Relationship of prediagnostic body mass index with survival after colorectal cancer: Stage-specific associations

Jonathan M. Kocarnik*, Andrew T. Chan, Martha L. Slattery, John D. Potter, Jeffrey Meyerhardt, Amanda Phipps, Hongmei Nan, Tabitha Harrison, Thomas E. Rohan, Lihong Qi, Lifang Hou, Bette Caan, Candyce H. Kroenke, Howard Strickler, Richard B. Hayes, Robert E. Schoen, Dawn Q. Chong, Emily White, Sonja I. Berndt, Ulrike PetersPolly A. Newcomb

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Higher body mass index (BMI) is a well-established risk factor for colorectal cancer (CRC), but is inconsistently associated with CRC survival. In 6 prospective studies participating in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), 2,249 non-Hispanic white CRC cases were followed for a median 4.5 years after diagnosis, during which 777 died, 554 from CRC-related causes. Associations between prediagnosis BMI and survival (overall and CRC-specific) were evaluated using Cox regression models adjusted for age at diagnosis, sex, study and smoking status (current/former/never). The association between BMI category and CRC survival varied by cancer stage at diagnosis (I-IV) for both all-cause (p-interaction = 0.03) and CRC-specific mortality (p-interaction = 0.04). Compared to normal BMI (18.5-24.9 kg/m2), overweight (BMI 25.0-29.9) was associated with increased mortality among those with Stage I disease, and decreased mortality among those with Stages II-IV disease. Similarly, obesity (BMI ≥30) was associated with increased mortality among those with Stages I-II disease, and decreased mortality among those with Stages III-IV disease. These results suggest the relationship between BMI and survival after CRC diagnosis differs by stage at diagnosis, and may emphasize the importance of adequate metabolic reserves for colorectal cancer survival in patients with late-stage disease.

Original languageEnglish (US)
Pages (from-to)1065-1072
Number of pages8
JournalInternational Journal of Cancer
Volume139
Issue number5
DOIs
StatePublished - Sep 1 2016

Keywords

  • body mass index (BMI)
  • cancer stage
  • colorectal cancer (CRC)
  • mortality
  • survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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