03 [95% CI 1.03-1.56]) were associated with an increased risk for colon cancer. In addition, males < 40 years of age exhibited a higher risk for colon cancer with > 20% weight gain (HR 1.65, P > z < 0.001 [95% CI 1.18-2.30]). Whereas, females within the BMI range of 18-30 kg/m2 who exhibited > 20% weight loss demonstrated a reduced risk (HR 0.77, P > z 0.04 [95% CI 0.60-0.98]). Moreover, females ≥ 40 years of age, who experienced weight loss > 20%, exhibited a decreased risk for colon cancer (HR 0.76; P > 0.02 [95% CI 0.60-0.96]). This nationwide cohort study demonstrated a relationship between body weight changes and the incidence of colon cancer, with differences based on sex and age. In particular, avoiding weight gain is crucial for males < 40 years of age, whereas weight loss could be beneficial for females > 40 years of age in reducing the risk of colon cancer.
Collapse
Affiliation(s)
- Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - Young Ko
- Graduate School of Public Health, Korea University College of Medicine, Seoul, South Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea.
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.
| |
Collapse
|
6
|
Fu X, Xiong Y, Tang R, Li X, Liu H, Ren X. Association of hTERT Gene Polymorphism and Colorectal Cancer (CRC) Risk in the Chinese Han Population. TOHOKU J EXP MED 2024; 263:89-95. [PMID: 38296486 DOI: 10.1620/tjem.2024.j008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
The catalytic subunit telomerase reverse transcriptase (hTERT) is a prerequisite for malignant transformation of human cells. Colorectal cancer (CRC) is a common malignant tumor. The genetic association of hTERT gene rs2853669 and rs2736098 polymorphisms with CRC was surveyed in the Chinese population. Two hundreds patients with CRC and 200 healthy controls were taken for blood sample collection. Sanger sequencing was applied for genotyping. Multiple logistic regression analysis was performed, and odds ratio (OR) together with confidence interval (CI) were calculated to obtain the corresponding association power. Among CRC cases (49.50%), hTERT gene rs2736098 GA genotype carriers were more prevalent compared with the control group (41.00%, P = 0.035), which increased the risk of CRC by 1.576 times (95% CI, 1.031-2.409). Distribution of the rs2736098 genotypes was significantly associated with TNM stage, tumor differentiation, tumor size and lymph node metastasis (P < 0.05). The frequencies of hTERT gene rs2853669 polymorphism were not significantly different between CRC patients and healthy controls. Logistic regression analysis indicated that both body mass index (BMI) and hTERT gene rs2736098 polymorphism remained significantly correlated with CRC susceptibility. The frequencies of hTERT gene rs2853669 polymorphism did not differ significantly between CRC patients and control group (P > 0.05). The hTERT gene rs2736098 polymorphism was correlated with CRC risk in the Chinese Han population, and the GA genotype was a risk element for the onset of CRC.
Collapse
Affiliation(s)
- Xianxian Fu
- Department of Laboratory, Haikou People's Hospital
| | - Yanyan Xiong
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University
| | - Renjin Tang
- Department of Integrated Traditional Chinese and Western Medicine, Chengdu Shangjin Nanfu Hospital
| | - Xuelin Li
- Department of Integrated Traditional Chinese and Western Medicine, Chengdu Shangjin Nanfu Hospital
| | - Hong Liu
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University
| | - Xiaowei Ren
- Department of Anorectal, Fuling Hospital of Chinese Medicine
| |
Collapse
|
7
|
Zhou Y, Zhang X, Li X, Zhu G, Gao T, Deng Y, Huang L, Liu Z. Anthropometric indicators may explain the high incidence of follicular lymphoma in Europeans: Results from a bidirectional two-sample two-step Mendelian randomisation. Gene 2024; 911:148320. [PMID: 38452876 DOI: 10.1016/j.gene.2024.148320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Non-Hodgkin's lymphoma incidence rates vary between European and Asian populations. The reasons remain unclear. This two-sample two-step Mendelian randomisation (MR) study aimed to investigate the causal relationship between anthropometric indicators (AIs) and diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) and the possible mediating role of basal metabolic rate (BMR) in Europe. METHODS We used the following AIs as exposures: body mass index (BMI), whole-body fat mass (WBFM), whole-body fat-free mass (WBFFM), waist circumference(WC), hip circumference(HC), standing height (SH), and weight(Wt). DLBCL and FL represented the outcomes, and BMR was a mediator. A two-sample MR analysis was performed to examine the association between AIs and DLBCL and FL onset. We performed reverse-MR analysis to determine whether DLBCL and FL interfered with the AIs. A two-step MR analysis was performed to determine whether BMR mediated the causality. FINDINGS WBFFM and SH had causal relationships with FL. A causal association between AIs and DLBCL was not observed. Reverse-MR analysis indicated the causal relationships were not bidirectional. Two-step MR suggested BMR may mediate the causal effect of WBFFM and SH on FL. CONCLUSIONS We observed a causal relationship between WBFFM and SH and the onset of FL in Europeans, Which may explain the high incidence of follicular lymphoma in Europeans.
Collapse
Affiliation(s)
- Yanqun Zhou
- The Second Clinical Medical School of Guizhou University of Chinese Medicine, Guiyang, China; Department of Hematology, the Second Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang, China
| | - Xiongfeng Zhang
- The Second Clinical Medical School of Guizhou University of Chinese Medicine, Guiyang, China; Department of Hematology, the Second Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang, China
| | - Xiaozhen Li
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guoqing Zhu
- The Second Clinical Medical School of Guizhou University of Chinese Medicine, Guiyang, China; Department of Hematology, the Second Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang, China
| | - Tianqi Gao
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingying Deng
- School of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Liming Huang
- The Second Clinical Medical School of Guizhou University of Chinese Medicine, Guiyang, China; Department of Hematology, the Second Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang, China.
| | - Zenghui Liu
- Department of Hematology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
| |
Collapse
|
8
|
Tito RY, Verbandt S, Aguirre Vazquez M, Lahti L, Verspecht C, Lloréns-Rico V, Vieira-Silva S, Arts J, Falony G, Dekker E, Reumers J, Tejpar S, Raes J. Microbiome confounders and quantitative profiling challenge predicted microbial targets in colorectal cancer development. Nat Med 2024; 30:1339-1348. [PMID: 38689063 PMCID: PMC11108775 DOI: 10.1038/s41591-024-02963-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/29/2024] [Indexed: 05/02/2024]
Abstract
Despite substantial progress in cancer microbiome research, recognized confounders and advances in absolute microbiome quantification remain underused; this raises concerns regarding potential spurious associations. Here we study the fecal microbiota of 589 patients at different colorectal cancer (CRC) stages and compare observations with up to 15 published studies (4,439 patients and controls total). Using quantitative microbiome profiling based on 16S ribosomal RNA amplicon sequencing, combined with rigorous confounder control, we identified transit time, fecal calprotectin (intestinal inflammation) and body mass index as primary microbial covariates, superseding variance explained by CRC diagnostic groups. Well-established microbiome CRC targets, such as Fusobacterium nucleatum, did not significantly associate with CRC diagnostic groups (healthy, adenoma and carcinoma) when controlling for these covariates. In contrast, the associations of Anaerococcus vaginalis, Dialister pneumosintes, Parvimonas micra, Peptostreptococcus anaerobius, Porphyromonas asaccharolytica and Prevotella intermedia remained robust, highlighting their future target potential. Finally, control individuals (age 22-80 years, mean 57.7 years, standard deviation 11.3) meeting criteria for colonoscopy (for example, through a positive fecal immunochemical test) but without colonic lesions are enriched for the dysbiotic Bacteroides2 enterotype, emphasizing uncertainties in defining healthy controls in cancer microbiome research. Together, these results indicate the importance of quantitative microbiome profiling and covariate control for biomarker identification in CRC microbiome studies.
Collapse
Affiliation(s)
- Raúl Y Tito
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, Katholieke Universiteit Leuven, Leuven, Belgium
- Center for Microbiology, Vlaams Instituut voor Biotechnologie, Leuven, Belgium
| | - Sara Verbandt
- Digestive Oncology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Marta Aguirre Vazquez
- Digestive Oncology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Leo Lahti
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, Katholieke Universiteit Leuven, Leuven, Belgium
- Department of Computing, University of Turku, Turku, Finland
| | - Chloe Verspecht
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, Katholieke Universiteit Leuven, Leuven, Belgium
- Center for Microbiology, Vlaams Instituut voor Biotechnologie, Leuven, Belgium
| | - Verónica Lloréns-Rico
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, Katholieke Universiteit Leuven, Leuven, Belgium
- Center for Microbiology, Vlaams Instituut voor Biotechnologie, Leuven, Belgium
- Systems Biology of Host-Microbiome Interactions Laboratory, Principe Felipe Research Center (CIPF), Valencia, Spain
| | - Sara Vieira-Silva
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, Katholieke Universiteit Leuven, Leuven, Belgium
- Institute of Medical Microbiology and Hygiene and Research Center for Immunotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Molecular Biology, Mainz, Germany
| | - Janine Arts
- Oncology, Janssen Pharmaceutica NV, Beerse, Belgium
| | - Gwen Falony
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, Katholieke Universiteit Leuven, Leuven, Belgium
- Center for Microbiology, Vlaams Instituut voor Biotechnologie, Leuven, Belgium
- Institute of Medical Microbiology and Hygiene and Research Center for Immunotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Evelien Dekker
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Joke Reumers
- Therapeutics Discovery, Janssen Pharmaceutica NV, Beerse, Belgium
| | - Sabine Tejpar
- Digestive Oncology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Jeroen Raes
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, Katholieke Universiteit Leuven, Leuven, Belgium.
