Association between body mass index and mortality for colorectal cancer survivors: Overall and by tumor molecular phenotype

Peter T. Campbell, Christina C. Newton, Polly A. Newcomb, Amanda I. Phipps, Dennis J. Ahnen, John A. Baron, Daniel D. Buchanan, Graham Casey, Sean P. Cleary, Michelle Cotterchio, Alton B. Farris, Jane C. Figueiredo, Steven Gallinger, Roger C. Green, Robert W. Haile, John L. Hopper, Mark A. Jenkins, Loïc Le Marchand, Karen W. Makar, John R. McLaughlinJohn D. Potter, Andrew G. Renehan, Frank A Sinicrope, Stephen N Thibodeau, Cornelia M. Ulrich, Aung Ko Win, Noralane Morey Lindor, Paul John Limburg

Research output: Contribution to journalArticle

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Abstract

Background: Microsatellite instability (MSI) and BRAF mutation status are associated with colorectal cancer survival, whereas the role of body mass index (BMI) is less clear. We evaluated the association between BMI and colorectal cancer survival, overall and by strata of MSI, BRAF mutation, sex, and other factors. Methods: This study included 5,615 men and women diagnosed with invasive colorectal cancer who were followed for mortality (maximum: 14.7 years; mean: 5.9 years). Prediagnosis BMI was derived from self-reported weight approximately one year before diagnosis and height. Tumor MSI and BRAF mutation status were available for 4,131 and 4,414 persons, respectively. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated from delayed-entry Cox proportional hazards models. Results: In multivariable models, high prediagnosis BMI was associated with higher risk of all-cause mortality in both sexes (per 5-kg/m2; HR, 1.10; 95% CI, 1.06-1.15), with similar associations stratified by sex (Pinteraction: 0.41), colon versus rectum (Pinteraction: 0.86), MSI status (Pinteraction: 0.84), and BRAF mutation status (Pinteraction: 0.28). In joint models, with MS-stable/MSI-low and normal BMI as the reference group, risk of death was higher for MS-stable/MSI-low and obese BMI (HR, 1.32; P value: 0.0002), not statistically significantly lower for MSI-high and normal BMI (HR, 0.86; P value: 0.29), and approximately the same for MSIhigh and obese BMI (HR, 1.00; P value: 0.98). Conclusions: High prediagnosis BMI was associated with increased mortality; this association was consistent across participant subgroups, including strata of tumor molecular phenotype. Impact: High BMI may attenuate the survival benefit otherwise observed with MSI-high tumors.

Original languageEnglish (US)
Pages (from-to)1229-1238
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Volume24
Issue number8
DOIs
StatePublished - Aug 1 2015

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Microsatellite Instability
Survivors
Colorectal Neoplasms
Body Mass Index
Phenotype
Mortality
Neoplasms
Mutation
Survival
Confidence Intervals
Sex Factors
Proportional Hazards Models
Rectum
Colon
Joints
Weights and Measures

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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Association between body mass index and mortality for colorectal cancer survivors : Overall and by tumor molecular phenotype. / Campbell, Peter T.; Newton, Christina C.; Newcomb, Polly A.; Phipps, Amanda I.; Ahnen, Dennis J.; Baron, John A.; Buchanan, Daniel D.; Casey, Graham; Cleary, Sean P.; Cotterchio, Michelle; Farris, Alton B.; Figueiredo, Jane C.; Gallinger, Steven; Green, Roger C.; Haile, Robert W.; Hopper, John L.; Jenkins, Mark A.; Le Marchand, Loïc; Makar, Karen W.; McLaughlin, John R.; Potter, John D.; Renehan, Andrew G.; Sinicrope, Frank A; Thibodeau, Stephen N; Ulrich, Cornelia M.; Win, Aung Ko; Lindor, Noralane Morey; Limburg, Paul John.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 24, No. 8, 01.08.2015, p. 1229-1238.

