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Endoscopy 2012; 44(09): 813-818
DOI: 10.1055/s-0032-1309837
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Obesity, weight change, and risk of adenoma recurrence: a prospective trial

A. O. Laiyemo
1   Department of Medicine, Howard University College of Medicine, Washington DC, USA
2   Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
,
C. Doubeni
3   Department of Family Medicine, University of Massachusetts, Worcester, Massachusetts, USA
,
D. S. Badurdeen
1   Department of Medicine, Howard University College of Medicine, Washington DC, USA
,
G. Murphy
2   Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
,
P. M. Marcus
2   Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
,
R. E. Schoen
5   Department of Medicine and Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
,
E. Lanza
6   Laboratory of Cancer Prevention, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
,
D. T. Smoot
1   Department of Medicine, Howard University College of Medicine, Washington DC, USA
,
A. J. Cross
4   Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Publikationsverlauf

submitted 03. Dezember 2012

accepted after revision 12. April 2012

Publikationsdatum:
27. August 2012 (online)

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Commentaire de travail de O. Laiyemo et al., pp.813Endoscopy 2012; 44(09): 887-887
DOI: 10.1055/s-0032-1325659

Background and study aims: Obesity is a risk factor for colorectal neoplasia. Lifestyle modifications, including weight loss, have been advocated to reduce the risk. However, no prospective study has evaluated whether weight loss actually affects adenoma recurrence. The aim of this study was to examine whether weight change (loss or gain) over 4 years is associated with adenoma recurrence.

Patients and methods: A total of 1826 patients with colorectal adenoma in the Polyp Prevention Trial had their height and weight measured at baseline. Adenoma recurrence was determined by end of trial colonoscopy 4 years after study entry when patients’ weights were re-measured. Poisson regression models were used to evaluate body mass index (BMI), weight change over 4 years, and the risk of any adenoma and advanced adenoma recurrence.

Results: Adenoma recurrence was observed in 723 patients (39.6 %), 118 (6.5 %) of whom had advanced adenoma recurrence. Among those with baseline BMI < 25 kg/m² (n = 466), BMI 25 – 29 kg/m² (n = 868), and BMI ≥ 30 kg/m² (n = 492), the recurrence rate was 34.5 %, 41.0 %, and 41.9 %, respectively. Obesity was associated with an increased risk of adenoma recurrence (RR = 1.19; 95 %CI 1.01 – 1.39) and advanced adenoma recurrence (RR = 1.62; 95 %CI 1.01 – 2.57). However, when compared with those with relatively stable weight (weight change < 5 lb) over the 4-year trial, weight gain or loss was not associated with adenoma recurrence. This was consistent, regardless of the baseline BMI.

Conclusions: Weight loss or gain over 4 years does not affect adenoma recurrence. This study does not support weight loss alone as an effective intervention for reducing adenoma recurrence.

 

