Li Hengjing, Boakye Daniel, Chen Xuechen, Jansen Lina, Chang-Claude Jenny, Hoffmeister Michael, Brenner Hermann
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
Gastroenterology. 2022 Apr;162(4):1088-1097.e3. doi: 10.1053/j.gastro.2021.12.239. Epub 2021 Dec 13.
BACKGROUND & AIMS: Incidence of colorectal cancer (CRC) in younger adults is increasing in many countries. Given the established association of body mass index (BMI) with CRC risk and the increasing obesity prevalence among younger generations, we aimed to evaluate the association of BMI at different ages during early adulthood with early-onset CRC.
Among 6602 patients with CRC and 7950 matched controls who were recruited in 2003-2020 in the Darmkrebs: Chancen der Verhütung durch Screening study, a population-based case-control study from Germany, 747 patients and 621 controls were younger than 55 years and included in this analysis. Self-reported height and weight at ages 20 years and 30 years and at approximately 10 years before diagnosis or interview were recorded in personal interviews. Associations of BMI with early-onset CRC were estimated using multiple logistic regression.
Compared with participants with BMI <25 kg/m, those with BMI ≥30 kg/m (obesity) at ages 20 years and 30 years and approximately 10 years before diagnosis or interview had 2.56- (95% confidence interval, 1.20-5.44), 2.06- (confidence interval, 1.25-3.40), and 1.88- (95% confidence interval, 1.30-2.73) fold risk of early-onset CRC. The association of BMI with early-onset CRC risk was particularly pronounced among, and essentially restricted to, the majority of participants with no previous colonoscopy.
Obesity at early adulthood is strongly associated with increased risk of early-onset CRC. German Clinical Trials Register ID: DRKS00011793.
在许多国家，年轻成年人结直肠癌（CRC）的发病率正在上升。鉴于体重指数（BMI）与CRC风险之间已确立的关联，以及年轻一代肥胖患病率的增加，我们旨在评估成年早期不同年龄的BMI与早发性CRC之间的关联。
在2003年至2020年于德国开展的一项基于人群的病例对照研究“结直肠癌：筛查预防机会”研究中招募的6602例CRC患者和7950例匹配对照中，747例患者和621例对照年龄小于55岁，并纳入本分析。在个人访谈中记录了20岁和30岁时以及诊断或访谈前约10年时自我报告的身高和体重。使用多因素逻辑回归估计BMI与早发性CRC的关联。
与BMI<25kg/m²的参与者相比，20岁、30岁时以及诊断或访谈前约10年时BMI≥30kg/m²（肥胖）的参与者发生早发性CRC的风险分别为2.56倍（95%置信区间，1.20 - 5.44）、2.06倍（置信区间，1.25 - 3.40）和1.88倍（95%置信区间，1.30 - 2.73）。BMI与早发性CRC风险的关联在大多数既往未进行过结肠镜检查的参与者中尤为明显，且基本局限于这些参与者。
成年早期肥胖与早发性CRC风险增加密切相关。德国临床试验注册号：DRKS00011793。