- Center for Microbiology, Vlaams Instituut voor Biotechnologie, Leuven, Belgium.
| |
Collapse
|
9
|
Su L, Hendryx M, Li M, Shadyab AH, Saquib N, Stefanick ML, Luo J. Body size over the adult life course and the risk of colorectal cancer among postmenopausal women. Public Health Nutr 2023; 26:1539-1548. [PMID: 37199248 PMCID: PMC10410385 DOI: 10.1017/s1368980023000988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 02/10/2023] [Accepted: 05/06/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To assess the associations among several anthropometric measures, as well as BMI trajectories and colorectal cancer (CRC) risk in older women. DESIGN Prospective cohort study. SETTING Forty clinical centres in the USA. PARTICIPANTS Totally, 79 034 postmenopausal women in the Women's Health Initiative Observational Study. RESULTS During an average of 15·8 years of follow-up, 1514 CRC cases were ascertained. Five BMI trajectories over 18-50 years of age were identified using growth mixture model. Compared with women who had a normal BMI at age 18, women with obesity at age 18 had a higher risk of CRC (HR 1·58, 95 % CI 1·02, 2·44). Compared with women who kept relatively low normal body size during adulthood, women who progressed from normal to obesity (HR 1·29, 95 % CI 1·09, 1·53) and women who progressed from overweight to obesity (HR 1·37, 95 % CI 1·13, 1·68) had higher CRC risks. A weight gain > 15 kg from age 18 to 50 (HR 1·20, 95 % CI 1·04, 1·40) and baseline waist circumference > 88 cm (HR 1·33, 95 % CI 1·19, 1·49) were associated with higher CRC risks, compared with stable weight and waist circumference ≤ 88 cm, respectively. CONCLUSION Women who have a normal weight in early adult life and gain substantial weight later, as well as those who are persistently heavy over adulthood, demonstrated a higher risk of developing CRC. Our study highlights the importance of maintaining a healthy body weight over the life course for reducing the risk of developing CRC in women.
Collapse
Affiliation(s)
- Le Su
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University – Bloomington, Bloomington, IN47408, USA
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Ming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University – Bloomington, Bloomington, IN47408, USA
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, San Diego, California, USA
| | - Nazmus Saquib
- College of Medicine at Sulaiman Al-Rajhi University, Al Bukayriyah, Kingdom of Saudi Arabia
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Stanford University, Stanford, CA, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University – Bloomington, Bloomington, IN47408, USA
| |
Collapse
|
10
|
Widyastuti TN, Turner R, Harcombe H, McLean R. Trends in BMI of Indonesian adults between 1993 and 2014: a longitudinal population-based study. Public Health Nutr 2023; 26:1394-1402. [PMID: 36912111 PMCID: PMC10346025 DOI: 10.1017/s1368980023000472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
OBJECTIVE To examine the trajectories of BMI in Indonesian adults from 1993 to 2014, investigating different patterns by sex and birth cohort. DESIGN Longitudinal study: secondary data analysis of the Indonesian Family Life Survey, a large-scale population-based longitudinal study, had their height and weight measured up to five times throughout the 21-year study period (1993-2014). The change in BMI across time was estimated using group-based trajectory models, then differences by sex and birth cohort were investigated using random effect (mixed) models. SETTING Thirteen out of twenty-seven provinces in Indonesia. PARTICIPANTS Indonesian adults aged 19 years and older (n 42 537) were included in the analysis. RESULTS Mean BMI in adults increased between 1993 (21·4 kg/m2) and 2014 (23·5 kg/m2). The group-based trajectory model found three distinct groups with mean BMI increasing more rapidly in the most recent time periods. The first group (56·7 % of participants) had a mean BMI entirely within the normal weight range; the second group (34·7 %) started in the normal weight category and were obese, on average by the end of the study period; and the third group (8·6 %) were always in the obese category, on average. The shape of these three trajectories differed by gender (P < 0·001) and birth cohort (P < 0·001). CONCLUSIONS The mean BMI among Indonesian adults has increased between 1993 and 2014, driven by those in the most recent birth cohorts. Our findings support the urgent need for targeted overweight and obesity prevention and intervention programmes in Indonesia.
Collapse
Affiliation(s)
- Tri Nisa Widyastuti
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, 18 Frederick Street, Dunedin9016, New Zealand
- Biostatistics Centre, Division of Health Sciences, University of Otago, 18 Frederick Street, Dunedin9016, New Zealand
| | - Robin Turner
- Biostatistics Centre, Division of Health Sciences, University of Otago, 18 Frederick Street, Dunedin9016, New Zealand
| | - Helen Harcombe
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, 18 Frederick Street, Dunedin9016, New Zealand
| | - Rachael McLean
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, 18 Frederick Street, Dunedin9016, New Zealand
| |
Collapse
|
11
|
Loomans-Kropp HA, Umar A. Analysis of Body Mass Index in Early and Middle Adulthood and Estimated Risk of Gastrointestinal Cancer. JAMA Netw Open 2023; 6:e2310002. [PMID: 37163267 PMCID: PMC10173015 DOI: 10.1001/jamanetworkopen.2023.10002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Importance In a population with significantly increasing rates of individuals with overweight or obesity, understanding the association of obesity with long-term disease risk, such as cancer, is necessary to improve public health. Objective To investigate the association between body mass index (BMI) and gastrointestinal (GI) cancer risk (colorectal cancer [CRC] and noncolorectal GI cancer) in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Design, Setting, and Participants This retrospective cohort study was a secondary analysis of data from the PLCO Cancer Screening Trial. Participants aged 55 to 74 years were enrolled and randomized to the intervention (screening group) or control group at 10 screening centers between November 8, 1993, and July 2, 2001. The initial analysis of PLCO Cancer Screening Trial data occurred after 13 years of follow-up or December 31, 2009, whichever came first. Participants were reconsented in 2011 and either continued follow-up or refused additional follow-up. For those who reconsented, follow-up for incident cancers continued until December 31, 2014, or death, whichever occurred first. Data analysis for this secondary analysis was performed from April 2022 through November 2022. Exposures Body mass index and aspirin use, defined as the frequency of use of aspirin or aspirin-containing substances in the last 12 months. Main Outcomes and Measures The primary outcomes were the diagnoses of CRC and noncolorectal GI cancer. The association between BMI and cancer (CRC and noncolorectal GI cancer) was assessed using Cox proportional hazards regression modeling. The association between cancer risk and change in BMI was further analyzed at different ages, and an exploratory analysis was performed to evaluate GI cancer risk among aspirin users. Results This analysis included 135 161 participants (median [range] age, 62 [55-78] years; 67 643 [50.0%] female). Overweight BMI in early adulthood (hazard ratio [HR], 1.23; 95% CI, 1.10-1.37) and overweight BMI in middle adulthood (HR, 1.23; 95% CI, 1.13-1.34) and later adulthood (HR, 1.21; 95% CI, 1.10-1.32) as well as obese BMI in middle adulthood (HR, 1.55; 95% CI, 1.38-1.75) and later adulthood (HR, 1.39; 95% CI, 1.25-1.54) were associated with increased risk of CRC. Similar results were observed for the association with overall GI and non-CRC GI risk and BMI in middle and later adulthood. Maintaining overweight or obese BMI or increasing BMI to overweight or obese in later adulthood was also associated with increased CRC risk. Aspirin use 3 or more times per week did not significantly modify this association. Conclusions and Relevance In this secondary analysis of the PLCO Cancer Screening Trial, overweight and obese BMI in early and middle adulthood was associated with an elevated risk of CRC and noncolorectal GI cancers. The results of the current study prompt further exploration into the mechanistic role of obese BMI in carcinogenesis.
Collapse
Affiliation(s)
- Holli A Loomans-Kropp
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus
- Comprehensive Cancer Center, The Ohio State University, Columbus
- Gastrointestinal and Other Cancers Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| | - Asad Umar
- Gastrointestinal and Other Cancers Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| |
Collapse
|
12
|
Li S, Zhang L, Tony Cai T, Li H. Estimation and Inference for High-Dimensional Generalized Linear Models with Knowledge Transfer. J Am Stat Assoc 2023; 119:1274-1285. [PMID: 38948492 PMCID: PMC11213555 DOI: 10.1080/01621459.2023.2184373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 02/15/2023] [Indexed: 03/06/2023]
Abstract
Transfer learning provides a powerful tool for incorporating data from related studies into a target study of interest. In epidemiology and medical studies, the classification of a target disease could borrow information across other related diseases and populations. In this work, we consider transfer learning for high-dimensional generalized linear models (GLMs). A novel algorithm, TransHDGLM, that integrates data from the target study and the source studies is proposed. Minimax rate of convergence for estimation is established and the proposed estimator is shown to be rate-optimal. Statistical inference for the target regression coefficients is also studied. Asymptotic normality for a debiased estimator is established, which can be used for constructing coordinate-wise confidence intervals of the regression coefficients. Numerical studies show significant improvement in estimation and inference accuracy over GLMs that only use the target data. The proposed methods are applied to a real data study concerning the classification of colorectal cancer using gut microbiomes, and are shown to enhance the classification accuracy in comparison to methods that only use the target data.
Collapse
Affiliation(s)
- Sai Li
- Institute of Statistics and Big Data, Renmin University of China, China
| | - Linjun Zhang
- Department of Statistics, Rutgers University, New Brunswick, NJ 08854
| | - T Tony Cai
- Department of Statistics, the Wharton School, University of Pennsylvania, Philadelphia, PA 19104
| | - Hongzhe Li
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| |
Collapse
|
13
|
Mottalib MM, Jones-Smith JC, Sheridan B, Beheshti R. Subtyping Patients With Chronic Disease Using Longitudinal BMI Patterns. IEEE J Biomed Health Inform 2023; 27:2083-2093. [PMID: 37021857 PMCID: PMC10350469 DOI: 10.1109/jbhi.2023.3237753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Obesity is a major health problem, increasing the risk of various major chronic diseases, such as diabetes, cancer, and stroke. While the role of obesity identified by cross-sectional BMI recordings has been heavily studied, the role of BMI trajectories is much less explored. In this study, we use a machine learning approach to subtype individuals' risk of developing 18 major chronic diseases by using their BMI trajectories extracted from a large and geographically diverse EHR dataset capturing the health status of around two million individuals for a period of six years. We define nine new interpretable and evidence-based variables based on the BMI trajectories to cluster the patients into subgroups using the k-means clustering method. We thoroughly review each cluster's characteristics in terms of demographic, socioeconomic, and physiological measurement variables to specify the distinct properties of the patients in the clusters. In our experiments, the direct relationship of obesity with diabetes, hypertension, Alzheimer's, and dementia has been re-established and distinct clusters with specific characteristics for several of the chronic diseases have been found to be conforming or complementary to the existing body of knowledge.
