Kim Jae Hyun, Ko Young, Kim Hyun Jung, Park Seun Ja
Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.
Graduate School of Public Health, Korea University College of Medicine, Seoul, South Korea.
Sci Rep. 2025 Jan 3;15(1):678. doi: 10.1038/s41598-024-74916-1.
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/m, 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/m 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.
结肠癌是一个重大的健康问题，肥胖是一个已被充分证实的风险因素。然而，以往的研究主要集中在评估体重作为特定时间点结肠癌的风险因素。这项全国性队列研究利用韩国国民健康保险服务（NHIS）提供的人口数据库，调查了个体一生中可能波动的体重变化与结肠癌发病率之间的关联。本研究纳入了2004年至2006年期间每两年接受一次健康筛查，并在2014年至2016年期间接受后续健康检查的参与者。体重变化分类如下：<5%、下降5 - 20%、下降>20%、增加5 - 20%或>20%。主要结局是新诊断结肠癌的发病率。采用统计分析来检验体重变化与按年龄和性别分层的结肠癌发病率之间的关系。Kaplan-Meier方法估计结肠癌的累积发病率，Cox比例风险模型用于计算风险比（HR）和95%置信区间（CI），并对混杂因素进行调整。分析纳入了10332397人的数据，平均（±标准差）年龄为45.5±13.1岁，其中54.9%为男性。在体重指数（BMI）范围为18 - 30kg/m²的男性中，体重增加5 - 20%（HR 1.07，P>z 0.01 [95% CI 1.02 - 1.13]）和体重增加>20%（HR 1.27，P>z 0.03 [95% CI 1.03 - 1.56]）均与结肠癌风险增加相关。此外，年龄<40岁的男性体重增加>20%时患结肠癌的风险更高（HR 1.65，P>z <0.001 [95% CI 1.18 - 2.30]）。而在BMI范围为18 - 30kg/m²且体重减轻>20%的女性中，风险降低（HR 0.77，P>z 0.04 [95% CI 0.60 - 0.98]）。此外，年龄≥40岁且体重减轻>20%的女性患结肠癌的风险降低（HR 0.76；P>0.02 [95% CI 0.60 - 0.96]）。这项全国性队列研究表明体重变化与结肠癌发病率之间存在关联，且存在性别和年龄差异。特别是，对于年龄<40岁的男性，避免体重增加至关重要，而对于年龄>40岁的女性，体重减轻可能有助于降低患结肠癌的风险。
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