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 M.
AU - Limburg, Paul J.
N1 - Publisher Copyright:
© 2015 American Association for Cancer Research.
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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U2 - 10.1158/1055-9965.EPI-15-0094
DO - 10.1158/1055-9965.EPI-15-0094
M3 - Article
C2 - 26038390
AN - SCOPUS:84941779721
SN - 1055-9965
VL - 24
SP - 1229
EP - 1238
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 8
ER -