Collapse
|
14
|
Dysbiotic microbiome variation in colorectal cancer patients is linked to lifestyles and metabolic diseases. BMC Microbiol 2023; 23:33. [PMID: 36709262 PMCID: PMC9883847 DOI: 10.1186/s12866-023-02771-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/12/2023] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Differences in the composition and diversity of the gut microbial communities among individuals are influenced by environmental factors. However, there is limited research on factors affecting microbiome variation in colorectal cancer patients, who display lower inter-individual variations than that of healthy individuals. In this study, we examined the association between modifiable factors and the microbiome variation in colorectal cancer patients. METHODS A total of 331 colorectal cancer patients who underwent resection surgery at the Department of Surgery, Seoul National University Hospital between October 2017 and August 2019 were included. Fecal samples from colorectal cancer patients were collected prior to the surgery. Variations in the gut microbiome among patients with different lifestyles and metabolic diseases were examined through the network analysis of inter-connected microbial abundance, the assessment of the Anna Karenina principle effect for microbial stochasticity, and the identification of the enriched bacteria using linear discrimination analysis effect size. Associations of dietary diversity with microbiome variation were investigated using the Procrustes analysis. RESULTS We found stronger network connectivity of microbial communities in non-smokers, non-drinkers, obese individuals, hypertensive subjects, and individuals without diabetes than in their counterparts. The Anna Karenina principle effect was found for history of smoking, alcohol consumption, and diabetes (with significantly greater intra-sample similarity index), whereas obesity and hypertension showed the anti-Anna Karenina principle effect (with significantly lower intra-sample similarity index). We found certain bacterial taxa to be significantly enriched in patients of different categories of lifestyles and metabolic diseases using linear discrimination analysis. Diversity of food and nutrient intake did not shape the microbial diversity between individuals (pProcrustes>0.05). CONCLUSIONS Our findings suggested an immune dysregulation and a reduced ability of the host and its microbiome in regulating the community composition. History of smoking, alcohol consumption, and diabetes were shown to affect partial individuals in shifting new microbial communities, whereas obesity and history of hypertension appeared to affect majority of individuals and shifted to drastic reductions in microbial compositions. Understanding the contribution of modifiable factors to microbial stochasticity may provide insights into how the microbiome regulates effects of these factors on the health outcomes of colorectal cancer patients.
Collapse
|
15
|
Étiévant L, Viallon V. Causal inference under over-simplified longitudinal causal models. Int J Biostat 2022; 18:421-437. [PMID: 34727585 DOI: 10.1515/ijb-2020-0081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/14/2021] [Indexed: 01/10/2023]
Abstract
Many causal models of interest in epidemiology involve longitudinal exposures, confounders and mediators. However, repeated measurements are not always available or used in practice, leading analysts to overlook the time-varying nature of exposures and work under over-simplified causal models. Our objective is to assess whether - and how - causal effects identified under such misspecified causal models relates to true causal effects of interest. We derive sufficient conditions ensuring that the quantities estimated in practice under over-simplified causal models can be expressed as weighted averages of longitudinal causal effects of interest. Unsurprisingly, these sufficient conditions are very restrictive, and our results state that the quantities estimated in practice should be interpreted with caution in general, as they usually do not relate to any longitudinal causal effect of interest. Our simulations further illustrate that the bias between the quantities estimated in practice and the weighted averages of longitudinal causal effects of interest can be substantial. Overall, our results confirm the need for repeated measurements to conduct proper analyses and/or the development of sensitivity analyses when they are not available.
Collapse
Affiliation(s)
| | - Vivian Viallon
- Nutritional Methodology and Biostatistics, International Agency for Research on Cancer, Lyon 69372, France
| |
Collapse
|
16
|
Mariosa D, Smith-Byrne K, Richardson TG, Ferrari P, Gunter MJ, Papadimitriou N, Murphy N, Christakoudi S, Tsilidis KK, Riboli E, Muller D, Purdue MP, Chanock SJ, Hung RJ, Amos CI, O’Mara TA, Amiano P, Pasanisi F, Rodriguez-Barranco M, Krogh V, Tjønneland A, Halkjær J, Perez-Cornago A, Chirlaque MD, Skeie G, Rylander C, Borch KB, Aune D, Heath AK, Ward HA, Schulze M, Bonet C, Weiderpass E, Davey Smith G, Brennan P, Johansson M. Body Size at Different Ages and Risk of 6 Cancers: A Mendelian Randomization and Prospective Cohort Study. J Natl Cancer Inst 2022; 114:1296-1300. [PMID: 35438160 PMCID: PMC9468294 DOI: 10.1093/jnci/djac061] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/11/2022] [Accepted: 03/16/2022] [Indexed: 02/02/2023] Open
Abstract
It is unclear if body weight in early life affects cancer risk independently of adult body weight. To investigate this question for 6 obesity-related cancers, we performed univariable and multivariable analyses using 1) Mendelian randomization (MR) analysis and 2) longitudinal analyses in prospective cohorts. Both the MR and longitudinal analyses indicated that larger early life body size was associated with higher risk of endometrial (odds ratioMR = 1.61, 95% confidence interval = 1.23 to 2.11) and kidney (odds ratioMR = 1.40, 95% confidence interval = 1.09 to 1.80) cancer. These associations were attenuated after accounting for adult body size in both the MR and cohort analyses. Early life body mass index (BMI) was not consistently associated with the other investigated cancers. The lack of clear independent risk associations suggests that early life BMI influences endometrial and kidney cancer risk mainly through pathways that are common with adult BMI.
Collapse
Affiliation(s)
- Daniela Mariosa
- International Agency for Research on Cancer (IARC/WHO), Genomic Epidemiology Branch, Lyon, France
| | - Karl Smith-Byrne
- International Agency for Research on Cancer (IARC/WHO), Genomic Epidemiology Branch, Lyon, France
| | - Tom G Richardson
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Novo Nordisk Research Centre Oxford, Oxford, UK
| | - Pietro Ferrari
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, Lyon, France
| | - Marc J Gunter
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, Lyon, France
| | - Nikos Papadimitriou
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, Lyon, France
| | - Neil Murphy
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, Lyon, France
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Transplantation, King’s College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - David Muller
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rayjean J Hung
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Christopher I Amos
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Tracy A O’Mara
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Pilar Amiano
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastián, Spain
- Epidemiology of Chronic and Communicable Diseases Group, Biodonostia Health Research Institute, San Sebastián, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Fabrizio Pasanisi
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Miguel Rodriguez-Barranco
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jytte Halkjær
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - María-Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Guri Skeie
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Charlotta Rylander
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | | | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Heather A Ward
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- IQVIA, Epidemiology and Outcomes Research, Real World Solutions, IQVIA, Cambridge, MA, USA
| | - Matthias Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology- IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | | | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Paul Brennan
- International Agency for Research on Cancer (IARC/WHO), Genomic Epidemiology Branch, Lyon, France
| | - Mattias Johansson
- International Agency for Research on Cancer (IARC/WHO), Genomic Epidemiology Branch, Lyon, France
| |
Collapse
|
17
|
Gray LA, Breeze PR, Williams EA. BMI trajectories, morbidity, and mortality in England: a two-step approach to estimating consequences of changes in BMI. Obesity (Silver Spring) 2022; 30:1898-1907. [PMID: 35920148 PMCID: PMC9546036 DOI: 10.1002/oby.23510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/03/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE BMI is known to have an association with morbidities and mortality. Many studies have argued that identifying health risks using single BMI measures has limitations, particularly in older adults, and that changes in BMI can help to identify risks. This study identifies distinct BMI trajectories and their association with the risks of a range of morbidities and mortality. METHODS The English Longitudinal Study of Aging provides data on BMI, mortality, and morbidities between 1998 and 2015, sampled from adults over 50 years of age. This study uses a growth-mixture model and discrete-time survival analysis, combined using a two-step approach, which is novel in this setting, to the authors' knowledge. RESULTS This study identified four trajectories: "stable overweight," "elevated BMI," "increasing BMI," and "decreasing BMI." No differences in mortality, cancer, or stroke risk were found between these trajectories. BMI trajectories were significantly associated with the risks of diabetes, asthma, arthritis, and heart problems. CONCLUSIONS These results emphasize the importance of looking at change in BMI alongside most recent BMI; BMI trajectories should be considered where possible when assessing health risks. The results suggest that established BMI thresholds should not be used in isolation to identify health risks, particularly in older adults.
