Early Life Body Fatness and Risk of Colorectal Cancer in U.s. Women and Men-results from Two Large Cohort Studies

Background: The association between body fatness before adulthood and later risk of colorectal cancer remains unclear. We hypothesized that, independent of adult body fatness, early life body fatness would be associated with a higher risk of developing colorectal cancer.

Methods: We assessed body fatness during childhood and adolescence using a validated 9-level somatotype and inquired body weight in young adulthood in the Nurses' Health Study and Health Professionals Follow-up Study. We used the Cox proportional hazard regression modeling to estimate relative risks [RR, 95% confidence intervals (CI)] adjusting for adult body mass index (BMI) and other known colorectal cancer risk factors.

Results: We identified 2,100 incident colorectal cancer cases (1,292 in women and 808 in men) during 22 years of follow-up. Among women, the RR (95% CI) for childhood body fatness of level 5 or higher versus level 1 was 1.28 (1.04-1.58; Ptrend = 0.08) and for adolescent body fatness, it was 1.27 (1.01-1.60; Ptrend = 0.23). The corresponding RRs for men were 1.04 (0.82-1.31; Ptrend = 0.48) and 0.98 (0.75-1.27; Ptrend = 0.20), respectively. Results were generally similar across anatomic subsites within the colorectum. In addition, the RRs comparing BMI categories ≥27.5 to <19 kg/m(2) were 1.44 (1.06-1.95, at age 18; Ptrend = 0.009) for women and 1.18 (0.84-1.65, at age 21; Ptrend = 0.57) for men.

Conclusion: Increased body fatness in early life, independent of adult obesity, might be a risk factor for colorectal cancer in women, but we observed a weaker association in men.

Impact: Our findings support the growing evidence that early life body fatness affects the risk of colorectal cancer many decades later.