FAT, LAZY, UNEDUCATED PEOPLE GET MORE COLON CANCER
Body Size and Colorectal Cancer Risk After 16.3 Years of Follow-up
An Analysis From the Netherlands Cohort Study
Laura A. E. Hughes; Colinda C. J. M. Simons; Piet A. van den Brandt; R. Alexandra Goldbohm; Manon van Engeland; Matty P. Weijenberg
Posted: 12/13/2011; American Journal of Epidemiology.
Abstract and Introduction
A large body size may differentially influence risk of colorectal cancer (CRC) by anatomic location.
The Netherlands Cohort Study includes 120,852 men and women aged 55–69 years who self-reported weight, height, and trouser/skirt size at baseline (1986), as well as weight at age 20 years.
Introduction
There is convincing evidence that a large body size increases the risk of colorectal cancer (CRC).
CRC risk has traditionally been studied according to anatomic location in the colon or rectum.
Such tumors are most frequently observed in the proximal colon.
It has been reported that adult BMI and indicators of abdominal obesity are associated more strongly with tumors that are not characterized by epigenetic instability.
This suggests that adult body fat rather influences CRC risk via chromosomal instability and may explain the stronger associations observed between body fat and distal tumors.
Furthermore, timing of exposure may be important for defining pathways. It has been observed that a high BMI in early adulthood and a large BMI change from early adulthood to later adulthood are associated with a higher risk of CRC;
Study Population and Design
The NLCS includes 58,279 men and 62,573 women aged 55–69 years at baseline (1986) who completed a self-administered questionnaire involving 150 food items, as well as questions on lifestyle and health.
Assessment Variables, Diet, and Physical Activity
Height (cm), body weight (kg), and body weight at age 20 years (kg) were self-reported on the baseline questionnaire. BMI was calculated as weight (kg)/height (m)2. Participants were also asked to report their lower-body clothing (trouser or skirt) size from their clothing label (in Dutch sizes). Trouser/skirt size has been shown to be an adequate proxy measure for waist circumference when predicting cancer risk in the NLCS.
Both occupational physical activity in the longest-/last-held job and baseline nonoccupational physical activity were used to assess risk, depending on sex.
Interaction with Physical Activity
Evidence suggests that among persons with lower physical activity, BMI becomes a more important indicator of colon cancer risk and that underlying population levels of physical activity can impair or enhance the ability to identify colon cancer associations with other risk factors.
Furthermore, the greatest proportion of persons with a university-level education was observed in the lowest quintile of BMI, as was the greatest proportion of current smokers. In men, levels of occupational physical activity were relatively similar across quintiles of BMI, whereas in women, higher levels of recreational physical activity were reported by persons in the lowest quintile of BMI.
SUMMARY
Fat, lazy, uneducated people had the highest rate of colon cancer. Did we need a large study to find this out?
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