Background & Aims

Incidence of colorectal cancer (CRC) in younger adults is increasing in many countries. Given the established association of body mass index (BMI) with CRC risk and the increasing obesity prevalence among younger generations, we aimed to evaluate the association of BMI at different ages during early adulthood with early-onset CRC.

Methods

Among 6602 patients with CRC and 7950 matched controls who were recruited in 2003-2020 in the Darmkrebs: Chancen der Verhütung durch Screening study, a population-based case–control study from Germany, 747 patients and 621 controls were younger than 55 years and included in this analysis. Self-reported height and weight at ages 20 years and 30 years and at approximately 10 years before diagnosis or interview were recorded in personal interviews. Associations of BMI with early-onset CRC were estimated using multiple logistic regression.

Results

Compared with participants with BMI <25 kg/m², those with BMI ≥30 kg/m² (obesity) at ages 20 years and 30 years and approximately 10 years before diagnosis or interview had 2.56- (95% confidence interval, 1.20–5.44), 2.06- (confidence interval, 1.25–3.40), and 1.88- (95% confidence interval, 1.30–2.73) fold risk of early-onset CRC. The association of BMI with early-onset CRC risk was particularly pronounced among, and essentially restricted to, the majority of participants with no previous colonoscopy.

Conclusions

Obesity at early adulthood is strongly associated with increased risk of early-onset CRC. German Clinical Trials Register ID: DRKS00011793.

中文翻译：

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不同年龄体重指数与早发性结直肠癌的关系

背景与目标

在许多国家，年轻人中结直肠癌 (CRC) 的发病率正在增加。鉴于体重指数 (BMI) 与 CRC 风险的既定关联以及年轻一代肥胖患病率的增加，我们旨在评估成年早期不同年龄的 BMI 与早发性 CRC 的关联。

方法

在 2003-2020 年在 Darmkrebs：Chancen der Verhütung durch 筛查研究中招募的 6602 名 CRC 患者和 7950 名匹配对照中，这是一项来自德国的基于人群的病例对照研究，其中 747 名患者和 621 名对照者年龄小于 55 岁，包括在本次分析中。在个人访谈中记录了 20 岁和 30 岁以及诊断或访谈前大约 10 年时自我报告的身高和体重。使用多元逻辑回归估计 BMI 与早发性 CRC 的关联。

结果

与 BMI <25 kg/m ²的参与者相比，那些在 20 岁和 30 岁以及诊断或访谈前约 10 年时 BMI ≥30 kg/m ² （肥胖）的参与者有 2.56-（95% 置信区间，1.20- 5.44）、2.06-（置信区间，1.25-3.40）和 1.88-（95% 置信区间，1.30-2.73）倍的早发性 CRC 风险。BMI 与早发性 CRC 风险的相关性在大多数之前没有进行过结肠镜检查的参与者中尤为明显，并且基本上仅限于这些参与者。

结论

成年早期肥胖与早发性 CRC 风险增加密切相关。德国临床试验注册 ID：DRKS00011793。