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Metabolic factors and risk of colorectal cancer in the metabolic syndrome and cancer project (Me-Can)
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
German Cancer Research Center, Germany.
University of Bergen, Norway.
Innsbruck Medical University, Austria.
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2011 (Engelska)Ingår i: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 117, nr 11, s. 2398-2407Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background

The metabolic syndrome (MetS) has been related to an increased risk of colorectal cancer in some small studies, but it is unknown which factors in the MetS that are most strongly related to risk, and if there is an interaction between factors.

Methods and Findings

In the Metabolic syndrome and Cancer project (Me-Can), data on body mass index (BMI), blood pressure, and blood levels of glucose, cholesterol, and triglycerides were available in 289,866 men and 288,834 women. Mean age at baseline was 44.0 years and mean follow-up time was 12.0 years. During follow-up, 2,834 men and 1,861 women were diagnosed with colorectal cancer. We used Cox regression models to calculate relative risk (RR) of colorectal cancer by exposures transformed into Z scores (mean = 0, standard deviation = 1), and for a MetS Z score, and used regression calibration to correct exposure levels for random error in measurement. Significant increases in risk per one unit increment of factors were observed in men for BMI, RR 1.07 (95% confidence interval, 1.02-1.13), blood pressure, RR 1.10 (1.02-1.18), and triglycerides, RR 1.17 (1.06-1.28), and in women for BMI, RR 1.08 (1.01-1.15). The RR of colorectal cancer per one unit increment of the MetS Z score was 1.24 (1.18-1.31) in men, and 1.14 (1.06-1.22) in women. There was no significant positive interaction for any combination of two metabolic factors. Associations between metabolic factors and risk of fatal colorectal cancer were similar to those for incident cancer.

Conclusions

Our data add further evidence for an association between factors in the MetS, in single and combined, and risk of colorectal cancer. Our data do not support an interaction between factors in the MetS on risk.

Ort, förlag, år, upplaga, sidor
2011. Vol. 117, nr 11, s. 2398-2407
Nyckelord [en]
epidemiology, cohort studies, colorectal neoplasms, overweight, blood pressure, blood glucose, cholesterol, triglycerides, metabolic syndrome X
Nationell ämneskategori
Cancer och onkologi
Forskningsämne
epidemiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-22559DOI: 10.1002/cncr.25772PubMedID: 21171019OAI: oai:DiVA.org:umu-22559DiVA, id: diva2:217133
Tillgänglig från: 2009-12-22 Skapad: 2009-05-13 Senast uppdaterad: 2018-06-08Bibliografiskt granskad
Ingår i avhandling
1. Metabolic factors and cancer risk: prospective studies on prostate cancer, colorectal cancer, and cancer overall
Öppna denna publikation i ny flik eller fönster >>Metabolic factors and cancer risk: prospective studies on prostate cancer, colorectal cancer, and cancer overall
2009 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Background: A large number of prospective studies have shown that overweight and diabetes are related to an increased risk of many cancers, including colorectal cancer. In contrast, diabetes has been related to a decreased risk of prostate cancer, and overweight has been related to an increased risk of fatal, but not of incident, prostate cancer. Data from studies on metabolic factors related to overweight and diabetes, and the association with cancer risk, are limited.

 Aim: The aim of this thesis was to study metabolic factors in relation to risk of prostate cancer (paper I and III), colorectal cancer (paper II and V), and cancer overall (paper VI).

 Methods: Study designs were i) case-control studies, nested within the Northern Sweden Health and Disease Cohort (paper I and II), and ii) cohort studies of the Swedish Construction Workers cohort (paper III), and the Metabolic syndrome and Cancer project (Me-Can) comprising seven European cohorts (paper V and VI). Paper IV was a descriptive paper of Me-Can.

 Results, prostate cancer: In paper I, increasing levels of several factors related to insulin resistance (insulin, insulin resistance index, leptin, HbA1c, and glucose) were associated with a decreased risk of overall incident prostate cancer, and the associations were stronger for non-aggressive tumours. In paper III, increasing levels of blood pressure was associated with a significant decreased risk of overall incident prostate cancer and of non-aggressive tumours. Body mass index (BMI) was significantly positively related to fatal prostate cancer. 

 Results, colorectal cancer: In paper II, obesity, hypertension, and hyperglycaemia, were associated with an increased risk of colorectal cancer, and presence of two or three of these factors was associated with a higher risk than the presence of one single factor. In paper V, BMI was associated with a significant linear positive association with risk of colorectal cancer in men and women, and significant positive associations were also found in men for blood pressure and triglycerides. A high metabolic syndrome score, based on levels of BMI, blood pressure, glucose, cholesterol, and triglycerides, was associated with a significant increased risk of colorectal cancer in men and women. The association was stronger than for any of the factors in single, but there was no evidence of a positive interaction between these metabolic factors.

 Results, cancer overall: Blood glucose was significantly positively associated with risk of incident and fatal cancer overall, and at several specific sites. The associations were stronger in women than in men, and for fatal than for incident cancer.

 Conclusions: Results from these studies indicate that elevated blood glucose is related to an increased risk of cancer overall and at several specific sites, and further, that overweight and metabolic aberrations increase the risk of colorectal cancer in an additive way. The association with prostate cancer seems to be more complex; insulin resistance and high blood pressure were in our studies related to a decreased risk of overall incident prostate cancer and of non-aggressive tumours, whereas overweight increased the risk of fatal prostate cancer.

Ort, förlag, år, upplaga, sidor
Umeå: Institutionen för kirurgi och perioperativ vetenskap, 2009. s. 90
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1267
Nationell ämneskategori
Urologi och njurmedicin
Forskningsämne
epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-22567 (URN)978-91-7264-784-8 (ISBN)
Distributör:
Urologi och andrologi, 901 85, Umeå
Disputation
2009-06-05, Sal B, byggnad 1 D, Umeå Universitetssjukhus, Umeå, 13:15 (Engelska)
Opponent
Handledare
Tillgänglig från: 2009-05-19 Skapad: 2009-05-13 Senast uppdaterad: 2010-03-26Bibliografiskt granskad

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