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000289940 1001_ $$aBecerra-Tomás, Nerea$$b0
000289940 245__ $$aPost-diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis.
000289940 260__ $$aBognor Regis$$bWiley-Liss$$c2024
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000289940 500__ $$a2024 Aug 1;155(3):400-425
000289940 520__ $$aThe adiposity influence on colorectal cancer prognosis remains poorly characterised. We performed a systematic review and meta-analysis on post-diagnosis adiposity measures (body mass index [BMI], waist circumference, waist-to-hip ratio, weight) or their changes and colorectal cancer outcomes. PubMed and Embase were searched through 28 February 2022. Random-effects meta-analyses were conducted when at least three studies had sufficient information. The quality of evidence was interpreted and graded by the Global Cancer Update Programme (CUP Global) independent Expert Committee on Cancer Survivorship and Expert Panel. We reviewed 124 observational studies (85 publications). Meta-analyses were possible for BMI and all-cause mortality, colorectal cancer-specific mortality, and cancer recurrence/disease-free survival. Non-linear meta-analysis indicated a reverse J-shaped association between BMI and colorectal cancer outcomes (nadir at BMI 28 kg/m2). The highest risk, relative to the nadir, was observed at both ends of the BMI distribution (18 and 38 kg/m2), namely 60% and 23% higher risk for all-cause mortality; 95% and 26% for colorectal cancer-specific mortality; and 37% and 24% for cancer recurrence/disease-free survival, respectively. The higher risk with low BMI was attenuated in secondary analyses of RCTs (compared to cohort studies), among studies with longer follow-up, and in women suggesting potential methodological limitations and/or altered physiological state. Descriptively synthesised studies on other adiposity-outcome associations of interest were limited in number and methodological quality. All the associations were graded as limited (likelihood of causality: no conclusion) due to potential methodological limitations (reverse causation, confounding, selection bias). Additional well-designed observational studies and interventional trials are needed to provide further clarification.
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000289940 650_7 $$2Other$$aadiposity
000289940 650_7 $$2Other$$acolorectal cancer
000289940 650_7 $$2Other$$aevidence grading
000289940 650_7 $$2Other$$asystematic review
000289940 7001_ $$00000-0001-8481-579X$$aMarkozannes, Georgios$$b1
000289940 7001_ $$aCariolou, Margarita$$b2
000289940 7001_ $$aBalducci, Katia$$b3
000289940 7001_ $$aVieira, Rita$$b4
000289940 7001_ $$aKiss, Sonia$$b5
000289940 7001_ $$00000-0002-4533-1722$$aAune, Dagfinn$$b6
000289940 7001_ $$aGreenwood, Darren C$$b7
000289940 7001_ $$aDossus, Laure$$b8
000289940 7001_ $$aCopson, Ellen$$b9
000289940 7001_ $$aRenehan, Andrew G$$b10
000289940 7001_ $$aBours, Martijn$$b11
000289940 7001_ $$00000-0001-5241-932X$$aDemark-Wahnefried, Wendy$$b12
000289940 7001_ $$aHudson, Melissa M$$b13
000289940 7001_ $$aMay, Anne M$$b14
000289940 7001_ $$aOdedina, Folakemi T$$b15
000289940 7001_ $$aSkinner, Roderick$$b16
000289940 7001_ $$0P:(DE-He78)a0c2037d9054be26907a05ae520d5756$$aSteindorf, Karen$$b17$$udkfz
000289940 7001_ $$aTjønneland, Anne$$b18
000289940 7001_ $$aVelikova, Galina$$b19
000289940 7001_ $$aBaskin, Monica L$$b20
000289940 7001_ $$aChowdhury, Rajiv$$b21
000289940 7001_ $$aHill, Lynette$$b22
000289940 7001_ $$aLewis, Sarah J$$b23
000289940 7001_ $$aSeidell, Jaap$$b24
000289940 7001_ $$aWeijenberg, Matty P$$b25
000289940 7001_ $$aKrebs, John$$b26
000289940 7001_ $$aCross, Amanda J$$b27
000289940 7001_ $$00000-0002-8452-8472$$aTsilidis, Konstantinos K$$b28
000289940 7001_ $$00000-0002-0198-1897$$aChan, Doris S M$$b29
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