Abstract
OBJECTIVE: To determine whether body size measurements are risk factors for colon cancer death among the Japanese.
DESIGN AND SUBJECTS: A nationwide prospective study, the Japan Collaborative Cohort (JACC) Study from 1988 to 1999. The present analysis included 43?171 men and 58?775 women aged 40–79?y who respond to a questionnaire on current weight and height, weight around 20?y of age, and other lifestyle factors. Body mass index (BMI) at baseline and 20?y of age (B-BMI and 20-BMI, respectively) were calculated.
RESULTS: We identified 127 deaths from colon cancer during the follow-up of 424?698 person-years among men and 122 deaths during the follow-up of 591?787 person-years among women. After adjustments for the lifestyle factors known to modify the risk of colon cancer, weight at baseline showed a significant positive association in women, while no such association was seen in men. There was also a significant trend of increasing risk with the increase in B-BMI among women. Women with B-BMI ≥28?kg/m2 had a relative risk (RR) of 3.41 (95% confidence interval (CI): 1.44–8.06) compared with those with BMI of 20–<22?kg/m2. 20-BMI also presented the same trend of increasing risk as B-BMI. Women with 20-BMI of <22 and B-BMI of >26?kg/m2, that is, excessive BMI gain, had a high RR of 3.41 (95% CI 1.29–9.02) compared with those with 20-BMI of <22 and B-BMI of <22?kg/m2. There were no corresponding trends of colon cancer risk for B-BMI, 20-BMI, or BMI change among men.
CONCLUSIONS: These study data suggest that obesity and excessive weight gain are associated with the risk of colon cancer death in Japanese women but no such relationship was found in Japanese men.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Ministry of Health, Labour and Welfare. Vital Statistics of Japan 1950–1999.
Parkin DM, Muir CS . Cancer incidence in five continents. Comparability and quality of data. IARC Sci Publ 1992; 120: 45–173.
Haenszel W, Kurihara M . Studies of Japanese migrants. I. Mortality from cancer and other diseases among Japanese in the United States. J Natl Cancer Inst 1968; 40: 43–68.
Garfinkel L . Overweight and cancer. Ann Intern Med 1985; 103: 1034–1036.
Phillips RL, Snowdon DA . Dietary relationships with fatal colorectal cancer among Seventh-Day Adventists. J Natl Cancer Inst 1985; 74: 307–317.
Thun MJ, Calle EE, Namboodiri MM, Flanders WD, Coates RJ, Byers T, Boffetta P, Garfinkel L, Heath Jr CW . Risk factors for fatal colon cancer in a large prospective study. J Natl Cancer Inst 1992; 84: 1491–1500.
Wu AH, Paganini-Hill A, Ross RK, Henderson BE . Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study. Br J Cancer 1987; 55: 687–694.
Ford ES . Body mass index and colon cancer in a national sample of adult US men and women. Am J Epidemiol 1999; 150: 390–398.
Murphy TK, Eugenia E. Calle EE, Rodriguez C, Kahn HS, Thun MJ . Body mass index and colon cancer mortality in a large prospective study. Am J Epidemiol 2000; 152: 847–854.
Chyou PH, Nomura AM, Stemmermann GN . A prospective study of colon and rectal cancer among Hawaii Japanese men. Ann Epidemiol 1996; 6: 276–282.
Giovannucci E, Ascherio A, Rimm EB, Colditz GA, Stampfer MJ, Willett WC . Physical activity, obesity, and risk for colon cancer and adenoma in men. Ann Intern Med 1995; 122: 327–334.
Le Marchand L, Wilkens LR, Mi MP . Obesity in youth and middle age and risk of colorectal cancer in men. Cancer Causes Control 1992; 3: 349–354.
Nomura A, Heilbrun LK, Stemmermann GN . Body mass index as a predictor of cancer in men. J Natl Cancer Inst 1985; 74: 319–323.
