Obesity as a risk factor for early-onset colorectal cancer: Evidence from a nationally representative database.

IF 3.2 Q3 ONCOLOGY

World journal of clinical oncology Pub Date : 2025-07-24 DOI:10.5306/wjco.v16.i7.108220

Omar Khattab, Mohamed Alharami, Frhaan Zahrawi, Ammar Hemaidan

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引用次数: 0

Abstract

Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths worldwide with an alarming rise in early-onset CRC (eoCRC) over the past several decades. Unlike late-onset CRC, the drivers behind eoCRC remain less clear. While certain risk factors such as obesity and smoking have demonstrated a relatively strong association with eoCRC in the literature, some studies have challenged these associations, emphasizing the need for additional studies.

Aim: To investigate the impact of various risk factors on eoCRC with a special focus on obesity.

Methods: This cross-sectional study used de-identified data from the National Health and Nutrition Examination Survey (1999-2023), including 30321 United States adults aged 18 to 49 years. Participants with missing key variables were excluded. Standardized protocols were used to collect demographic, lifestyle, anthropometric [body mass index (BMI), body roundness index (BRI), waist circumference (WC)], and self-reported CRC data. Logistic regression and propensity score matching assessed associations between obesity-related parameters and eoCRC. Statistical analyses were performed in R and Stata, with P < 0.05 defined as significant.

Results: Of 30321 participants, 48 received a diagnosis of eoCRC. Patients with eoCRC were older (mean age 39.96 years vs 34.36 years; P < 0.001) and had higher WC and BRI. None of the eoCRC patients were heavy drinkers (P = 0.006). Unadjusted models demonstrated significant associations of eoCRC with BRI quartiles, as well as BMI-defined obesity, WC, and smoking. In unadjusted models, BRI remained the strongest independent predictor; those in the highest BRI quartiles had over 10-fold greater odds of eoCRC. In fully adjusted models, BRI remained significant, but BMI- and waist-based obesity were not.

Conclusion: BRI is a stronger predictor of eoCRC risk compared to other obesity indices and is a superior tool for identifying young individuals at higher risk of CRC.

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肥胖是早发性结直肠癌的危险因素：来自全国代表性数据库的证据。

背景：结直肠癌（CRC）是全球癌症相关死亡的第二大原因，在过去的几十年里，早发性结直肠癌（eoCRC）的发病率惊人地上升。与晚发性CRC不同，eoCRC背后的驱动因素尚不清楚。虽然某些风险因素，如肥胖和吸烟，在文献中已经证明与eoCRC有相对较强的关联，但一些研究对这些关联提出了质疑，强调需要进一步的研究。目的：探讨各种危险因素对eoCRC的影响，并特别关注肥胖。方法：本横断面研究使用1999-2023年国家健康和营养检查调查（National Health and Nutrition Examination Survey）的未识别数据，包括30321名18至49岁的美国成年人。缺少关键变量的参与者被排除在外。采用标准化方案收集人口统计、生活方式、人体测量[身体质量指数（BMI）、身体圆度指数（BRI）、腰围（WC）]和自我报告的CRC数据。Logistic回归和倾向评分匹配评估了肥胖相关参数与eoCRC之间的关系。R和Stata进行统计学分析，以P < 0.05为差异有统计学意义。结果：在30321名参与者中，48人被诊断为eoCRC。eoCRC患者年龄较大(平均年龄39.96岁vs 34.36岁；P < 0.001)，且WC和BRI较高。eoCRC患者均无重度饮酒者（P = 0.006）。未经调整的模型显示eoCRC与BRI四分位数、bmi定义的肥胖、WC和吸烟有显著关联。在未经调整的模型中，BRI仍然是最强的独立预测因子；BRI最高四分位数的人患eoCRC的几率高出10倍以上。在完全调整后的模型中，BRI仍然显著，但BMI和腰围肥胖则不显著。结论：与其他肥胖指标相比，BRI是一个更强的eoCRC风险预测指标，是识别CRC高风险年轻人的优越工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World journal of clinical oncology ONCOLOGY-

自引率

0.00%

发文量

585

期刊介绍： The WJCO is a high-quality, peer reviewed, open-access journal. The primary task of WJCO is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of oncology. In order to promote productive academic communication, the peer review process for the WJCO is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCO are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in oncology. Scope: Art of Oncology, Biology of Neoplasia, Breast Cancer, Cancer Prevention and Control, Cancer-Related Complications, Diagnosis in Oncology, Gastrointestinal Cancer, Genetic Testing For Cancer, Gynecologic Cancer, Head and Neck Cancer, Hematologic Malignancy, Lung Cancer, Melanoma, Molecular Oncology, Neurooncology, Palliative and Supportive Care, Pediatric Oncology, Surgical Oncology, Translational Oncology, and Urologic Oncology.