Collapse
Affiliation(s)
- Laura A. Gray
- Health Economics and Decision Science, School of Health and Related ResearchUniversity of SheffieldSheffieldUK
- Healthy Lifespan InstituteUniversity of SheffieldSheffieldUK
| | - Penny R. Breeze
- Health Economics and Decision Science, School of Health and Related ResearchUniversity of SheffieldSheffieldUK
- Healthy Lifespan InstituteUniversity of SheffieldSheffieldUK
| | - Elizabeth A. Williams
- Healthy Lifespan InstituteUniversity of SheffieldSheffieldUK
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
| |
Collapse
|
18
|
Yang W, Zeng X, Petrick JL, Danford CJ, Florio AA, Lu B, Nan H, Ma J, Wang L, Zeng H, Sudenga SL, Campbell PT, Giovannucci E, McGlynn KA, Zhang X. Body mass index trajectories, weight gain and risks of liver and biliary tract cancers. JNCI Cancer Spectr 2022; 6:pkac056. [PMID: 35960613 PMCID: PMC9406603 DOI: 10.1093/jncics/pkac056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/18/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Little is known about the role of early obesity or weight change during adulthood in the development of liver cancer and biliary tract cancer (BTC). METHODS We investigated the associations of body mass index (BMI) and weight trajectories with the risk of liver cancer and BTC in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO). BMI was self-reported at ages 20, 50, and at enrollment. BMI trajectories were determined using latent class growth models. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS During a median follow-up of 15.9 years among 138,922 participants, 170 liver cancer and 143 BTC cases were identified. Compared with those whose BMI does not exceed 25 kg/m2, participants with BMI exceeding 25 kg/m2 at age 20 had increased risks of liver cancer (HR = 2.03, 95% CI: 1.26-3.28) and BTC (HR = 1.99, 95% CI: 1.16-3.39). Compared to participants maintaining normal BMI until enrollment, trajectory of normal weight at age 20 to obesity at enrollment was associated with increased risk for liver cancer (HR = 2.50, 95% CI: 1.55-4.04) and BTC (HR = 1.83, 95% CI: 1.03-3.22). Compared to adults with stable weight (+/-5kg) between age 20 to 50 years, weight gain ≥20 kg between ages 20 to 50 years had higher HRs of 2.24 (95%CI: 1.40-3.58) for liver cancer and 1.86 (95% CI: 1.12-3.09) for BTC. CONCLUSIONS Being overweight/obese at age 20, and BMI trajectories that result in being overweight and/or obese, may increase risk for both liver cancer and BTC.
Collapse
Affiliation(s)
- Wanshui Yang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Xufen Zeng
- Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, Anhui, P.R. China
| | | | - Christopher J Danford
- Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Andrea A Florio
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Bing Lu
- Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Hongmei Nan
- Department of Epidemiology, Richard M Fairbanks School of Public Health, Indiana University, and Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA
| | - Jiantao Ma
- Framingham Heart Study, Framingham, MA, USA
- Division of Nutrition Data Science, Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, TX, USA
| | - Hongmei Zeng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Staci L Sudenga
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Peter T Campbell
- Department of Epidemiology and Population Science, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Edward Giovannucci
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
19
|
Saleem S, Aleem I, Zeshan M, Bakar MA, Atiq A, Tahseen M, Mahmood MT, Hassan S, Syed AA, Hussain M, Ahmad AH, Khattak S, Yusuf MA. Body Mass Index and Other Risk Factors Effects on Colon Cancer Prognosis in Pakistan. JOURNAL OF CANCER & ALLIED SPECIALTIES 2022; 8:477. [PMID: 37197568 PMCID: PMC10187604 DOI: 10.37029/jcas.v8i2.477;] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/30/2022] [Indexed: 07/31/2024]
Abstract
INTRODUCTION Asian developing countries share the burden of colorectal cancer (CRC) with rising mortality rates. This prospective study aims to apprehend the clinical relevance of age, gender, lifestyle choices (dietary habits and addiction) and body mass index (BMI) to the occurrence and progression of colon cancer (CC). METHODS A cohort of non-cancer (NC) and CC patients of South-Central Asian origin registered for screening colonoscopy or surgery at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH and RC), Lahore, Pakistan, from 2015 to 2020 was identified. BMI (Kg/m2) was classified according to the World Health Organization criteria as underweight (<18.5 Kg/m2), normal weight (18.5-24.9 Kg/m2) and overweight (≥25 Kg/m2). RESULTS Among 236 participants, 99 (41.9%) belonged to the NC group, and 137 (58.1 %) participants had CC Overall, participants included 74 women and 162 men aged 20-85 years (mean ± SD; 49.9 ± 14.9). Notably, 46.0% of cancer patients had a family history of cancer. There was a direct relationship between CC with abnormal BMI (underweight and overweight), positive smoking history and positive family history of cancer. CONCLUSION Being underweight or overweight is a potential risk factor for CC patients. The overall survival in patients with CC is clinically associated with lifestyle choices before CC diagnosis. A balanced diet, walking and other forms of exercise should be strongly recommended to the community and those undergoing screening colonoscopy.
Collapse
Affiliation(s)
- Saira Saleem
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Iffat Aleem
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammad Zeshan
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammad Abu Bakar
- Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Aribah Atiq
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammad Tahseen
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Mohammad Tariq Mahmood
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Sadia Hassan
- Department of Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Aamir Ali Syed
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Mudassar Hussain
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Asad Hayat Ahmad
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Shahid Khattak
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammed Aasim Yusuf
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| |
Collapse
|
20
|
Saleem S, Aleem I, Zeshan M, Bakar MA, Atiq A, Tahseen M, Mahmood MT, Hassan S, Syed AA, Hussain M, Ahmad AH, Khattak S, Yusuf MA. Body Mass Index and Other Risk Factors Effects on Colon Cancer Prognosis in Pakistan. JOURNAL OF CANCER & ALLIED SPECIALTIES 2022; 8:477. [PMID: 37197568 PMCID: PMC10187604 DOI: 10.37029/jcas.v8i2.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/30/2022] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Asian developing countries share the burden of colorectal cancer (CRC) with rising mortality rates. This prospective study aims to apprehend the clinical relevance of age, gender, lifestyle choices (dietary habits and addiction) and body mass index (BMI) to the occurrence and progression of colon cancer (CC). METHODS A cohort of non-cancer (NC) and CC patients of South-Central Asian origin registered for screening colonoscopy or surgery at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH and RC), Lahore, Pakistan, from 2015 to 2020 was identified. BMI (Kg/m2) was classified according to the World Health Organization criteria as underweight (<18.5 Kg/m2), normal weight (18.5-24.9 Kg/m2) and overweight (≥25 Kg/m2). RESULTS Among 236 participants, 99 (41.9%) belonged to the NC group, and 137 (58.1 %) participants had CC Overall, participants included 74 women and 162 men aged 20-85 years (mean ± SD; 49.9 ± 14.9). Notably, 46.0% of cancer patients had a family history of cancer. There was a direct relationship between CC with abnormal BMI (underweight and overweight), positive smoking history and positive family history of cancer. CONCLUSION Being underweight or overweight is a potential risk factor for CC patients. The overall survival in patients with CC is clinically associated with lifestyle choices before CC diagnosis. A balanced diet, walking and other forms of exercise should be strongly recommended to the community and those undergoing screening colonoscopy.
Collapse
Affiliation(s)
- Saira Saleem
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Iffat Aleem
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammad Zeshan
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammad Abu Bakar
- Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Aribah Atiq
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammad Tahseen
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Mohammad Tariq Mahmood
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Sadia Hassan
- Department of Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Aamir Ali Syed
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Mudassar Hussain
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Asad Hayat Ahmad
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Shahid Khattak
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| | - Muhammed Aasim Yusuf
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Punjab, Pakistan
| |
Collapse
|
21
|
The timing of adiposity and changes in the life course on the risk of cancer. Cancer Metastasis Rev 2022; 41:471-489. [PMID: 35908000 DOI: 10.1007/s10555-022-10054-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/23/2022] [Indexed: 11/02/2022]
Abstract
Excess body weight has been established as a risk factor for at least twelve cancer sites, though questions remain as to the timing of associations for adiposity and cancer risk throughout the life course. We conducted a narrative review summarizing existing evidence to provide insights into the complex timing relationship between adiposity and risk of seven common obesity-related cancers. We considered five types of studies, including traditional epidemiologic studies examining adiposity at different time points, studies examining weight gain in specific life phases, studies examining weight loss over a period including from bariatric surgery, life course trajectory analysis, and Mendelian randomization studies. The results showed that lifetime excess body weight is associated with increased risk of cancers of endometrium, colorectum, liver, kidney, and pancreas. Early life obesity is one of the strongest risk factors for pancreatic cancer but less directly important than adult obesity for endometrial and kidney cancer. Interestingly, heavy weight during childhood, adolescence, and early adulthood is protective against pre- and postmenopausal breast cancer and possibly advanced prostate cancer. It is apparent that preventing weight gain later in adulthood would likely reduce risk of many cancers, including postmenopausal breast cancer, endometrial cancer, colorectal cancer (especially in men), liver cancer, kidney cancer, and probably advanced prostate cancer. Furthermore, weight loss even late in life may confer benefits for cancers of breast, endometrium, colorectum, and liver among patients with obesity, as mostly demonstrated by studies of bariatric surgery. Overall, maintaining a healthy weight throughout the life course will help prevent a large number of cancers.
Collapse
|
22
|
Bassett JK, MacInnis RJ, Yang Y, Hodge AM, Lynch BM, English DR, Giles GG, Milne RL, Jayasekara H. Alcohol intake trajectories during the life course and risk of alcohol-related cancer: A prospective cohort study. Int J Cancer 2022; 151:56-66. [PMID: 35182083 DOI: 10.1002/ijc.33973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/10/2022]
Abstract
We examined associations between sex-specific alcohol intake trajectories and alcohol-related cancer risk using data from 22 756 women and 15 701 men aged 40 to 69 years at baseline in the Melbourne Collaborative Cohort Study. Alcohol intake for 10-year periods from age 20 until the decade encompassing recruitment, calculated using recalled beverage-specific frequency and quantity, was used to estimate group-based sex-specific intake trajectories. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for primary invasive alcohol-related cancer (upper aerodigestive tract, breast, liver and colorectum). Three distinct alcohol intake trajectories for women (lifetime abstention, stable light, increasing moderate) and six for men (lifetime abstention, stable light, stable moderate, increasing heavy, early decreasing heavy, late decreasing heavy) were identified. 2303 incident alcohol-related cancers were diagnosed during 485 525 person-years in women and 789 during 303 218 person-years in men. For men, compared with lifetime abstention, heavy intake (mean ≥ 60 g/day) at age 20 to 39 followed by either an early (from age 40 to 49) (early decreasing heavy; HR = 1.75, 95% CI: 1.25-2.44) or late decrease (from age 60 to 69) (late decreasing heavy; HR = 1.94, 95% CI: 1.28-2.93), and moderate intake (mean <60 g/day) at age 20 to 39 increasing to heavy intake in middle-age (increasing heavy; HR = 1.45, 95% CI: 1.06-1.97) were associated with increased risk of alcohol-related cancer. For women, compared with lifetime abstention, increasing intake from age 20 (increasing moderate) was associated with increased alcohol-related cancer risk (HR = 1.25, 95% CI: 1.06-1.48). Similar associations were observed for colorectal (men) and breast cancer. Heavy drinking during early adulthood might increase cancer risk later in life.
