A study of Swedish men has found an association between increased BMI and inflammation between the ages of 16-18 years, and risk of colorectal cancer in later life.
Research into potential causes for colorectal cancer has been primarily focused on risk factors present in adulthood. However, a recent study has set out to investigate if risk factors in adolescence can increase the risk of colorectal cancer in later life. The researchers who conducted the study suggest that a time period that may be important in risk of colorectal cancer may be adolescence, due to the rapid growth seen during this period, especially evident in males. The researchers therefore assessed whether BMI and inflammation during adolescence impact on risk of colorectal cancer in later life, since these are known risk factors during adulthood.
The researchers assessed a cohort of 239 658 Swedish men who attended military enlistment examinations between the ages of 16 and 20 years, from 1969-1976. During these examinations, height and weight measurements were taken, and erythrocyte sedimentation rate (ESR) was tested as a marker of inflammation. The researchers then linked participants through the national cancer registry through 2010. During the 35-year follow up, there were 885 cases of colorectal cancer reported (501 colon cancers and 384 rectal cancers). For the purposes of the study, BMI measurements were separated into 4 groups. ‘Underweight’ (BMI 15 to <18.5), ‘normal weight’ (BMI 18.5 to <25), ‘lower overweight’ (BMI 25 to <27.5), ‘upper overweight’ (BMI 27.5 to <30), and ‘obese’ (BMI >30).
The results of the study showed that when compared to normal weight, a BMI in the upper overweight range in adolescence was associated with a >2-fold increased risk of colorectal cancer. In addition, obesity during adolescence was also associated with a >2-fold increased risk of colorectal cancer. Although not significant, the results also demonstrated a trend toward lower risk of colorectal cancer in men who were in the underweight group during adolescence. Higher levels of ESR during adolescents was associated with a 63% increased risk of colorectal cancer, compared with low levels of ESR. The results were not different when assessing specific sites of colorectal cancer.
Overall the results demonstrate that in the study group, BMI and inflammation during adolescence was associated with increased risk of colorectal cancer. These finding could have implications for early intervention prevention of colorectal cancer in later life.
Kantor, ED, Udumyan, R, Signorello, LB, Giovannucci, EL, Montgomery, S, Fall, K. “Adolescent body mass index and erythrocyte sedimentation rate in relation to colorectal cancer risk” Gut doi:10.1136/gutjnl-2014-309007 Online first.
Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net
Written by Deborah Tallarigo, PhD