Research output: Contribution to journalArticle

Campbell, PT, Newton, CC, Newcomb, PA, Phipps, AI, Ahnen, DJ, Baron, JA, Buchanan, DD, Casey, G, Cleary, SP, Cotterchio, M, Farris, AB, Figueiredo, JC, Gallinger, S, Green, RC, Haile, RW, Hopper, JL, Jenkins, MA, Le Marchand, L, Makar, KW, McLaughlin, JR, Potter, JD, Renehan, AG, Sinicrope, FA, Thibodeau, SN, Ulrich, CM, Win, AK, Lindor, NM & Limburg, PJ 2015, 'Association between body mass index and mortality for colorectal cancer survivors: Overall and by tumor molecular phenotype', Cancer Epidemiology Biomarkers and Prevention, vol. 24, no. 8, pp. 1229-1238. https://doi.org/10.1158/1055-9965.EPI-15-0094
Campbell, Peter T. ; Newton, Christina C. ; Newcomb, Polly A. ; Phipps, Amanda I. ; Ahnen, Dennis J. ; Baron, John A. ; Buchanan, Daniel D. ; Casey, Graham ; Cleary, Sean P. ; Cotterchio, Michelle ; Farris, Alton B. ; Figueiredo, Jane C. ; Gallinger, Steven ; Green, Roger C. ; Haile, Robert W. ; Hopper, John L. ; Jenkins, Mark A. ; Le Marchand, Loïc ; Makar, Karen W. ; McLaughlin, John R. ; Potter, John D. ; Renehan, Andrew G. ; Sinicrope, Frank A ; Thibodeau, Stephen N ; Ulrich, Cornelia M. ; Win, Aung Ko ; Lindor, Noralane Morey ; Limburg, Paul John. / Association between body mass index and mortality for colorectal cancer survivors : Overall and by tumor molecular phenotype. In: Cancer Epidemiology Biomarkers and Prevention. 2015 ; Vol. 24, No. 8. pp. 1229-1238.
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abstract = "Background: Microsatellite instability (MSI) and BRAF mutation status are associated with colorectal cancer survival, whereas the role of body mass index (BMI) is less clear. We evaluated the association between BMI and colorectal cancer survival, overall and by strata of MSI, BRAF mutation, sex, and other factors. Methods: This study included 5,615 men and women diagnosed with invasive colorectal cancer who were followed for mortality (maximum: 14.7 years; mean: 5.9 years). Prediagnosis BMI was derived from self-reported weight approximately one year before diagnosis and height. Tumor MSI and BRAF mutation status were available for 4,131 and 4,414 persons, respectively. Multivariable hazard ratios (HR) and 95{\%} confidence intervals (CI) were estimated from delayed-entry Cox proportional hazards models. Results: In multivariable models, high prediagnosis BMI was associated with higher risk of all-cause mortality in both sexes (per 5-kg/m2; HR, 1.10; 95{\%} CI, 1.06-1.15), with similar associations stratified by sex (Pinteraction: 0.41), colon versus rectum (Pinteraction: 0.86), MSI status (Pinteraction: 0.84), and BRAF mutation status (Pinteraction: 0.28). In joint models, with MS-stable/MSI-low and normal BMI as the reference group, risk of death was higher for MS-stable/MSI-low and obese BMI (HR, 1.32; P value: 0.0002), not statistically significantly lower for MSI-high and normal BMI (HR, 0.86; P value: 0.29), and approximately the same for MSIhigh and obese BMI (HR, 1.00; P value: 0.98). Conclusions: High prediagnosis BMI was associated with increased mortality; this association was consistent across participant subgroups, including strata of tumor molecular phenotype. Impact: High BMI may attenuate the survival benefit otherwise observed with MSI-high tumors.",
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TY - JOUR

T1 - Association between body mass index and mortality for colorectal cancer survivors

T2 - Overall and by tumor molecular phenotype

AU - Campbell, Peter T.

AU - Newton, Christina C.

AU - Newcomb, Polly A.

AU - Phipps, Amanda I.

AU - Ahnen, Dennis J.

AU - Baron, John A.

AU - Buchanan, Daniel D.

