Anthropometric risk factors for colorectal polyps in African-American women

Objective:Colorectal adenomas are thought to be precursor lesions to colorectal cancer, a leading cause of cancer incidence and mortality in African-American women. Studies suggest that obesity is associated with risk of adenomas in white women, but little is known about the relation in African-American women. We prospectively examined the association between selected anthropometric factors and colorectal polyps in African-American women.Methods and Procedures:Data were obtained from the Black Women\u27s Health Study (BWHS), a prospective cohort study of African-American women. From 1997 to 2003, we followed 33,403 women aged -30 years with no prior diagnosis of cancer or polyps. Cox regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for risk of polyps, with adjustment for potential confounders.Results:After 211,797 person-years of follow-up, 1,189 cases of colorectal polyps were reported. The IRR comparing women with a current BMI -35 to \u3c25 kg/m2 was 1.35 (95% CI = 1.12-1.62), after adjustment for covariates including waist-to-hip ratio (WHR). Women who gained -30 kg since age 18 were 1.76 times as likely as those who gained \u3c5 kg to report polyps (95% CI = 1.33-2.33). The IRR comparing the highest (-0.87) to lowest (\u3c0.71) quintiles of WHR was 1.26 (95% CI = 1.04-1.54), after adjustment for covariates including BMI. BMI at age 18, adult height, and waist circumference (BMI-adjusted) were not materially associated with risk. Results were similar among women with a recent endoscopy.Discussion:Weight gain and obesity in adulthood may increase the risk of colorectal polyps in African-American women. © 2008 The Obesity Society