Collapse
Affiliation(s)
- Julie K Bassett
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Robert J MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yi Yang
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Harindra Jayasekara
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
23
|
You D, Wang D, Wu Y, Chen X, Shao F, Wei Y, Zhang R, Lange T, Ma H, Xu H, Hu Z, Christiani DC, Shen H, Chen F, Zhao Y. Associations of genetic risk, BMI trajectories, and the risk of non-small cell lung cancer: a population-based cohort study. BMC Med 2022; 20:203. [PMID: 35658861 PMCID: PMC9169327 DOI: 10.1186/s12916-022-02400-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/10/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Body mass index (BMI) has been found to be associated with a decreased risk of non-small cell lung cancer (NSCLC); however, the effect of BMI trajectories and potential interactions with genetic variants on NSCLC risk remain unknown. METHODS Cox proportional hazards regression model was applied to assess the association between BMI trajectory and NSCLC risk in a cohort of 138,110 participants from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. One-sample Mendelian randomization (MR) analysis was further used to access the causality between BMI trajectories and NSCLC risk. Additionally, polygenic risk score (PRS) and genome-wide interaction analysis (GWIA) were used to evaluate the multiplicative interaction between BMI trajectories and genetic variants in NSCLC risk. RESULTS Compared with individuals maintaining a stable normal BMI (n = 47,982, 34.74%), BMI trajectories from normal to overweight (n = 64,498, 46.70%), from normal to obese (n = 21,259, 15.39%), and from overweight to obese (n = 4,371, 3.16%) were associated with a decreased risk of NSCLC (hazard ratio [HR] for trend = 0.78, P < 2×10-16). An MR study using BMI trajectory associated with genetic variants revealed no significant association between BMI trajectories and NSCLC risk. Further analysis of PRS showed that a higher GWAS-identified PRS (PRSGWAS) was associated with an increased risk of NSCLC, while the interaction between BMI trajectories and PRSGWAS with the NSCLC risk was not significant (PsPRS= 0.863 and PwPRS= 0.704). In GWIA analysis, four independent susceptibility loci (P < 1×10-6) were found to be associated with BMI trajectories on NSCLC risk, including rs79297227 (12q14.1, located in SLC16A7, Pinteraction = 1.01×10-7), rs2336652 (3p22.3, near CLASP2, Pinteraction = 3.92×10-7), rs16018 (19p13.2, in CACNA1A, Pinteraction = 3.92×10-7), and rs4726760 (7q34, near BRAF, Pinteraction = 9.19×10-7). Functional annotation demonstrated that these loci may be involved in the development of NSCLC by regulating cell growth, differentiation, and inflammation. CONCLUSIONS Our study has shown an association between BMI trajectories, genetic factors, and NSCLC risk. Interestingly, four novel genetic loci were identified to interact with BMI trajectories on NSCLC risk, providing more support for the aetiology research of NSCLC. TRIAL REGISTRATION http://www. CLINICALTRIALS gov , NCT01696968 .
Collapse
Affiliation(s)
- Dongfang You
- Department of Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Danhua Wang
- Department of Public Health and Preventive Medicine, Kangda College of Nanjing Medical University, Lianyungang, 222000, China
| | - Yaqian Wu
- Department of Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Xin Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Fang Shao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
| | - Yongyue Wei
- Department of Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- China International Cooperation Center for Environment and Human Health, Center for Global Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- The Center of Biomedical Big Data and the Laboratory of Biomedical Big Data, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Ruyang Zhang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, China
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- China International Cooperation Center for Environment and Human Health, Center for Global Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- The Center of Biomedical Big Data and the Laboratory of Biomedical Big Data, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Theis Lange
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, ØsterFarimagsgade 5, 1353, Copenhagen, Denmark
| | - Hongxia Ma
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Hongyang Xu
- Department of Critical Care Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Zhibin Hu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, MA, 02115, USA
| | - Hongbing Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Feng Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, China.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- China International Cooperation Center for Environment and Human Health, Center for Global Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
- The Center of Biomedical Big Data and the Laboratory of Biomedical Big Data, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
| | - Yang Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, China.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- China International Cooperation Center for Environment and Human Health, Center for Global Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
- The Center of Biomedical Big Data and the Laboratory of Biomedical Big Data, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
| |
Collapse
|
24
|
Lin A, Qi C, Li M, Guan R, Imyanitov EN, Mitiushkina NV, Cheng Q, Liu Z, Wang X, Lyu Q, Zhang J, Luo P. Deep Learning Analysis of the Adipose Tissue and the Prediction of Prognosis in Colorectal Cancer. Front Nutr 2022; 9:869263. [PMID: 35634419 PMCID: PMC9131178 DOI: 10.3389/fnut.2022.869263] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
Research has shown that the lipid microenvironment surrounding colorectal cancer (CRC) is closely associated with the occurrence, development, and metastasis of CRC. According to pathological images from the National Center for Tumor diseases (NCT), the University Medical Center Mannheim (UMM) database and the ImageNet data set, a model called VGG19 was pre-trained. A deep convolutional neural network (CNN), VGG19CRC, was trained by the migration learning method. According to the VGG19CRC model, adipose tissue scores were calculated for TCGA-CRC hematoxylin and eosin (H&E) images and images from patients at Zhujiang Hospital of Southern Medical University and First People's Hospital of Chenzhou. Kaplan-Meier (KM) analysis was used to compare the overall survival (OS) of patients. The XCell and MCP-Counter algorithms were used to evaluate the immune cell scores of the patients. Gene set enrichment analysis (GSEA) and single-sample GSEA (ssGSEA) were used to analyze upregulated and downregulated pathways. In TCGA-CRC, patients with high-adipocytes (high-ADI) CRC had significantly shorter OS times than those with low-ADI CRC. In a validation queue from Zhujiang Hospital of Southern Medical University (Local-CRC1), patients with high-ADI had worse OS than CRC patients with low-ADI. In another validation queue from First People's Hospital of Chenzhou (Local-CRC2), patients with low-ADI CRC had significantly longer OS than patients with high-ADI CRC. We developed a deep convolution network to segment various tissues from pathological H&E images of CRC and automatically quantify ADI. This allowed us to further analyze and predict the survival of CRC patients according to information from their segmented pathological tissue images, such as tissue components and the tumor microenvironment.
Collapse
Affiliation(s)
- Anqi Lin
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Chang Qi
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Mujiao Li
- College of Biomedical Engineering, Southern Medical University, Guangzhou, China
- Department of Information, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Rui Guan
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Evgeny N. Imyanitov
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, St. Petersburg, Russia
| | - Natalia V. Mitiushkina
- Department of Tumor Growth Biology, N.N. Petrov Institute of Oncology, St. Petersburg, Russia
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zaoqu Liu
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaojun Wang
- First People's Hospital of Chenzhou City, Chenzhou, China
| | - Qingwen Lyu
- Department of Information, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Qingwen Lyu
| | - Jian Zhang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Jian Zhang
| | - Peng Luo
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Peng Luo
| |
Collapse
|
25
|
Li X, Jansen L, Chang-Claude J, Hoffmeister M, Brenner H. Risk of Colorectal Cancer Associated With Lifetime Excess Weight. JAMA Oncol 2022; 8:730-737. [PMID: 35297997 PMCID: PMC8931669 DOI: 10.1001/jamaoncol.2022.0064] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Importance Excess weight is associated with increased cancer risk, but the risk may have been underestimated, as previous studies did not consider cumulative lifetime exposure. Objective To assess the association of cumulative lifetime excess weight with risk of colorectal cancer (CRC). Design, Setting, and Participants In a population-based case-control study conducted since 2003 in Germany, height and self-reported weight documented in 10-year increments starting at age 20 years up to the current age were obtained from 5635 individuals with CRC and 4515 persons serving as controls. Body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, was calculated for each year of age from age 20 years to the current age by linear interpolation. Excess BMI (eBMI) at each year of age was determined as BMI - 25 and summed across ages to obtain the weighted number of years lived with overweight or obesity (WYOs), determined as year × eBMI. The eBMI was set to 0 in case of a BMI below 25. Associations with CRC risk were estimated for BMI at various ages and for WYOs by multiple logistic regression. Data analyses were performed from June 4, 2021, to December 17, 2021. Main Outcomes and Measures Relative risk of CRC according to lifetime exposure to excess weight compared with relative risks according to BMI at various ages. Results The mean (SD) age of the patients with CRC (n = 5635) was 68.4 (10.9) years; 3366 were men (59.7%); mean (SD) age of the control participants (n = 4515) was 68.5 (10.6) years; 2759 were men (61.1%). An association was observed between WYOs and CRC risk, with adjusted odds ratios (ORs) increasing from 1.25 (95% CI, 1.09-1.44) to 2.54 (95% CI, 2.24-2.89) from the first to the fourth quartile of WYOs compared with participants who remained within the normal weight range. Each SD increment in WYOs was associated with an increase of CRC risk by 55% (adjusted OR, 1.55; 95% CI, 1.46-1.64). This OR was higher than the OR per SD increase of eBMI at any single point of time, which ranged from 1.04 (95% CI, 0.93-1.16) to 1.27 (95% CI 1.16-1.39). Conclusions and Relevance The results of this case-control study suggest a greater role of cumulative lifetime excess weight for CRC risk than estimated by traditional analyses based on BMI measures taken at a single point.
