TY - JOUR
T1 - Long-term weight loss after colorectal cancer diagnosis is associated with lower survival
T2 - The Colon Cancer Family Registry
AU - Kocarnik, Jonathan M.
AU - Hua, Xinwei
AU - Hardikar, Sheetal
AU - Robinson, Jamaica
AU - Lindor, Noralane M.
AU - Win, Aung Ko
AU - Hopper, John L.
AU - Figueiredo, Jane C.
AU - Potter, John D.
AU - Campbell, Peter T.
AU - Gallinger, Steven
AU - Cotterchio, Michelle
AU - Adams, Scott V.
AU - Cohen, Stacey A.
AU - Phipps, Amanda I.
AU - Newcomb, Polly A.
N1 - Funding Information:
Supported by grants from the National Cancer Institute (K05 CA152715, K07 CA172298, and UM1 CA167551) and the National Center for Advancing Translational Sciences (KL2 TR000421) at the National Institutes of Health, and through cooperative agreements with the following centers: the Australasian Colorectal Cancer Family Registry (grants U01 CA074778 and U01/U24 CA097735), the Mayo Clinic Cooperative Family Registry for Colon Cancer Studies (grant U01/U24 CA074800), the Ontario Familial Colorectal Cancer Registry (grant U01/U24 CA074783), and the Seattle Colorectal Cancer Family Registry (grant U01/U24 CA074794). Seattle Colorectal Cancer Family Registry research also was supported by the Cancer Surveillance System of the Fred Hutchinson Cancer Research Center, which was funded by controls N01-CN-67009 (1996-2003) and N01-PC-35142 (2003-2010) and contract HHSN2612013000121 (2010-2017) from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute with additional support from the Fred Hutchinson Cancer Research Center.
Publisher Copyright:
© 2017 American Cancer Society
PY - 2017/12/1
Y1 - 2017/12/1
N2 - BACKGROUND: Body weight is associated with colorectal cancer (CRC) risk and survival, but to the authors' knowledge, the impact of long-term postdiagnostic weight change is unclear. Herein, the authors investigated whether weight change over the 5 years after a diagnosis of CRC is associated with survival. METHODS: CRC cases diagnosed from 1997 to 2008 were identified through 4 population-based cancer registry sites. Participants enrolled within 2 years of diagnosis and reported their height and weight 2 years prior. Follow-up questionnaires were administered approximately 5 years after diagnosis. Associations between change in weight (in kg) or body mass index (BMI) with overall and CRC-specific survival were estimated using Cox regression analysis adjusted for age, sex, American Joint Committee on Cancer stage of disease, baseline BMI, nonsteroidal anti-inflammatory drug use, smoking, time between diagnosis and enrollment, and study site. RESULTS: At the 5-year postdiagnostic survey, 2049 participants reported higher (53%; median plus 5 kg), unchanged (12%), or lower (35%; median -4 kg) weight. Over a median of 5.1 years of subsequent follow-up (range, 0.3-9.9 years), 344 participants died (91 of CRC). Long-term weight loss (per 5 kg) was found to be associated with poorer overall survival (hazard ratio, 1.13; 95% confidence interval, 1.07-1.21) and CRC-specific survival (hazard ratio, 1.25; 95% confidence interval, 1.13-1.39). Significantly lower survival was similarly observed for relative weight loss (>5% vs ≤5% change), BMI reduction (per 1 unit), or BMI category change (overweight to normal vs remaining overweight). CONCLUSIONS: Weight loss 5 years after a diagnosis of CRC was found to be significantly associated with decreased long-term survival, suggesting the importance of avoiding weight loss in survivors of CRC. Future research should attempt to further evaluate this association, accounting for whether this weight change was intentional or represents a marker of declining health. Cancer 2017;123:4701-4708.
AB - BACKGROUND: Body weight is associated with colorectal cancer (CRC) risk and survival, but to the authors' knowledge, the impact of long-term postdiagnostic weight change is unclear. Herein, the authors investigated whether weight change over the 5 years after a diagnosis of CRC is associated with survival. METHODS: CRC cases diagnosed from 1997 to 2008 were identified through 4 population-based cancer registry sites. Participants enrolled within 2 years of diagnosis and reported their height and weight 2 years prior. Follow-up questionnaires were administered approximately 5 years after diagnosis. Associations between change in weight (in kg) or body mass index (BMI) with overall and CRC-specific survival were estimated using Cox regression analysis adjusted for age, sex, American Joint Committee on Cancer stage of disease, baseline BMI, nonsteroidal anti-inflammatory drug use, smoking, time between diagnosis and enrollment, and study site. RESULTS: At the 5-year postdiagnostic survey, 2049 participants reported higher (53%; median plus 5 kg), unchanged (12%), or lower (35%; median -4 kg) weight. Over a median of 5.1 years of subsequent follow-up (range, 0.3-9.9 years), 344 participants died (91 of CRC). Long-term weight loss (per 5 kg) was found to be associated with poorer overall survival (hazard ratio, 1.13; 95% confidence interval, 1.07-1.21) and CRC-specific survival (hazard ratio, 1.25; 95% confidence interval, 1.13-1.39). Significantly lower survival was similarly observed for relative weight loss (>5% vs ≤5% change), BMI reduction (per 1 unit), or BMI category change (overweight to normal vs remaining overweight). CONCLUSIONS: Weight loss 5 years after a diagnosis of CRC was found to be significantly associated with decreased long-term survival, suggesting the importance of avoiding weight loss in survivors of CRC. Future research should attempt to further evaluate this association, accounting for whether this weight change was intentional or represents a marker of declining health. Cancer 2017;123:4701-4708.
KW - body mass index (BMI)
KW - colorectal neoplasms
KW - epidemiology
KW - follow-up studies
KW - mortality
KW - survivors
KW - weight loss
UR - http://www.scopus.com/inward/record.url?scp=85028529276&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028529276&partnerID=8YFLogxK
U2 - 10.1002/cncr.30932
DO - 10.1002/cncr.30932
M3 - Article
C2 - 28841225
AN - SCOPUS:85028529276
SN - 0008-543X
VL - 123
SP - 4701
EP - 4708
JO - Cancer
JF - Cancer
IS - 23
ER -
