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.
United European Gastroenterol J. 2019 Jul;7(6):790-797. doi: 10.1177/2050640619840451. Epub 2019 Mar 21.
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.
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.
Overweight and obese individuals present with a less advanced CRC in screening setting ( = 0.014). This trend is the most pronounced in males ( = 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; = 0.047). Furthermore, overweight and obesity were not statistically significant predictors of risk of death ( = 0.614 and = 0.446, respectively).
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.
肥胖是结直肠癌(CRC)的已知危险因素。然而,过多的体脂与 CRC 之间的确切联系仍不清楚。因此,本研究的目的是评估超重和肥胖个体中检测到的 CRC 分期是否与正常体重指数(BMI)个体不同。本研究的次要目的是阐明超重和肥胖是否会影响 CRC 的总生存率。
这是一项横断面分析,共纳入 163129 名在波兰结肠镜筛查计划的前瞻性维护数据库中接受筛查结肠镜检查的个体。
在筛查环境中,超重和肥胖个体的 CRC 分期较低( = 0.014)。这种趋势在男性中最为明显( = 0.001)。单变量和多变量分析表明,肥胖是检测晚期 CRC 的负面预测因素,优势比为 0.72(95%置信区间 0.52-1.00; = 0.047)。此外,超重和肥胖与死亡风险无统计学显著相关性( = 0.614 和 = 0.446)。
与非肥胖者相比,肥胖筛查者的疾病分期较低。此外,按临床分期分层的生存率似乎不受 BMI 类别的影响。因此,这一人群中早期诊断癌症的比例较高可能会带来生存获益。