Collapse
Affiliation(s)
- Xiangwei Li
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jenny Chang-Claude
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Network Aging Research, Heidelberg University, Heidelberg, Germany.,German Cancer Consortium, DKFZ, Heidelberg, Germany.,Division of Preventive Oncology, DKFZ National Center for Tumor Diseases, Heidelberg, Germany
| |
Collapse
|
26
|
Syed Soffian SS, Mohammed Nawi A, Hod R, Ja’afar MH, Isa ZM, Chan HK, Hassan MRA. Meta-Analysis of the Association between Dietary Inflammatory Index (DII) and Colorectal Cancer. Nutrients 2022; 14:nu14081555. [PMID: 35458117 PMCID: PMC9031004 DOI: 10.3390/nu14081555] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 02/07/2023] Open
Abstract
The Dietary Inflammatory Index (DII) was extensively used to examine the inflammatory potential of diet related to colorectal cancer (CRC). This meta-analysis aimed to update the evidence of the association between the DII and CRC across various culture-specific dietary patterns. Literature search was performed through online databases (Scopus, Web of Science, PubMed, and EBSCOHost). Observational studies exploring the association between the DII and CRC, published between 2017 and 2021, were included. The risk ratio (RR) and 95% confidence interval (CI) were separately computed for 12 studies comparing the highest and lowest DII scores and for 3 studies that presented continuous DII scores. A high DII score was associated with a higher risk of CRC (RR:1.16; 95% CI, 1.05–1.27). In the subgroup analysis, significant associations were seen in cohort design (RR: 1.24; 95% CI, 1.06–1.44), those lasting for 10 years or longer (RR: 2.95; 95% CI, 2.47–3.52), and in adjustment factor for physical activity (RR: 1.13; 95% CI, 1.07–1.20). An increase of one point in the DII score elevates the risk of CRC by 1.34 (95% CI: 1.15–1.55) times. The findings call for standardized measurement of the inflammatory potential of diet in future studies to enable the establishment of global guidelines for CRC prevention.
Collapse
Affiliation(s)
- Sharifah Saffinas Syed Soffian
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (S.S.S.S.); (R.H.); (M.H.J.); (Z.M.I.)
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (S.S.S.S.); (R.H.); (M.H.J.); (Z.M.I.)
- Correspondence:
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (S.S.S.S.); (R.H.); (M.H.J.); (Z.M.I.)
| | - Mohd Hasni Ja’afar
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (S.S.S.S.); (R.H.); (M.H.J.); (Z.M.I.)
| | - Zaleha Md Isa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (S.S.S.S.); (R.H.); (M.H.J.); (Z.M.I.)
| | - Huan-Keat Chan
- Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar 05400, Malaysia; (H.-K.C.); (M.R.A.H.)
| | - Muhammad Radzi Abu Hassan
- Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar 05400, Malaysia; (H.-K.C.); (M.R.A.H.)
| |
Collapse
|
27
|
Brown LD, Vasquez D, Lopez DI, Portillo EM. Addressing Hispanic Obesity Disparities Using a Community Health Worker Model Grounded in Motivational Interviewing. Am J Health Promot 2022; 36:259-268. [PMID: 34791885 PMCID: PMC8995140 DOI: 10.1177/08901171211049679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To determine whether Hispanic residents receiving the Healthy Fit intervention enhanced with Motivational Interviewing (MI) experienced greater improvements in body composition, relative to participants receiving the initial intervention. DESIGN Quasi-experimental evaluation. SETTING El Paso, Texas. SAMPLE Among 656 baseline participants, 374 (54%) completed the 12-month assessment. INTERVENTION In Healthy Fit, community health workers (CHWs) promote nutrition and exercise. To strengthen intrinsic motivation and help participants overcome barriers to change, we incorporated a 30-minute motivational interview into the baseline assessment. Follow-up phone calls at 1, 3, and 6 months were identical across conditions. MEASURES CHWs assessed body mass index (BMI) and body fat percentage (BFP) using a bioelectrical impedance scale. ANALYSIS Regression models estimated differences between intervention conditions on change in BMI and BFP from baseline to the 12-month assessment. RESULTS Participants receiving MI had 2.13 times higher odds of losing weight (OR = 2.14, 95% CI [1.30, 3.53], P = .003) and 2.59 times higher odds of reduced BFP (OR = 2.59, 95% CI [1.51, 4.41], P < .001), relative to initial intervention participants. MI participants lost an average of 1.23 kg (2.71 lbs.) and their BFP declined 2% over 12 months. CONCLUSION Findings suggest CHW use of MI is a promising approach for promoting incremental changes in diet and exercise, which Healthy Fit integrates into a low-cost intervention.
Collapse
Affiliation(s)
- Louis D. Brown
- School of Public Health, The University of Texas Health Science Center at Houston, El Paso, TX, USA
| | - Denise Vasquez
- School of Public Health, The University of Texas Health Science Center at Houston, El Paso, TX, USA
| | - Diane I. Lopez
- School of Public Health, The University of Texas Health Science Center at Houston, El Paso, TX, USA
| | | |
Collapse
|
28
|
Ngeow J, Eng C. Oh GxE! The Complexity of Body Mass Index and Colon Cancer Risk. J Natl Cancer Inst 2021; 113:5-6. [PMID: 32324885 DOI: 10.1093/jnci/djaa059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/16/2020] [Indexed: 12/28/2022] Open
Affiliation(s)
- Joanne Ngeow
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre, Singapore.,Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore.,Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Charis Eng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.,Center for Personalized Genetic Healthcare, Cleveland Clinic Community Care and Population Health, Cleveland, OH, USA.,Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.,Stanley Shalom Zielony Institute of Nursing Excellence, Cleveland Clinic, Cleveland, OH, USA.,Department of Genetics and Genome Sciences, and CASE Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
29
|
Whelton SP, Berning P, Blumenthal RS, Marshall CH, Martin SS, Mortensen MB, Blaha MJ, Dzaye O. Multidisciplinary prevention and management strategies for colorectal cancer and cardiovascular disease. Eur J Intern Med 2021; 87:3-12. [PMID: 33610416 DOI: 10.1016/j.ejim.2021.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/09/2021] [Accepted: 02/06/2021] [Indexed: 02/06/2023]
Abstract
Colorectal cancer (CRC) and cardiovascular disease (CVD) are leading causes of morbidity and mortality worldwide. Their numerous shared and modifiable risk factors underscore the importance of effective prevention strategies for these largely preventable diseases. Conventionally regarded as separate disease entities, clear pathophysiological links and overlapping risk factors represent an opportunity for synergistic collaborative efforts of oncologists and cardiologists. In addition, current CRC treatment approaches can exert cardiotoxicity and thus increase CVD risk. Given the complex interplay of both diseases and increasing numbers of CRC survivors who are at increased risk for CVD, multidisciplinary cardio-oncological approaches are warranted for optimal patient care from primary prevention to acute disease treatment and long-term surveillance.
Collapse
Affiliation(s)
- Seamus P Whelton
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Philipp Berning
- Department of Hematology and Oncology, University Hospital Muenster, Muenster, Germany
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Catherine Handy Marshall
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Seth S Martin
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Martin Bødtker Mortensen
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Omar Dzaye
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| |
Collapse
|
30
|
Christakoudi S, Pagoni P, Ferrari P, Cross AJ, Tzoulaki I, Muller DC, Weiderpass E, Freisling H, Murphy N, Dossus L, Turzanski Fortner R, Agudo A, Overvad K, Perez-Cornago A, Key TJ, Brennan P, Johansson M, Tjønneland A, Halkjaer J, Boutron-Ruault MC, Artaud F, Severi G, Kaaks R, Schulze MB, Bergmann MM, Masala G, Grioni S, Simeon V, Tumino R, Sacerdote C, Skeie G, Rylander C, Borch KB, Quirós JR, Rodriguez-Barranco M, Chirlaque MD, Ardanaz E, Amiano P, Drake I, Stocks T, Häggström C, Harlid S, Ellingjord-Dale M, Riboli E, Tsilidis KK. Weight change in middle adulthood and risk of cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Int J Cancer 2021; 148:1637-1651. [PMID: 33038275 DOI: 10.1002/ijc.33339] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022]
Abstract
Obesity is a risk factor for several major cancers. Associations of weight change in middle adulthood with cancer risk, however, are less clear. We examined the association of change in weight and body mass index (BMI) category during middle adulthood with 42 cancers, using multivariable Cox proportional hazards models in the European Prospective Investigation into Cancer and Nutrition cohort. Of 241 323 participants (31% men), 20% lost and 32% gained weight (>0.4 to 5.0 kg/year) during 6.9 years (average). During 8.0 years of follow-up after the second weight assessment, 20 960 incident cancers were ascertained. Independent of baseline BMI, weight gain (per one kg/year increment) was positively associated with cancer of the corpus uteri (hazard ratio [HR] = 1.14; 95% confidence interval: 1.05-1.23). Compared to stable weight (±0.4 kg/year), weight gain (>0.4 to 5.0 kg/year) was positively associated with cancers of the gallbladder and bile ducts (HR = 1.41; 1.01-1.96), postmenopausal breast (HR = 1.08; 1.00-1.16) and thyroid (HR = 1.40; 1.04-1.90). Compared to maintaining normal weight, maintaining overweight or obese BMI (World Health Organisation categories) was positively associated with most obesity-related cancers. Compared to maintaining the baseline BMI category, weight gain to a higher BMI category was positively associated with cancers of the postmenopausal breast (HR = 1.19; 1.06-1.33), ovary (HR = 1.40; 1.04-1.91), corpus uteri (HR = 1.42; 1.06-1.91), kidney (HR = 1.80; 1.20-2.68) and pancreas in men (HR = 1.81; 1.11-2.95). Losing weight to a lower BMI category, however, was inversely associated with cancers of the corpus uteri (HR = 0.40; 0.23-0.69) and colon (HR = 0.69; 0.52-0.92). Our findings support avoiding weight gain and encouraging weight loss in middle adulthood.
