Body mass index and risk of colorectal cancer in Chinese Singaporeans

The Singapore Chinese Health Study

Authors

  • Andrew O. Odegaard PhD, MPH,

    Corresponding author
    1. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
    • University of Minnesota, Epidemiology and Community Health, 1300 Second Street, Suite 300, Minneapolis, MN 55454
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  • Woon Puay Koh PhD,

    1. Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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  • Mimi C. Yu PhD,

    1. The Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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  • Jian Min Yuan PhD, MD

    1. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
    2. The Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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  • We thank Siew Hong Low of the National University of Singapore for supervising the field work of the Singapore Chinese Health Study and Kazuko Arakawa and Renwei Wang for the development and maintenance of the cohort study database. We also thank the Singapore Cancer Registry for assistance with the identification of cancer outcomes via database linkages.

Abstract

BACKGROUND:

The authors chose to examine the association between body mass index (BMI) and incident colorectal cancer across the spectrum of BMI, including underweight persons, because detailed prospective cohort data on this topic in Asians is scarce, as is data on underweight persons (BMI, <18.5 kg/m2) in any population.

METHODS:

Analysis of the Singapore Chinese Health Study included 51,251 men and women aged 45-74 years enrolled in 1993-1998 and followed through 2007. Incident cancer cases and deaths among cohort members were identified through record linkage, and 980 cases were identified. Cox regression models were used to investigate the association of baseline BMI with risk of incident colorectal cancer during a mean of 11.5 years of follow-up.

RESULTS:

A significant, U-shaped, quadratic association was observed between BMI and colon cancer risk, with increased risk in BMIs ≥27.5 and <18.5 kg/m2. The association was more pronounced in never smokers and most prominent when further limiting the sample to those free of diabetes and cases with longer than 5 years of follow-up. Localized cases had a more pronounced association in BMIs ≥27.5, whereas advanced cases had a more pronounced association in BMIs <18.5 kg/m2. No association was found in relation to rectal cancer risk. The association was also stronger among patients aged 65 years and older.

CONCLUSIONS:

BMI displays a U-shaped, quadratic association with colon cancer risk in this Chinese population in Southeast Asia. Cancer 2011;. © 2011 American Cancer Society.

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