Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, 1000 New Jersey Ave SE, Washington, DC, 20003, USA.
Cancer Causes Control. 2020 Apr;31(4):291-302. doi: 10.1007/s10552-020-01283-3. Epub 2020 Mar 2.
Evidence for the association of anthropometrics with colorectal neoplasms is limited for African Americans.
We examined anthropometric measures with both colorectal adenoma and colorectal cancer (CRC) risk in the ongoing Black Women's Health Study. In a nested case-control analysis, 954 cases of colorectal adenoma were compared with 3,816 polyp-free controls, matched on age and follow-up time. For the CRC analyses, 413 incident CRC cases were identified over a 16-year follow-up (802,783 person-years). Adenoma cases and CRC were verified by medical record review. We used multivariable conditional logistic regression analyses (for adenoma) and Cox proportional hazards analyses (for CRC) that included anthropometric exposures and selected confounders.
Overall body mass index (BMI) and other anthropometric factors were not associated with colorectal adenoma or cancer risk in Black women. However, increased risk of adenoma (but not CRC) was observed among especially related to adenomas in the proximal colon. Among women ≥ 50 years of age, risk of proximal adenoma increased 14% (95% CI 1.00, 1.31), 35% (95% CI 1.12, 1.63), and 25% (0.93, 1.68) with each standard deviation increase in BMI, waist circumference, and waist-to-hip ratio, respectively. None of the anthropometric factors were associated with young onset CRC or adenoma risk.
Our results suggest that obesity might be an initiator for colon adenomas but not a promoter for colorectal cancer among Black women.
有关非裔美国人的人体测量学与结直肠肿瘤相关性的证据有限。
我们在正在进行的黑人女性健康研究中检查了人体测量指标与结直肠腺瘤和结直肠癌（CRC）风险的关系。在巢式病例对照分析中，954 例结直肠腺瘤病例与 3816 例无息肉对照相匹配，按年龄和随访时间匹配。对于 CRC 分析，在 16 年的随访期间（802783 人年）确定了 413 例 CRC 病例。腺瘤病例和 CRC 通过病历复查进行验证。我们使用多变量条件逻辑回归分析（用于腺瘤）和 Cox 比例风险分析（用于 CRC），包括人体测量暴露和选定的混杂因素。
总体而言，BMI 和其他人体测量因素与黑人女性的结直肠腺瘤或癌症风险无关。然而，在近端结肠中，尤其与近端腺瘤相关的腺瘤风险增加。在≥50 岁的女性中，近端腺瘤的风险分别增加了 14%（95%CI 1.00, 1.31）、35%（95%CI 1.12, 1.63）和 25%（0.93, 1.68），BMI、腰围和腰臀比每增加一个标准差。在年轻发病的 CRC 或腺瘤风险方面，没有任何人体测量因素与这些风险相关。
我们的研究结果表明，肥胖可能是非裔美国女性结肠腺瘤的启动因素，但不是 CRC 的促进因素。
