Abstract
BackgroundMounting evidence indicates that obesity may be associated with the risk of colorectal cancer (CRC). To conduct a systematic review of prospective studies assessing the association of obesity with the risk of CRC using meta-analysis.Methodology/Principal FindingsRelevant studies were identified by a search of MEDLINE and EMBASE databases before January 2012, with no restrictions. We also reviewed reference lists from retrieved articles. We included prospective studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the association between general obesity [measured using body mass index (BMI)] or central obesity [measured using waist circumference (WC)] and the risk of colorectal, colon, or rectal cancer. Approximately 9, 000, 000 participants from several countries were included in this analysis. 41 studies on general obesity and 13 studies on central obesity were included in the meta-analysis. The pooled RRs of CRC for the obese vs. normal category of BMI were 1.334 (95% CI, 1.253–1.420), and the highest vs. lowest category of WC were 1.455 (95% CI, 1.327–1.596). There was heterogeneity among studies of BMI (P<0.001) but not among studies of WC (P = 0.323).ConclusionsBoth of general and central obesity were positively associated with the risk of CRC in this meta-analysis.
Highlights
Colorectal cancer (CRC) is one of the most common cancer in the Western World [1]
Both of general and central obesity were positively associated with the risk of colorectal cancer (CRC) in this meta-analysis
Studies were included in the meta-analysis if they met the following criteria: (1) prospective design; (2) the study of interest was the measurement of body mass index (BMI) or the waist circumference (WC) for participants; (3) the outcome of interest was colorectal, colon, or rectal cancer; and (4) the relative risk (RR) estimates with 95% confidence intervals (CIs) were reported
Summary
Colorectal cancer (CRC) is one of the most common cancer in the Western World [1]. Recent decades have witnessed a rapid increase in CRC morbidity in rapidly developing countries like China, especially in major cities where significant lifestyle alterations have occurred [2]. The relationship between obesity and the risk of CRC has been assessed by a large number of studies and review papers [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28, 29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49, 50,51]. To conduct a systematic review of prospective studies assessing the association of obesity with the risk of CRC using metaanalysis
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