Collapse
Affiliation(s)
- Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Transplantation, King's College London, London, UK
| | - Panagiota Pagoni
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Pietro Ferrari
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Ioanna Tzoulaki
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - David C Muller
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Heinz Freisling
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Neil Murphy
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Laure Dossus
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Antonio Agudo
- Unit of Nutrition and Cancer. Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paul Brennan
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Mattias Johansson
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Jytte Halkjaer
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Marie-Christine Boutron-Ruault
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe "Exposome, Hérédité, Cancer et Santé", CESP, Gustave Roussy, Villejuif, France
| | - Fanny Artaud
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe "Exposome, Hérédité, Cancer et Santé", CESP, Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe "Exposome, Hérédité, Cancer et Santé", CESP, Gustave Roussy, Villejuif, France
- Department of Statistics, Computer Science, and Applications "G. Parenti" (DISIA), University of Florence, Florence, Italy
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutrition Science, University of Potsdam, Nuthetal, Germany
| | - Manuela M Bergmann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Nuthetal, Germany
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Vittorio Simeon
- Dep. of Mental, Physical Health and Preventive Medicine University "L.Vanvitelli", Naples, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP) Ragusa, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Guri Skeie
- Department of Community Medicine, UiT The Arctic university of Norway, Tromsø, Norway
| | - Charlotta Rylander
- Department of Community Medicine, UiT The Arctic university of Norway, Tromsø, Norway
| | | | | | - Miguel Rodriguez-Barranco
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria-Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Researach Institute, San Sebastian, Spain
| | - Isabel Drake
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Tanja Stocks
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Christel Häggström
- Department of Biobank Research, Umeå University, Umeå, Sweden
- Department of Surgical Science, Uppsala University, Uppsala, Sweden
| | - Sophia Harlid
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Merete Ellingjord-Dale
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| |
Collapse
|
31
|
Tang F, Gates Kuliszewski M, Carrascal A, Vásquez E. Physical multimorbidity and cancer prevalence in the National Health and Nutrition Examination Survey. Public Health 2021; 193:94-100. [PMID: 33751964 DOI: 10.1016/j.puhe.2021.01.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 01/22/2021] [Accepted: 01/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES As the US population ages, both cancer and multimorbidity become more common and pose challenges to the healthcare system. Limited studies have examined the association between multimorbidity and cancer prevalence in the US adult population. To help address this gap, we evaluated the associations between individual chronic conditions and all-site cancer, multimorbidity and all-site cancer, and multimorbidity and site-specific cancers. STUDY DESIGN This is a cross-sectional study. METHODS Data from 10,731 adults aged 20 years or older who participated in the 2013-2016 National Health and Nutrition Examination Survey were used in our study. Self-reported demographics, smoking status, sedentary behavior, body mass index, individual chronic conditions, multimorbidity status, cancer history, and cancer sites were assessed. RESULTS In our sample, the prevalence of having any type of cancer or multimorbidity was 9% (N = 861) and 38% (N = 4248), respectively. Respiratory conditions (multivariable-adjusted odds ratio [OR]: 1.3; 95% confidence interval [CI]: 1.1-1.6) and arthritis (multivariable-adjusted OR: 1.5; 95% CI: 1.2-1.8) were observed to be statistically significantly associated with having all-site cancer after adjusting for potential confounders. Having multimorbidity was also statistically significantly associated with having all-site cancer (multivariable-adjusted OR: 1.4; 95% CI: 1.2-1.7), cervical cancer (multivariable-adjusted OR: 2.6; 95% CI: 1.2-5.4), and bladder cancer (multivariable-adjusted OR: 2.8; 95% CI: 1.0-7.6). CONCLUSIONS Multimorbidity was associated with all-site cancer, cervical cancer, and bladder cancer. The present study provides new evidence of the potential relationships between multimorbidity and cancer. Future longitudinal studies are warranted to clarify the temporality and potential biological mechanisms of the associations between multimorbidity and cancer.
Collapse
Affiliation(s)
- F Tang
- Department of Epidemiology and Biostatistics, University at Albany State University of New York, United States.
| | - M Gates Kuliszewski
- Department of Epidemiology and Biostatistics, University at Albany State University of New York, United States
| | - A Carrascal
- Department of Epidemiology and Biostatistics, University at Albany State University of New York, United States
| | - E Vásquez
- Department of Epidemiology and Biostatistics, University at Albany State University of New York, United States
| |
Collapse
|
32
|
Chu H, Xin J, Yuan Q, Wu Y, Du M, Zheng R, Liu H, Wu S, Zhang Z, Wang M. A prospective study of the associations among fine particulate matter, genetic variants, and the risk of colorectal cancer. ENVIRONMENT INTERNATIONAL 2021; 147:106309. [PMID: 33338681 DOI: 10.1016/j.envint.2020.106309] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/17/2020] [Accepted: 11/26/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) is suspected to increase the risk of colorectal cancer, but the mechanism remains unknown. We aimed to investigate the association between PM2.5 exposure, genetic variants and colorectal cancer risk in the Prostate, Lung, Colon and Ovarian (PLCO) Cancer Screening trial. METHODS We included a prospective cohort of 139,534 cancer-free individuals from 10 United States research centers with over ten years of follow-up. We used a Cox regression model to assess the association between PM2.5 exposure and colorectal cancer incidence by calculating the hazard ratio (HR) and 95% confidence interval (CI) with adjustment for potential confounders. The polygenic risk score (PRS) and genome-wide interaction analysis (GWIA) were used to evaluate the multiplicative interaction between PM2.5 exposure and genetic variants in regard to colorectal cancer risk. RESULTS After a median of 10.43 years of follow-up, 1,666 participants had been diagnosed with colorectal cancer. PM2.5 exposure was significantly associated with an increased risk of colorectal cancer (HR = 1.27; 95% CI = 1.17-1.37 per 5 μg/m3 increase). Five independent susceptibility loci reached statistical significance at P < 1.22 × 10-8 in the interaction analysis. Furthermore, a joint interaction was observed between PM2.5 exposure and the PRS based on these five loci with colorectal cancer risk (P = 3.11 × 10-29). The Gene Ontology analysis showed that the vascular endothelial growth factor (VEGF) receptor signaling pathway was involved in the biological process of colorectal cancer. CONCLUSIONS Our large-scale analysis has shown for the first time that long-term PM2.5 exposure potential increases colorectal cancer risk, which might be modified by genetic variants.
Collapse
Affiliation(s)
- Haiyan Chu
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China; Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Junyi Xin
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China; Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qi Yuan
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China; Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Yanling Wu
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Mulong Du
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Rui Zheng
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Hanting Liu
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Zhengdong Zhang
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China; Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Meilin Wang
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China; Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
| |
Collapse
|
33
|
Mehrzad J, Dayyani M, Erfanian-Khorasani M. The independent and combined effects of selected risk factors and Arg399Gln XRCC1 polymorphism in the risk of colorectal cancer among an Iranian population. Med J Islam Repub Iran 2020; 34:75. [PMID: 33306066 PMCID: PMC7711031 DOI: 10.34171/mjiri.34.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Indexed: 12/07/2022] Open
Abstract
Background: Several environmental and genetic factors have contributed to the development of colorectal cancer (CRC). We aimed to investigate the independent and combined effects of some selected risk factors and Arg399Gln XRCC1 polymorphism on CRC.
Methods: A total of 180 patients with CRC and 160 healthy individuals who were matched for sex, age, and place of residence (Northeast of Iran) participated in this case-control study. Before collecting blood samples and filling out questionnaires, a written consent form was obtained from all participants. Genotypes were determined by RFLP-PCR. The comparison of genotype and allele frequencies was performed using p value based on the results of chi-square test. The odds ratios (OR) and 95% confidence intervals (CI) were calculated by employing a logistic regression model. All statistical calculations were performed using SPSS. Each of the 2- sided p values less than 0.05 were considered statistically significant.
Results: The level of literacy, physical activity, consumption of vegetables and fruits, and tea intake of the patients were significantly lower than healthy individuals, but gastrointestinal disorders, family history of cancer, BMI, and fast food consumption were significantly higher in cases than in controls. No significant difference was observed between the 2 groups regarding smoking, opioid addiction, alcohol consumption, diet, fish consumption, and liquid intake, using the kitchen hood, diabetes, and cardiovascular disease. Arg/Gln + Gln/Gln and Arg/Gln genotypes were involved in increased CRC risk (The crude OR =1.781 with a 95% CI of 1.156-2.744 and OR = 1.690 with a 95% CI of 0.787-3.630). Also, Gln/Gln genotype was more frequent in CRC group than in control group. However, none of the risk factors interacted with polymorphism, and thus did not have an effect on CRC.
Conclusion: Some risk factors, such as reducing the consumption of vegetables and fruits or reducing physical activity as well as polymorphism of the XRCC1 Arg399Gln alone, increase the risk of CRC, but they do not interact with each other.
Collapse
Affiliation(s)
- Jamshid Mehrzad
- Department of Biochemistry, Neyshabur Medical Sciences Branch, Islamic Azad University, Neyshabur, Iran
| | - Mahdieh Dayyani
- Radiation Oncology Department, Reza Radiotherapy and Oncology Center, Mashhad, Iran
| | | |
Collapse
|
34
|
Yang Y, Lynch BM, Dugué PA, Karahalios A, MacInnis RJ, Bassett JK, McAleese A, Sinclair C, Giles GG, Milne RL, Hodge AM, English DR. Latent Class Trajectory Modeling of Adult Body Mass Index and Risk of Obesity-Related Cancer: Findings from the Melbourne Collaborative Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 30:373-379. [PMID: 33268487 DOI: 10.1158/1055-9965.epi-20-0690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/28/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Obesity increases the risk of 13 cancer types. Given the long process of carcinogenesis, it is important to determine the impact of patterns of body mass over time. METHODS Using data from 30,377 participants in the Melbourne Collaborative Cohort Study, we identified body mass index (BMI) trajectories across adulthood and examined their association with the risk of obesity-related cancer. Participants completed interviews and questionnaires at baseline (1990-1994, age 40-69 years), follow-up 1 (1995-1998), and follow-up 2 (2003-2005). Body mass was recalled for age 18 to 21 years, measured at baseline, self-reported at follow-up 1, and measured at follow-up 2. Height was measured at baseline. Cancer diagnoses were ascertained from the Victorian Cancer Registry and the Australian Cancer Database. A latent class trajectory model was used to identify BMI trajectories that were not defined a priori. Cox regression was used to estimate HRs and 95% confidence intervals (CI) of obesity-related cancer risks by BMI trajectory. RESULTS Six distinct BMI trajectories were identified. Compared with people who maintained lower normal BMI, higher risks of developing obesity-related cancer were observed for participants who transitioned from normal to overweight (HR, 1.29; 95% CI, 1.13-1.47), normal to class I obesity (HR, 1.50; 95% CI, 1.28-1.75), or from overweight to class II obesity (HR, 1.66; 95% CI, 1.32-2.08). CONCLUSIONS Our findings suggest that maintaining a healthy BMI across the adult lifespan is important for cancer prevention. IMPACT Categorization of BMI by trajectory allowed us to identify specific risk groups to target with public health interventions.
