Department of Clinical Epidemiology, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.
Department of Surgery, Zealand University Hospital, Copenhagen University, Lykkebækvej 1, 4600, Køge, Denmark.
Eur J Epidemiol. 2017 Dec;32(12):1097-1106. doi: 10.1007/s10654-017-0289-0. Epub 2017 Aug 12.
As colorectal cancers have a long latency period, their origins may lie early in life. Therefore childhood body mass index (BMI; kg/m) and height may be associated with adult colorectal cancer. Using a cohort design, 257,623 children from The Copenhagen School Health Records Register born from 1930 to 1972 with measured heights and weights at ages 7 to 13 years were followed for adult colon and rectal adenocarcinomas by linkage to the Danish Cancer Registry. Hazard ratios (HRs) with 95% confidence intervals (CI) were estimated by Cox proportional hazard regressions. During follow-up, 2676 colon and 1681 rectal adenocarcinomas were diagnosed. No sex differences were observed in the associations between child BMI or height and adult colon or rectal cancers. Childhood BMI and height were positively associated with colon cancer; at age 13 years the HRs were 1.09 (95% CI 1.04-1.14) and 1.14 (95% CI 1.09-1.19) per z-score, respectively. Children who were persistently taller or heavier than average, had increased risk of colon cancer. Similarly, growing taller or gaining more weight than average was positively associated with colon cancer. No associations were observed between BMI or height and rectal cancer. Childhood BMI and height, along with above average change during childhood are significantly and positively associated with adult colon cancers, but not with rectal cancer, suggesting different etiologies.
由于结直肠癌潜伏期较长,其起源可能早在生命早期就存在。因此,儿童时期的体重指数(BMI;kg/m)和身高可能与成人结直肠癌有关。采用队列设计,对 1930 年至 1972 年期间出生于哥本哈根学校健康记录登记处的 257623 名儿童进行研究,这些儿童在 7 至 13 岁时测量了身高和体重,并通过与丹麦癌症登记处的链接,对其成年后的结肠癌和直肠癌腺癌进行随访。通过 Cox 比例风险回归估计了风险比(HR)及其 95%置信区间(CI)。在随访期间,诊断出 2676 例结肠癌和 1681 例直肠癌。在儿童 BMI 或身高与成年结肠癌或直肠癌之间的关联中,未观察到性别差异。儿童 BMI 和身高与结肠癌呈正相关;在 13 岁时,HR 分别为 1.09(95%CI 1.04-1.14)和 1.14(95%CI 1.09-1.19)。身高持续高于平均水平或体重持续高于平均水平的儿童,结肠癌风险增加。同样,身高增长或体重增加高于平均水平与结肠癌呈正相关。BMI 或身高与直肠癌无关。儿童 BMI 和身高以及儿童期平均水平以上的变化与成年结肠癌显著正相关,但与直肠癌无关,这表明两者的病因不同。