ASPO Abstracts
Gender Differences in the Relationship between Risk of Advanced Colorectal Neoplasia and Changes in Waist Circumference and BMI from early to late adulthood
Category: Lifestyles Behavior, Energy Balance & Chemoprevention, Early Detection & Risk Prediction
Conference Year: 2018
Abstract Body:
Introduction: Obesity is an established risk factor for Colorectal cancer (CRC), however, consistent results show that the association is stronger in men than women. The role of gender in the relationship of obesity and CRC risk remains unclear. Therefore, we sought to examine gender differences in the relationships between risk of advanced colorectal neoplasia (AN) and early measures (age 21) and changes in waist circumference (WC) and Body mass Index (BMI) Methods: In 4,449 adults (2,283 women), ages 50-80, with no previous neoplasia and undergoing screening colonoscopy were included in the study. Changes in BMI were categorized as 1) increase from normal to overweight or to obese, 2) increase from overweight to obese, and 3) stable BMI (stable-normal, stable-overweight or stable-obese) at age 21 and time of screening. Changes for WC were categorized as 1) increase from a low- risk WC to a high-risk WC (females 35 inches and males 40 inches), and 2) stable-risk WC at age 21 and time of screening. Known CRC risk factors were controlled in the logistic models and interaction p-values were used to determine gender differences. Results: Although no gender differences were observed, being obese (OR=2.7, 95% CI 1.26-5.21) or having a large WC (OR=2.0, 95% CI 1.37-3.02) at age 21 in women was associated with risk of AN. No relationship between risk of AN and changes in BMI or WC was observed in men, but a monotonic relationship was observed in women. Increased risk of AN was associated with increases in BMI from normal to obesity (OR=1.8, 95% CI 1.07-3.03), overweight to obesity (OR=2.1, 95% CI 1.02-4.45), or having a stable-overweight BMI (OR=3.8, 95% CI 1.41-10.32) or stable-obese BMI (OR=4.1, 95% CI 1.80-9.17) compared to women a stable-normal BMI. Independent of BMI change, risk of AN was associated with increase in WC from low to high-risk (OR=2.1; 95% CI 1.20-3.51) or having a stable-high risk WC (OR=2.7; 95% CI 1.15-6.41) compared to women with a low-risk WC. Conclusion: Changes in BMI and WC from early adulthood to time of screening are associated with risk of AN, with a stronger association in women. The findings underscore the importance of maintaining a healthy BMI and low-risk WC throughout adulthood.
Keywords: BMI change, waist circumference change, Advanced colorectal neoplasia, gender differences Obesity