Collapse
Affiliation(s)
- Yi Yang
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia. .,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Pierre-Antoine Dugué
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Robert J MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Julie K Bassett
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Alison McAleese
- Prevention Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Craig Sinclair
- Prevention Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| |
Collapse
|
35
|
Shokrzadeh M, Goleij P, Behravan E, Ghassemi-Barghi N, Salehabadi Y, Rezaei A. ASSOCIATION BETWEEN DIABETICS AND INTESTINAL CANCER WITH THE RISK OF MUTATION IN CD38 GENE IN IRANIAN POPULATION. ARQUIVOS DE GASTROENTEROLOGIA 2020; 57:137-143. [PMID: 32490905 DOI: 10.1590/s0004-2803.202000000-25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 03/17/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Intestinal cancer often occurs in type 2 diabetic patients. The concept of increasing insulin levels and insulin-like growth factor in the blood with type 2 diabetes are stimulated with the growth and depletion of cloned cell walls, and the continuation of this process leads to the cellular deformation. This is the evidence for intestinal cancer in type 2 diabetes in population. OBJECTIVE In this study, we aimed to find out the relationship between diabetics and intestinal cancer based on CD38 gene mutation. METHODS Samples were collected from 200 population including normal and case ones. PCR products related to rs 6449181 of CD38 gene was amplified with ARMS-PCR technique, and a 420-bp sharp banding was observed as well. According three ARMS-PCR techniques, three primers were designed by oligo7 software. Primers include F1, F2 and R (amplifying for normal, mutant and reverse primer respectively). RESULTS This band was observed using a primer F1 that carries the wild type nucleotide using a primer, and when it is used with the F2 primer, it brings the mutant primer to populations of patients with diabetes and diabetes-cancer. In addition, the clinical results including body mass index, blood glucose and insulin level were analyzed. The means ±SD and Tuckey's post hoc test were significant between the clinical characterization parameters between cases and healthy populations. The allelic gene frequencies and Hardy-Weinberg equilibrium between nucleotides were evaluated, and the significant level between the alleles and gene frequencies was observed. CONCLUSION In general, the current study found that there is a relationship between diabetes and intestinal cancer among the studied populations.
Collapse
Affiliation(s)
- Mohammad Shokrzadeh
- Mazandaran University of Medical Sciences, Faculty of Pharmacy, Department of Toxicology, Sari, Iran
| | - Pouya Goleij
- Sana Institute of Higher Education, Faculty of Biology, Department of Genetics, Sari, Iran
| | - Elmira Behravan
- Islamic Azad University, Faculty of Biological Sciences, Department of Genetics, Tonekabon Branch, Iran
| | - Nasrin Ghassemi-Barghi
- Mazandaran University of Medical Sciences, Faculty of Pharmacy, Department of Toxicology, Sari, Iran
| | - Yaser Salehabadi
- Mazandaran University of Medical Sciences, Faculty of Pharmacy, Department of Toxicology, Sari, Iran
| | - Abolhasan Rezaei
- Islamic Azad University, Faculty of Biological Sciences, Department of Genetics, Tonekabon Branch, Iran
| |
Collapse
|
36
|
Luo L, Liu Y, Wang Z, Yan Y, Xie C, Chi J, Yang Y, Li J, Xu R. Relationship between prediagnostic body mass index trajectory and colorectal adenomas: an analysis of the PLCO cancer screening trial. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:815. [PMID: 32793660 PMCID: PMC7396232 DOI: 10.21037/atm-19-4634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Studies on the relationship between lifetime body mass index (BMI) trajectory and colorectal premalignant precursor lesions are limited. This study aimed to assess the relationship between prediagnostic adulthood BMI trajectory and the risk of colorectal adenomas using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial. Methods In total, 39,824 participants in the intervention arm of the prospective PLCO cohort, who have undergone at least one colonoscopy or sigmoidoscopy examination with a confirmed diagnosis of colorectal adenomas, were enrolled and divided into four groups (underweight, normal weight, overweight, and obese) according to BMI during each age period. SAS Proc Traj was used to establish the BMI trajectory model. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Compared with normal weight, overweight or obesity significantly increased colorectal adenomas risk in each age period after 30 years. Specifically, obesity in the 50s was most closely related to colorectal adenomas risk [HR: 1.32, 95% CI: (1.22, 1.43)]. BMI gain from the age of 40 to 50 [HR: 1.25, 95% CI: (1.11, 1.42)] showed the strongest correlation with an increased incidence of colorectal adenomas, followed by that from the age of 30 to 50 [HR: 1.19, 95% CI: (1.10, 1.29)], the age of 20 to 50 [HR: 1.16, 95% CI: (1.10, 1.24)], the age of 20 to 40 [HR: 1.14, 95% CI: (1.05, 1.23)], and the age of 20 to 30 [HR: 1.13, 95% CI: (1.02, 1.26)]. Additionally, compared with those who maintained normal weight throughout adulthood, those who progressed from normal weight to obesity [HR: 1.15, 95% CI: (1.06, 1.25)], or from overweight to obesity [HR: 1.33, 95% CI: (1.11, 1.61)], had a higher risk of colorectal adenomas. Conclusions Overweight and obesity increased the risk of colorectal adenomas, and this risk increased with advancing age.
Collapse
Affiliation(s)
- Linna Luo
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yuying Liu
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zixian Wang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yue Yan
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Chuanbo Xie
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jun Chi
- Department of Endoscopy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Youzhuo Yang
- Department of Endoscopy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jianjun Li
- Department of Endoscopy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ruihua Xu
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| |
Collapse
|
37
|
Abdel-Rahman O. Prediagnostic BMI and thyroid cancer incidence in the PLCO trial. Future Oncol 2019; 15:3451-3456. [DOI: 10.2217/fon-2019-0292] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To assess the correlation between prediagnostic BMI and thyroid cancer risk within the prostate, lung, colorectal and ovary (PLCO) trial. Methods: PLCO trial participants without a history of thyroid cancer before study enrollment who have complete information about prediagnostic BMI were included. Multivariable Cox regression analyses were conducted to assess the impact of prediagnostic BMI on thyroid cancer risk. Results: Higher BMI at the time of the study enrollment was associated with a higher thyroid cancer risk (hazard ratio: 1.046; p < 0.01). Furthermore, compared with a normal to normal prediagnostic BMI trajectory, both normal to overweight as well as normal to obese trajectories were associated with a higher thyroid cancer risk (p = 0.04 and p = 0.03, respectively). Conclusion: Higher BMI at the time of study entry as well as an increasing prediagnostic BMI trajectory are associated with a higher thyroid cancer risk.
Collapse
Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta T6G 1Z2, Canada
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
38
|
Abdel-Rahman O. Pre-diagnostic body mass index trajectory in relationship to lung cancer incidence and mortality; findings from the PLCO trial. Expert Rev Respir Med 2019; 13:1029-1035. [DOI: 10.1080/17476348.2019.1656532] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Omar Abdel-Rahman
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta, Canada
| |
Collapse
|
39
|
Spychalski P, Kobiela J, Wieszczy P, Kamiński MF, Reguła J. Clinical stages of colorectal cancer diagnosed in obese and overweight individuals in the Polish Colonoscopy Screening Program. United European Gastroenterol J 2019; 7:790-797. [PMID: 31316783 DOI: 10.1177/2050640619840451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/07/2019] [Indexed: 12/14/2022] Open
Abstract
Background Obesity is a known risk factor of colorectal cancer (CRC). However, precise interconnections between excessive body fat and CRC are still vague. Therefore, the aim of this study was to assess whether stage of CRC detected in overweight and obese individuals differs from individuals with normal body mass index (BMI). A secondary aim of this study was to elucidate whether overweight and obesity influence the overall survival in CRC. Methods This study was a cross-sectional analysis of 163,129 individuals who underwent screening colonoscopy performed on data from a prospectively maintained database of the Polish Colonoscopy Screening Program. Results Overweight and obese individuals present with a less advanced CRC in screening setting (p = 0.014). This trend is the most pronounced in males (p = 0.001). Univariable and multivariable analyses revealed that obesity was a negative predictor of detection of advanced CRC with odds ratio 0.72 (95% confidence interval 0.52-1.00; p = 0.047). Furthermore, overweight and obesity were not statistically significant predictors of risk of death (p = 0.614 and p = 0.446, respectively). Conclusions Obese screenees present with a less advanced disease in comparison to non-obese. Moreover, survival stratified by clinical stage seems to not be influenced by BMI category. Therefore, a higher proportion of early diagnosed cancers can potentially create a survival benefit in this group.
Collapse
Affiliation(s)
- Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Paulina Wieszczy
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Michał F Kamiński
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Oncological Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.,Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Jarosław Reguła
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| |
Collapse
|
40
|
Song M. Trajectory analysis in obesity epidemiology: a promising life course approach. CURRENT OPINION IN ENDOCRINE AND METABOLIC RESEARCH 2019; 4:37-41. [PMID: 30906899 PMCID: PMC6426320 DOI: 10.1016/j.coemr.2018.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Mingyang Song
- Departments of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA
| |
Collapse
|