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@ARTICLE{Safizadeh:294599,
      author       = {F. Safizadeh$^*$ and M. Mandic$^*$ and B. Schöttker$^*$
                      and M. Hoffmeister$^*$ and H. Brenner$^*$},
      title        = {{C}entral obesity may account for most of the colorectal
                      cancer risk linked to obesity: evidence from the {UK}
                      {B}iobank prospective cohort.},
      journal      = {International journal of obesity},
      volume       = {49},
      number       = {4},
      issn         = {0307-0565},
      address      = {Avenel, NJ},
      publisher    = {Nature Publ. Group},
      reportid     = {DKFZ-2024-02369},
      pages        = {619-626},
      year         = {2025},
      note         = {#EA:C070#LA:C070# / 2025 Apr;49(4):619-626},
      abstract     = {General obesity commonly represented by body mass index
                      (BMI) is an established risk factor for colorectal cancer
                      (CRC). However, it is unclear to what extent this
                      association is accounted for by central obesity. We aimed to
                      evaluate the associations between BMI, waist-to-hip ratio
                      (WHR), and waist circumference (WC) with CRC risk and to
                      investigate if and to what extent these associations are
                      independent from each other.Data from more than 500,000 male
                      and female participants aged 40-69, recruited in the UK
                      Biobank study between 2006 and 2010, were analyzed.
                      Multivariable Cox proportional hazards models were fitted
                      and hazard ratios (HR) and their $95\%$ confidence intervals
                      (CI) were calculated.During a median follow-up of 12.5
                      years, of 460,784 participants, 5,977 developed CRC.
                      Multivariable adjusted HRs $(95\%$ CIs) per standard
                      deviation increase of BMI, WHR, and WC were 1.10
                      (1.07-1.13), 1.18 (1.14-1.22), and 1.14 (1.11-1.18),
                      respectively. After mutual adjustment, the association with
                      CRC was substantially attenuated for BMI (1.04 (1.01-1.07)),
                      and remained substantially stronger for WHR (1.15
                      (1.11-1.20)). Furthermore, WHR showed strong, statistically
                      significant associations with CRC risk within all BMI
                      categories, whereas associations of BMI with CRC risk were
                      weak and not statistically significant within WHR
                      categories. BMI was also not associated with CRC risk in
                      women and with rectal cancer after mutual adjustment.
                      Conversely, WHR was strongly associated with CRC risk in
                      both sexes and with both colon and rectal cancer risk before
                      and after adjustment for BMI. BMI and WC could not be
                      mutually adjusted for due to their high correlation.Central
                      obesity is a much stronger predictor of CRC and may account
                      for most of the CRC risk linked to obesity. Our findings
                      also emphasize the need for incorporating measures such as
                      WHR alongside BMI in clinical practice to improve obesity
                      prevention and management.},
      cin          = {C070 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / 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:39562688},
      doi          = {10.1038/s41366-024-01680-7},
      url          = {https://inrepo02.dkfz.de/record/294599},
}