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A longitudinal study of the metabolic syndrome and risk of colorectal cancer in postmenopausal women

Kabat, Geoffrey C.a; Kim, Mimi Y.a; Peters, Ulrikeb; Stefanick, Marciac; Hou, Lifangd; Wactawski-Wende, Jeane; Messina, Catherinef; Shikany, James M.g; Rohan, Thomas E.a

European Journal of Cancer Prevention:
doi: 10.1097/CEJ.0b013e32834dbc81
Research Paper: Colorectal Cancer
Abstract

The metabolic syndrome is associated with increased risk of diabetes and coronary heart disease. Although higher BMI and other related factors have been frequently associated with colorectal cancer, whether the metabolic syndrome is associated with the risk of colorectal cancer is unclear. We therefore assessed the association of the metabolic syndrome with the risk of colorectal cancer in a subsample of participants of the Women's Health Initiative who had repeated measurements of the components of the syndrome at baseline and during follow-up. Women with diabetes at baseline enrollment were excluded. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) at baseline and in time-dependent analyses. Among 4862 eligible women, 81 incident cases of colorectal cancer were identified over a median follow-up of 12 years. Presence of the metabolic syndrome at baseline was associated with increased risk of colorectal cancer (HR 2.15, 95% CI 1.30–3.53) and colon cancer (HR 2.28, 95% CI 1.31–3.98). These associations were largely explained by positive associations of serum glucose and systolic blood pressure with both outcomes. Time-dependent covariate analyses supported the baseline findings. Our results suggest that the positive association of the metabolic syndrome with risk of colorectal cancer is largely accounted for by serum glucose levels and systolic blood pressure. The biological mechanism underlying these associations remains to be clarified.

Author Information

aDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx

bFred Hutchinson Cancer Research Center, Seattle, Washington

cDepartment of Medicine, Prevention Research Center, Stanford University School of Medicine, Stanford, California

dDepartment of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

eDepartment of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo

fDepartment of Preventive Medicine, University at Stony Brook, Stony Brook, New York

gDivision of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA

Correspondence to Dr Geoffrey C. Kabat, PhD, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA Tel: +1 718 430 3038; fax: +1 718 430 8653; e-mail: Geoffrey.kabat@einstein.yu.edu

Received September 26, 2011

Accepted October 2, 2011

© 2012 Lippincott Williams & Wilkins, Inc.