AU - Casey, Graham

AU - Cleary, Sean P.

AU - Cotterchio, Michelle

AU - Farris, Alton B.

AU - Figueiredo, Jane C.

AU - Gallinger, Steven

AU - Green, Roger C.

AU - Haile, Robert W.

AU - Hopper, John L.

AU - Jenkins, Mark A.

AU - Le Marchand, Loïc

AU - Makar, Karen W.

AU - McLaughlin, John R.

AU - Potter, John D.

AU - Renehan, Andrew G.

AU - Sinicrope, Frank A

AU - Thibodeau, Stephen N

AU - Ulrich, Cornelia M.

AU - Win, Aung Ko

AU - Lindor, Noralane Morey

AU - Limburg, Paul John

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background: Microsatellite instability (MSI) and BRAF mutation status are associated with colorectal cancer survival, whereas the role of body mass index (BMI) is less clear. We evaluated the association between BMI and colorectal cancer survival, overall and by strata of MSI, BRAF mutation, sex, and other factors. Methods: This study included 5,615 men and women diagnosed with invasive colorectal cancer who were followed for mortality (maximum: 14.7 years; mean: 5.9 years). Prediagnosis BMI was derived from self-reported weight approximately one year before diagnosis and height. Tumor MSI and BRAF mutation status were available for 4,131 and 4,414 persons, respectively. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated from delayed-entry Cox proportional hazards models. Results: In multivariable models, high prediagnosis BMI was associated with higher risk of all-cause mortality in both sexes (per 5-kg/m2; HR, 1.10; 95% CI, 1.06-1.15), with similar associations stratified by sex (Pinteraction: 0.41), colon versus rectum (Pinteraction: 0.86), MSI status (Pinteraction: 0.84), and BRAF mutation status (Pinteraction: 0.28). In joint models, with MS-stable/MSI-low and normal BMI as the reference group, risk of death was higher for MS-stable/MSI-low and obese BMI (HR, 1.32; P value: 0.0002), not statistically significantly lower for MSI-high and normal BMI (HR, 0.86; P value: 0.29), and approximately the same for MSIhigh and obese BMI (HR, 1.00; P value: 0.98). Conclusions: High prediagnosis BMI was associated with increased mortality; this association was consistent across participant subgroups, including strata of tumor molecular phenotype. Impact: High BMI may attenuate the survival benefit otherwise observed with MSI-high tumors.

AB - Background: Microsatellite instability (MSI) and BRAF mutation status are associated with colorectal cancer survival, whereas the role of body mass index (BMI) is less clear. We evaluated the association between BMI and colorectal cancer survival, overall and by strata of MSI, BRAF mutation, sex, and other factors. Methods: This study included 5,615 men and women diagnosed with invasive colorectal cancer who were followed for mortality (maximum: 14.7 years; mean: 5.9 years). Prediagnosis BMI was derived from self-reported weight approximately one year before diagnosis and height. Tumor MSI and BRAF mutation status were available for 4,131 and 4,414 persons, respectively. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated from delayed-entry Cox proportional hazards models. Results: In multivariable models, high prediagnosis BMI was associated with higher risk of all-cause mortality in both sexes (per 5-kg/m2; HR, 1.10; 95% CI, 1.06-1.15), with similar associations stratified by sex (Pinteraction: 0.41), colon versus rectum (Pinteraction: 0.86), MSI status (Pinteraction: 0.84), and BRAF mutation status (Pinteraction: 0.28). In joint models, with MS-stable/MSI-low and normal BMI as the reference group, risk of death was higher for MS-stable/MSI-low and obese BMI (HR, 1.32; P value: 0.0002), not statistically significantly lower for MSI-high and normal BMI (HR, 0.86; P value: 0.29), and approximately the same for MSIhigh and obese BMI (HR, 1.00; P value: 0.98). Conclusions: High prediagnosis BMI was associated with increased mortality; this association was consistent across participant subgroups, including strata of tumor molecular phenotype. Impact: High BMI may attenuate the survival benefit otherwise observed with MSI-high tumors.

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