Association of body mass index with colorectal cancer risk by genome-wide variants

Peter T. Campbell, Yi Lin, Stephanie A. Bien, Jane C. Figueiredo, Tabitha A. Harrison, Mark A. Guinter, Sonja I. Berndt, Hermann Brenner, Andrew T. Chan, Jenny Chang-Claude, Steven J. Gallinger, Susan M. Gapstur, Graham G. Giles, Edward Giovannucci, Stephen B. Gruber, Marc Gunter, Michael Hoffmeister, Eric J. Jacobs, Mark A. Jenkins, Loic Le MarchandLi Li, John R. McLaughlin, Neil Murphy, Roger L. Milne, Polly A. Newcomb, Christina Newton, Shuji Ogino, John D. Potter, Gad Rennert, Hedy S. Rennert, Jennifer Robinson, Lori C. Sakoda, Martha L. Slattery, Yiqing Song, Emily White, Michael O. Woods, Graham Casey, Li Hsu, Ulrike Peters

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Body mass index (BMI) is a complex phenotype that may interact with genetic variants to influence colorectal cancer risk. Methods: We tested multiplicative statistical interactions between BMI (per 5 kg/m2) and approximately 2.7 million single nucleotide polymorphisms with colorectal cancer risk among 14 059 colorectal cancer case (53.2% women) and 14 416 control (53.8% women) participants. All analyses were stratified by sex a priori. Statistical methods included 2-step (ie, Cocktail method) and single-step (ie, case-control logistic regression and a joint 2-degree of freedomtest) procedures. All statistical tests were two-sided. Results: Each 5 kg/m2 increase in BMI was associated with higher risks of colorectal cancer, less so for women (odds ratio [OR] = 1.14, 95% confidence intervals [CI] = 1.11 to 1.18; P = 9.75 × 10-17) than for men (OR = 1.26, 95% CI = 1.20 to 1.32; P = 2.13 × 10-24). The 2-step Cocktail method identified an interaction for women, but not men, between BMI and a SMAD7 intronic variant at 18q21.1 (rs4939827; Pobserved = .0009; Pthreshold = .005). A joint 2-degree of freedom test was consistent with this finding for women (joint P = 2.43 × 10-10). Each 5 kg/m2 increase in BMI was more strongly associated with colorectal cancer risk for women with the rs4939827-CC genotype (OR = 1.24, 95% CI = 1.16 to 1.32; P = 2.60 × 10-10) than for women with the CT (OR = 1.14, 95% CI = 1.09 to 1.19; P = 1.04 × 10-8) or TT (OR = 1.07, 95% CI = 1.01 to 1.14; P = .02) genotypes. Conclusion: These results provide novel insights on a potential mechanism through which a SMAD7 variant, previously identified as a susceptibility locus for colorectal cancer, and BMI may influence colorectal cancer risk for women.

Original languageEnglish (US)
Pages (from-to)38-47
Number of pages10
JournalJournal of the National Cancer Institute
Issue number1
StatePublished - 2021
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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