Assistant Professor The Ohio State University Wexner Medical Center Columbus, OH
Award: Category Award (Obesity)
Award: Presidential Poster Award
Hisham Hussan, MD, FACG1, Arsheya Patel, MD1, Alice Hinton, PhD2, Qin Ma, PhD1, Fred Tabung, PhD, MS1, Steven Clinton, MD, PhD1; 1The Ohio State University Wexner Medical Center, Columbus, OH; 2The Ohio State University, Columbus, OH
Introduction: The rapid rise in early-onset colorectal cancer (CRC diagnosed < 50 years) in the U.S has stimulated efforts to understand risk factors and define preventive strategies. Obesity is likely one contributing risk factor, although details regarding timing and associated comorbidities are uncertain. Of course, precision in defining this relationship may be confounded by reverse causality (i.e. CRC induced weight loss). Thus, we investigated the long-term Body Mass Index (BMI) history of adults with early-onset CRC compared to controls. Methods: We queried the 1999-2018 NHANES database for all adults diagnosed with CRC within nine years of the survey date. We classified early- and later-onset CRC based on a diagnosis age of < 50 and ≥50 years, respectively. Individuals under the age of 50 without a history of cancer were classified as controls. Propensity weighted analysis was used to compare outcomes between the groups after balancing early-onset CRC on gender, race, and years between diagnosis and survey when compared with later-onset CRC and age, sex, and race when compared with controls. Results: We included 133,008 adults with early-onset CRC, 133,680 with late-onset CRC, and 133,009 controls in this propensity-weighted analyses. Age, gender, racial and income distributions are in Table 1. Participants with early-onset CRC reported a higher BMI at age 25 or 10 years prior to survey compared to later-onset CRC and higher greatest BMI compared to later-onset CRC or controls without cancer (Table 2). We then assessed the proportions with previous obesity by dichotomizing the greatest prior BMI into < 30 vs. ≥ 30 kg/m2 (Figure 1). Using this method, we identified that 100% of adults with early-onset CRC were previously obese compared to 51.5% of later-onset CRC and 46.1% of controls without CRC. Finally, adults with early-onset CRC reported younger age of diabetes diagnosis (37 years old vs. 58 for later-onset CRC vs. 46 for controls). Discussion: Early-onset CRC is strongly associated with prior obesity (BMI ≥30 kg/m2) and earlier age of diabetes in a nationally representative sample. This data support efforts targeting early-age obesity in order to prevent early-onset CRC.
Table 1. Demographics and income of the early-onset CRC, late-onset CRC, and controls < 50 without cancer control groups in the propensity-weighted model.
Table 2. Historical BMI and age of diabetes onset in adults with early-onset CRC, late -onset CRC, and controls < 50 without cancer: A propensity-weighted analysis of NHANES
Figure 1. Prior obesity in adults with early-onset CRC, late-onset CRC, and controls: A propensity-weighted analysis of NHANES
Disclosures: Hisham Hussan indicated no relevant financial relationships. Arsheya Patel indicated no relevant financial relationships. Alice Hinton indicated no relevant financial relationships. Qin Ma indicated no relevant financial relationships. Fred Tabung indicated no relevant financial relationships. Steven Clinton indicated no relevant financial relationships.