Central obesity may account for most of the colorectal cancer risk linked to obesity: evidence from the UK Biobank prospective cohort
Authors' conclusion
Central obesity is a much stronger predictor of CRC and may account for most of the CRC risk linked to obesity. Our findings also emphasize the need for incorporating measures such as WHR alongside BMI in clinical practice to improve obesity prevention and management.
Study context
- Population
- Male and female participants aged 40–69 recruited in the UK Biobank study between 2006 and 20105,977 developed colorectal cancer (CRC)
- Participants
- 460,784 participants
- Exposure
- Body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC) and CRC risk
- Outcome
- Incident colorectal cancer (CRC)
- Follow-up
- Median 12.5 years
Methodological detailsUK Biobank, multivariable Cox proportional hazards models, BMI and WC could not be mutually adjusted for due to their high correlation
- UK Biobank
- Multivariable Cox proportional hazards models
- BMI and WC could not be mutually adjusted for due to their high correlation
Main finding
As reported in the abstract
CRC risk per SD increase, multivariable adjusted
| Group | HR |
|---|---|
| BMI | 1.10 (95% CI 1.07-1.13) |
| WHR | 1.18 (95% CI 1.14-1.22) |
| WC | 1.14 (95% CI 1.11-1.18) |
HR
BMI1.10 (95% CI 1.07-1.13)
WHR1.18 (95% CI 1.14-1.22)
WC1.14 (95% CI 1.11-1.18)
Observational data: associations, not effects.
Further findings
| Outcome | BMI | WHR |
|---|---|---|
| CRC risk per SD increase after mutual adjustment of BMI and WHR | ||
| HR | 1.04 (95% CI 1.01-1.07) | 1.15 (95% CI 1.11-1.20) |
CRC risk per SD increase after mutual adjustment of BMI and WHR
- Association substantially attenuated for BMI, remained substantially stronger for WHR
CRC risk within BMI and WHR categories
- WHR strongly, significantly associated with CRC risk within all BMI categories; BMI associations weak and not significant within WHR categories
CRC risk by sex and by colon and rectal cancer
- After mutual adjustment, BMI not associated with CRC risk in women or with rectal cancer
- WHR strongly associated with CRC risk in both sexes and with colon and rectal cancer, before and after adjustment for BMI
Original publication
Central obesity may account for most of the colorectal cancer risk linked to obesity: evidence from the UK Biobank prospective cohort. Int J Obes (Lond). Published 19 November 2024. doi:10.
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