Abstract
The association between abdominal obesity (as measured by waist circumference (WC) and waist-to-hip ratio (WHR)) and colorectal cancer (CRC) has not been fully quantified, and the magnitude of CRC risk associated with abdominal obesity is still unclear. A meta-analysis of prospective studies was performed to elucidate the CRC risk associated with abdominal obesity. Pubmed and Embase were searched for studies assessing the association between abdominal obesity and CRC risk. Relative risks (RRs) with 95% confidence intervals (95% CIs) were pooled using random-effects model of meta-analysis. Nineteen prospective cohort studies from eighteen publications were included in this meta-analysis. A total of 12,837 CRC cases were identified among 1,343,560 participants. Greater WC and WHR were significantly associated with increased risk of total colorectal cancer (WC: RR 1.42, 95% CI 1.30, 1.55; WHR: RR 1.39, 95% CI 1.25, 1.53), colon cancer (WC: RR 1.53, 95% CI 1.36, 1.72; WHR: 1.39, 95% CI 1.18, 1.63), and rectal cancer (WC: RR 1.20, 95% CI 1.03, 1.39; WHR: RR 1.22, 95% CI 1.05, 1.42). Subgroup analyses further identified the robustness of the association above. No obvious risk of publication bias was observed. In summary, abdominal obesity may play an important role in the development of CRC.
Highlights
Colorectal cancer (CRC) is a major public health concern, as it is one of the leading causes of cancer deaths in the Western world [1]
Greater waist circumference (WC) and waist-to-hip ratio (WHR) were significantly associated with increased risk of total colorectal cancer (WC: relative risk (RR) 1.42, 95% confidence interval (CI) 1.30, 1.55; WHR: RR 1.39, 95% confidence intervals (95% CIs) 1.25, 1.53), colon cancer (WC: RR 1.53, 95% CI 1.36, 1.72; WHR: 1.39, 95% CI 1.18, 1.63), and rectal cancer (WC: RR 1.20, 95% CI 1.03, 1.39; WHR: RR 1.22, 95% CI 1.05, 1.42)
This systematic review and meta-analysis aimed to examine the association between abdominal obesity and risk of total colorectal cancer, colon cancer, and rectal cancer, which was the first meta-analysis on this subject
Summary
Colorectal cancer (CRC) is a major public health concern, as it is one of the leading causes of cancer deaths in the Western world [1]. Several environmental risk factors, such as smoking, obesity, a high-fat/low-fiber diet or physical inactivity, have been suggested for CRC development [3,4,5]. In contrast with general obesity, body fat distribution— abdominal obesity—appears to play a role in the development of CRC [15,16]. This positive association of WC or WHR with CRC remained even after adjustment for body mass index (BMI) [15,17,18]
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