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@ARTICLE{Mandic:275584,
      author       = {M. Mandic$^*$ and F. Safizadeh$^*$ and T. Niedermaier$^*$
                      and M. Hoffmeister$^*$ and H. Brenner$^*$},
      title        = {{A}ssociation of {O}verweight, {O}besity, and {R}ecent
                      {W}eight {L}oss {W}ith {C}olorectal {C}ancer {R}isk.},
      journal      = {JAMA network open},
      volume       = {6},
      number       = {4},
      issn         = {2574-3805},
      address      = {Chicago, Ill.},
      publisher    = {American Medical Association},
      reportid     = {DKFZ-2023-00795},
      pages        = {e239556},
      year         = {2023},
      note         = {#EA:C070#LA:C070#LA:C120#},
      abstract     = {Overweight and obesity, conditions with rising prevalence
                      in many countries, are associated with increased colorectal
                      cancer (CRC) risk. However, many patients with CRC lose
                      weight before diagnosis, which may lead the association to
                      be underestimated.To evaluate the association of body mass
                      index (BMI) and weight change with CRC risk when considering
                      BMI at different time frames, with the intention to account
                      for prediagnostic weight loss.This population-based
                      case-control study was conducted in southwestern Germany
                      between 2003 and 2021. Cases with a first diagnosis of CRC
                      and controls (frequency matched by age, sex, and county)
                      with comprehensive risk factor information and self-reported
                      weight at different time points were included. Data were
                      analyzed between October 2022 and March 2023.BMI and weight
                      change at different time frames before the time of diagnosis
                      (cases) or recruitment (controls).Association of BMI and
                      weight change at various points in time before and up to
                      diagnosis with CRC, assessed by multivariable logistic
                      regression with comprehensive confounder adjustment.A total
                      of 11 887 participants (6434 CRC cases, 5453 controls;
                      median [IQR] age, 69 [61-77] years; 7173 male $[60.3\%])$
                      were included. At the time of diagnosis, 3998 cases
                      $(62.1\%)$ and 3601 controls $(66.0\%)$ were overweight or
                      obese, suggesting an inverse association between excess
                      weight and CRC risk. Conversely, we found significant
                      positive associations of overweight (adjusted odds ratio
                      [aOR], 1.27; $95\%$ CI, 1.03-1.56), obesity (aOR, 2.09;
                      $95\%$ CI, 1.61-2.70), and a 5-unit increase in BMI (aOR,
                      1.35; $95\%$ CI, 1.21-1.50) with CRC risk when using BMI
                      measured 8 to 10 years before diagnosis. High BMI as a risk
                      factor for CRC was increased as earlier periods before
                      diagnosis were examined, with the association being
                      particularly pronounced using BMI at least 8 years before
                      diagnosis. An opposite trend was found for the association
                      of weight loss (at or exceeding 2 kg) with CRC, with the
                      greatest effect sizes occurring for weight loss within 2
                      years before diagnosis (aOR, 7.52; $95\%$ CI, 5.61-10.09),
                      and gradually decreased for earlier intervals.In this
                      population-based case-control study, accounting for
                      substantial prediagnostic weight loss further highlighted
                      the association of overweight and obesity with CRC risk.},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37083659},
      pmc          = {pmc:PMC10122181},
      doi          = {10.1001/jamanetworkopen.2023.9556},
      url          = {https://inrepo02.dkfz.de/record/275584},
}