Obesity Has a Stronger Relationship with Colorectal Cancer in Postmenopausal Women Than Premenopausal Women

Colorectal Cancer
01/09/2020

Cancer Epidemiol Biomarkers Prev. 2020 Aug 31:cebp.0594.2020. doi: 10.1158/1055-9965.EPI-20-0594. Online ahead of print.

ABSTRACT

BACKGROUND: To examine the relationship between obesity measured by waist circumference (WC) and body mass index (BMI) and the incidence of colorectal cancer (CRC) in premenopausal and postmenopausal women.

METHODS: A total of 1,418,180 premenopausal and 4,854,187 postmenopausal women without cancer at baseline and aged over 40 were identified using the Korean National Health Insurance System Cohort during 2009-2014. The hazard ratio (HR) for CRC incidence was assessed according to menopausal state using Cox proportional hazards models.

RESULTS: During a mean follow-up period of 7.2 years, 7,094 and 57,449 CRC occurred in premenopausal and postmenopausal women, respectively. Compared to the reference group (WC 65-75), the HR (95% confidence interval [CI]) of CRC in WC <65, 75-85, 85-95, and >95 groups were 1.01 (0.91-1.11), 1.02 (0.97-1.07), 1.09 (1.00-1.18), and 1.31 (1.12-1.52), respectively, in premenopausal women and 1.01 (0.95-1.17), 1.09 (1.07-1.12), 1.19 (1.00-1.18), and 1.30 (1.25-1.35), respectively, in postmenopausal women. Compared to the reference group (BMI 18.5-22.9), HR (95% CI) for CRC in BMI <18.5, 23-25, 25-30, and >30 groups were 0.99 (0.87-1.14), 0.99 (0.94-1.06), 0.98 (0.92-1.04), and 1.06 (0.92-1.20), respectively, in premenopausal women. In postmenopausal women, those values were 0.99 (0.93-1.05), 1.05 (1.03-1.08), 1.11 (1.09-1.13), and 1.20 (1.16-1.25), respectively.

CONCLUSIONS: WC is associated with the risk of CRC in both groups of women, but this association was stronger in postmenopausal women than in premenopausal women. BMI increased the incidence of CRC only in postmenopausal women Impact: Obesity has a stronger relationship with CRC in postmenopausal women than premenopausal women.