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@ARTICLE{BecerraToms:289940,
author = {N. Becerra-Tomás and G. Markozannes and M. Cariolou and K.
Balducci and R. Vieira and S. Kiss and D. Aune and D. C.
Greenwood and L. Dossus and E. Copson and A. G. Renehan and
M. Bours and W. Demark-Wahnefried and M. M. Hudson and A. M.
May and F. T. Odedina and R. Skinner and K. Steindorf$^*$
and A. Tjønneland and G. Velikova and M. L. Baskin and R.
Chowdhury and L. Hill and S. J. Lewis and J. Seidell and M.
P. Weijenberg and J. Krebs and A. J. Cross and K. K.
Tsilidis and D. S. M. Chan},
title = {{P}ost-diagnosis adiposity and colorectal cancer prognosis:
{A} {G}lobal {C}ancer {U}pdate {P}rogramme ({CUP} {G}lobal)
systematic literature review and meta-analysis.},
journal = {International journal of cancer},
volume = {155},
number = {3},
issn = {0020-7136},
address = {Bognor Regis},
publisher = {Wiley-Liss},
reportid = {DKFZ-2024-00923},
pages = {400-425},
year = {2024},
note = {2024 Aug 1;155(3):400-425},
abstract = {The 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.},
keywords = {adiposity (Other) / colorectal cancer (Other) / evidence
grading (Other) / systematic review (Other)},
cin = {C110},
ddc = {610},
cid = {I:(DE-He78)C110-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:38692659},
doi = {10.1002/ijc.34905},
url = {https://inrepo02.dkfz.de/record/289940},
}