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Prospective investigation of body mass index , colorectal adenoma , and colorectal cancer in the prostate , lung , colorectal , and ovarian cancer screening trial . PURPOSE Obesity has consistently been linked to an increased risk of colorectal cancer , particularly among men . Whether body mass index ( BMI ) differentially influences the risk across the stages of colorectal cancer development remains unclear . We evaluated the associations of BMI with colorectal adenoma incidence , adenoma recurrence , and cancer in the context of a large screening trial , in which cases and controls had an equal chance for disease detection . METHODS We prospectively evaluated the association between baseline BMI and the risk of incident distal adenoma ( 1,213 cases ) , recurrent adenoma ( 752 cases ) , and incident colorectal cancer ( 966 cases ) among men and women , ages 55 to 74 years , randomly assigned to receive flexible sigmoidoscopy screening as part of the Prostate , Lung , Colorectal , and Ovarian Cancer Screening Trial . We calculated odds ratios ( ORs ) and 95 % CIs for adenoma incidence and recurrence , and hazard ratios ( HRs ) and 95 % CIs for colorectal cancer incidence , using multivariable-adjusted models . RESULTS Compared with normal-weight men ( 18.5 to 24.9 kg/m ( 2 ) ) , obese men ( ≥ 30 kg/m ( 2 ) ) had significantly higher risk of incident adenoma ( OR , 1.32 ; 95 % CI , 1.06 to 1.65 ) and colorectal cancer ( HR , 1.48 ; 95 % CI , 1.16 to 1.89 ) and a borderline increased risk of recurrent adenoma ( OR , 1.50 ; 95 % CI , 0.98 to 2.30 ) . No associations were observed for either adenoma or cancer in women . CONCLUSION Data from this large prospective study suggest that obesity is important throughout the natural history of colorectal cancer , at least in men , and colorectal cancer prevention efforts should encourage the achievement and maintenance of a healthy body weight in addition to regular screenings .
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Intervention_Physical
flexible sigmoidoscopy screening
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Outcome_Physical
colorectal adenoma
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Outcome_Physical
colorectal cancer
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Outcome_Physical
risk of colorectal cancer
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Outcome_Physical
colorectal adenoma incidence
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Outcome_Physical
adenoma recurrence , and cancer
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Outcome_Physical
incident distal adenoma
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recurrent adenoma
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Outcome_Physical
incident colorectal cancer
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Outcome_Physical
odds ratios ( ORs ) and 95 % CIs
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Outcome_Physical
adenoma incidence and recurrence
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Outcome_Physical
hazard ratios ( HRs )
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Outcome_Physical
95 % CIs
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Outcome_Physical
colorectal cancer incidence