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Body Mass Index and Risk of Second Obesity-Associated Cancers After Colorectal Cancer: A Pooled Analysis of Prospective Cohort Studies.
[esophageal adenocarcinoma]
To
determine
whether
prediagnostic
body
mass
index
(
BMI
)
is
associated
with
risk
of
second
obesity
-associated
cancers
in
colorectal
cancer
(
CRC
)
survivors
,
and
whether
CRC
survivors
have
increased
susceptibility
to
obesity
-associated
cancer
compared
with
cancer
-free
individuals
.
Incident
first
primary
CRC
cases
(
N
=
11
,
598
)
were
identified
from
five
prospective
cohort
studies
.
We
used
Cox
proportional
hazards
regression
models
to
examine
associations
between
baseline
(
prediagnostic
)
BMI
and
risk
of
second
obesity
-associated
cancers
(
postmenopausal
breast
,
kidney
,
pancreas
,
esophageal
adenocarcinoma
,
endometrium
)
in
CRC
survivors
,
and
compared
associations
to
those
for
first
obesity
-associated
cancers
in
the
full
cohort
.
Compared
with
survivors
with
normal
prediagnostic
BMI
(
18
.
5
-
24
.
9
kg
/
m
(
2
)
)
,
those
who
were
overweight
(
25
-
29
.
9
kg
/
m
(
2
)
)
or
obese
(
30
+
kg
/
m
(
2
)
)
had
greater
risk
of
a
second
obesity
-associated
cancer
(
n
=
224
;
overweight
hazard
ratio
[
HR
]
,
1
.
39
;
95
%
CI
,
1
.
01
to
1
.
92
;
obese
HR
,
1
.
47
;
95
%
CI
,
1
.
02
to
2
.
12
;
per
5
-
unit
change
in
BMI
HR
,
1
.
12
;
95
%
CI
,
0
.
98
to
1
.
29
)
.
The
magnitude
of
risk
for
developing
a
first
primary
obesity
-associated
cancer
was
similar
(
overweight
HR
,
1
.
18
;
95
%
CI
,
1
.
14
to
1
.
21
;
obese
HR
,
1
.
61
;
95
%
CI
,
1
.
56
to
1
.
66
;
per
5
-
unit
change
in
BMI
HR
,
1
.
23
;
95
%
CI
,
1
.
21
to
1
.
24
)
.
Before
diagnosis
CRC
patients
were
somewhat
more
likely
than
the
overall
cohort
to
be
overweight
(
44
%
v
41
%
)
or
obese
(
25
%
v
21
%
)
.
CRC
survivors
who
were
overweight
or
obese
before
diagnosis
had
increased
risk
of
second
obesity
-associated
cancers
compared
with
survivors
with
normal
weight
.
The
risks
were
similar
in
magnitude
to
those
observed
for
first
cancers
in
this
population
,
suggesting
increased
prevalence
of
overweight
or
obesity
,
rather
than
increased
susceptibility
,
may
contribute
to
elevated
second
cancer
risks
in
colorectal
cancer
survivors
compared
with
the
general
population
.
These
results
support
emphasis
of
existing
weight
guidelines
for
this
high
-risk
group
.
Diseases
Validation
Diseases presenting
"first primary obesity-associated cancer"
symptom
esophageal adenocarcinoma
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