Association of changes in obesity and abdominal obesity status with early-onset colorectal cancer risk: a nationwide population-based cohort study

Ji Hyun Song; Ji Yeon Seo; Eun Hyo Jin; Goh Eun Chung; Young Sun Kim; Jung Ho Bae; Sunmie Kim; Kyung-Do Han; Sun Young Yang

doi:10.3389/fmed.2023.1208489

Association of changes in obesity and abdominal obesity status with early-onset colorectal cancer risk: a nationwide population-based cohort study

Front Med (Lausanne). 2023 Jun 21:10:1208489. doi: 10.3389/fmed.2023.1208489. eCollection 2023.

Authors

Ji Hyun Song¹, Ji Yeon Seo¹, Eun Hyo Jin¹, Goh Eun Chung¹, Young Sun Kim¹, Jung Ho Bae¹, Sunmie Kim², Kyung-Do Han², Sun Young Yang¹

Affiliations

¹ Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea.
² Department of Obstetrics and Gynecology, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea.

Abstract

Background and aims: The incidence of early-onset colorectal cancer (EO-CRC, diagnosed before 50 years of age) has increased in recent decades. The aim of this study was to investigate the association between changes in obesity status and EO-CRC risk.

Methods: From a nationwide population-based cohort, individuals <50 years old who participated in the national health checkup program in both 2009 and 2011 were included. Obesity was defined as a body mass index ≥25 kg/m². Abdominal obesity was defined as a waist circumference ≥ 90 cm in men and ≥ 85 cm in women. Participants were classified into 4 groups according to the change in obesity (normal/normal, normal/obese, obese/normal, persistent obese) and abdominal obesity (normal/normal, normal/abdominal obesity, abdominal obesity/normal, persistent abdominal obesity) status. Participants were followed up until 2019 and censored when they became 50 years old.

Results: Among 3,340,635 participants, 7,492 patients were diagnosed with EO-CRC during 7.1 years of follow-up. The risk of EO-CRC was higher in the persistent obesity and persistent abdominal obesity groups than in the normal/normal groups (hazard ratio (HR) [95% confidence interval (CI)] = 1.09 [1.03-1.16] and 1.18 [1.09-1.29], respectively). Participants with both persistent obesity and abdominal obesity had a higher EO-CRC risk than those in the normal/normal groups for both [HR (95% CI) = 1.19 (1.09-1.30)].

Conclusion: Persistent obesity and persistent abdominal obesity before the age of 50 are associated with a slightly increased risk of EO-CRC. Addressing obesity and abdominal obesity in young individuals might be beneficial in reducing the risk of EO-CRC.

Keywords: abdominal obesity; cohort study; early onset colorectal cancer; obesity; obesity change.