  • References

  • 1 Terry MB, Neugut AI, Bostick RM et al. Risk factors for advanced colorectal adenomas: a pooled analysis. Cancer Epidemiol Biomarkers Prev 2002; 11: 622-629
    PubMedSuche in Google Scholar
  • 2 Giovannucci E, Colditz GA, Stampfer MJ et al. Physical activity, obesity, and risk of colorectal adenoma in women (United States). Cancer Causes Control 1996; 7: 253-263
    CrossrefPubMedSuche in Google Scholar
  • 3 Boutron-Ruault MC, Senesse P, Méance S et al. Energy intake, body mass index, physical activity, and the colorectal adenoma-carcinoma sequence. Nutr Cancer 2001; 39: 50-57
    CrossrefPubMedSuche in Google Scholar
  • 4 Dai Z, Xu YC, Niu L. Obesity and colorectal cancer risk: a meta-analysis of cohort studies. World J Gastroenterol 2007; 13: 4199-4206
    PubMedSuche in Google Scholar
  • 5 Giovannucci E, Ascherio A, Rimm EB et al. Physical activity, obesity, and risk for colon cancer and adenoma in men. Ann Intern Med 1995; 122: 327-334
    CrossrefPubMedSuche in Google Scholar
  • 6 Renehan AG, Tyson M, Egger M et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 2008; 371: 569-578
    CrossrefPubMedSuche in Google Scholar
  • 7 Moghaddam AA, Woodward M, Huxley R. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomarkers Prev 2007; 16: 2533-2547
    CrossrefPubMedSuche in Google Scholar
  • 8 Calle EE, Rodriguez C, Walker-Thurmond K et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults.. N Engl J Med 2003; 348: 1625-1638
    CrossrefPubMedSuche in Google Scholar
  • 9 Parr CL, Batty GD, Lam TH et al. Body-mass index and cancer mortality in the Asia-Pacific Cohort Studies Collaboration: pooled analyses of 424,519 participants. Asia-Pacific Cohort Studies Collaboration. Lancet Oncol 2010; 11: 741-752 Erratum in: Lancet Oncol 2010; 11: 721
    CrossrefPubMedSuche in Google Scholar
  • 10 Frezza EE, Wachtel MS, Chiriva-Internati M. Influence of obesity on the risk of developing colon cancer. Gut 2006; 55: 285-291
    CrossrefPubMedSuche in Google Scholar
  • 11 Gunter MJ, Leitzmann MF. Obesity and colorectal cancer: epidemiology, mechanisms and candidate genes. J Nutr Biochem 2006; 17: 145-156
    CrossrefPubMedSuche in Google Scholar
  • 12 Selassie M, Sinha AC. The epidemiology and aetiology of obesity: a global challenge. Best Pract Res Clin Anaesthesiol 2011; 25: 1-9
    CrossrefPubMedSuche in Google Scholar
  • 13 Ogden CL, Carroll MD, Curtin LR et al. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006; 295: 1549-1555
    CrossrefPubMedSuche in Google Scholar
  • 14 Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet 2010; 15 (375) 1737-1748
    PubMedSuche in Google Scholar
  • 15 Edwards BK, Ward E, Kohler BA et al. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 2010; 116: 544-573
    CrossrefPubMedSuche in Google Scholar
  • 16 Almendingen K, Hofstad B, Vatn MH. Does high body fatness increase the risk of presence and growth of colorectal adenomas followed up in situ for 3 years?. Am J Gastroenterol 2001; 96: 2238-2246
    CrossrefPubMedSuche in Google Scholar
  • 17 Jacobs ET, Martínez ME, Alberts DS et al. Association between body size and colorectal adenoma recurrence. Clin Gastroenterol Hepatol 2007; 5: 982-990
    CrossrefPubMedSuche in Google Scholar
  • 18 Jacobs ET, Ahnen DJ, Ashbeck EL et al. Association between body mass index and colorectal neoplasia at follow-up colonoscopy: a pooling study. Am J Epidemiol 2009; 169: 657-666
    CrossrefPubMedSuche in Google Scholar
  • 19 Yamaji Y, Okamoto M, Yoshida H et al. The effect of body weight reduction on the incidence of colorectal adenoma. Am J Gastroenterol 2008; 103: 2061-2067
    CrossrefPubMedSuche in Google Scholar
  • 20 Schatzkin A, Lanza E, Freedman LS et al. The polyp prevention trial I: rationale, design, recruitment, and baseline participant characteristics. Cancer Epidemiol Biomarkers Prev 1996; 5: 375-383
    PubMedSuche in Google Scholar
  • 21 Lanza E, Schatzkin A, Ballard-Barbash R et al. The polyp prevention trial II: dietary intervention program and participant baseline dietary characteristics. Cancer Epidemiol Biomarkers Prev 1996; 5: 385-392 Erratum in: Cancer Epidemiol Biomarkers Prev 1996; 5: 584
    PubMedSuche in Google Scholar
  • 22 Schatzkin A, Lanza E, Corle D et al. Lack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas. Polyp Prevention Trial Study Group. N Engl J Med 2000; 342: 1149-1155
    CrossrefPubMedSuche in Google Scholar
  • 23 Kanazawa M, Yoshiike N, Osaka T et al. Criteria and classification of obesity in Japan and Asia-Oceania. Asia Pac J Clin Nutr 2002; 11: 732-S737
    CrossrefPubMedSuche in Google Scholar
  • 24 Bei-Fan Z. Cooperative Meta-Analysis Group of Working Group on Obesity in China. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Asia Pac J Clin Nutr 2002; 11: 685-693
    CrossrefPubMedSuche in Google Scholar
  • 25 Rapp K, Klenk J, Ulmer H et al. Weight change and cancer risk in a cohort of more than 65,000 adults in Austria. Ann Oncol 2008; 19: 641-648
    PubMedSuche in Google Scholar
  • 26 Bassett JK, Severi G, English DR et al. Body size, weight change, and risk of colon cancer. Cancer Epidemiol Biomarkers Prev 2010; 19: 2978-2986
    CrossrefPubMedSuche in Google Scholar