Martinez ME, Giovannucci E, Spiegelman D, Hunter DJ, Willett WC, Colditz GA . Leisure-time physical activity, body size, and colon cancer in women. Nurses' Health Study Research Group. J Natl Cancer Inst 1997; 89: 948–955.
Chute CG, Willett WC, Colditz GA, Stampfer MJ, Baron JA, Rosner B, Speizer FE . A prospective study of body mass, height, and smoking on the risk of colorectal cancer in women. Cancer Causes Control 1991; 2: 117–124.
Bostick RM, Potter JD, Kushi LH, Sellers TA, Steinmetz KA, McKenzie DR, Gapstur SM, Folsom AR . Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women (United States). Cancer Causes Control 1994; 5: 38–52.
Terry PD, Miller AB, Rohan TE . Obesity and colorectal cancer risk in women. Gut 2002; 51: 191–194.
Suadicani P, Hein HO, Gyntelberg F . Height, weight, and risk of colorectal cancer. An 18-year follow-up in a cohort of 5249 men. Scand J Gastroenterol 1993; 28: 285–288.
Caan BJ, Coates AO, Slattery ML, Potter JD, Quesenberry Jr CP, Edwards SM . Body size and the risk of colon cancer in a large case–control study. Int J Obes Relat Metab Disord 1998; 22: 178–184.
Gerhardsson de Verdier M, Hagman U, Steineck G, Rieger A, Norell SE . Diet, body mass and colorectal cancer: a case-referent study in Stockholm. Int J Cancer 1990; 46: 832–838.
Graham S, Marshall J, Haughey B, Mittelman A, Swanson M, Zielezny M, Byers T, Wilkinson G, West D . Dietary epidemiology of cancer of the colon in western New York. Am J Epidemiol 1988; 128: 490–503.
Le Marchand L, Wilkens LR, Kolonel LN, Hankin JH, Lyu LC . Associations of sedentary lifestyle, obesity, smoking, alcohol use, and diabetes with the risk of colorectal cancer. Cancer Res 1997; 57: 4787–4794.
Slattery ML, Potter J, Caan B, Edwards S, Coates A, Ma KN, TDerry TD . Energy balance and colon cancer—beyond physical activity. Cancer Res 1997; 57: 75–80.
West DW, Slattery ML, Robison LM, Henderson BE . Dietary intake and colon cancer: sex- and anatomic site-specific associations. Am J Epidemiol 1989; 130: 883–894.
Dietz AT, Newcomb PA, Marcus PM, Storer BE . The association of body size and large bowel cancer risk in Wisconsin (United States) women. Cancer Causes Control 1995; 6: 30–36.
Kune GA, Kune S, Watson LF . Body weight and physical activity as predictors of colorectal cancer risk. Nutr Cancer 1990; 13: 9–17.
Ohno Y, Tamakoshi A, JACC Study Group. Japan collaborative cohort study for evaluation of cancer risk sponsored by Monbusho (JACC study). J Epidemiol 2001; 11: 144–150.
Giovannucci E . Insulin and colon cancer. Cancer Causes Control 1995; 6: 164–179.
McKeown-Eyssen G . Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk? Cancer Epidemiol Biomarkers Prev 1994; 3: 687–695.
Calle EE, Miracle-McMahill HL, Thun MJ, Heath Jr CW . Estrogen replacement therapy and risk of fatal colon cancer in a prospective cohort of postmenopausal women. J Natl Cancer Inst 1995; 87: 517–523.
Edman CD, MacDonald PC . Effect of obesity on conversion of plasma androstenedione to estrone in ovulatory and anovulator young women. Am J Obstet Gynecol 1978; 130: 456–461.
Simpson ER, Bulun SE, Nichols JE, Zhao Y . Estrogen biosynthesis in adipose tissue: regulation by paracrine and autocrine mechanisms. J Endocrinol 1996; 150: 51–57.
Polderman KH, Gooren LJ, Asscheman H, Bakker A, Heine RJ . Induction of insulin resistance by androgens and estrogens. J Clin Endocrinol Metab 1994; 79: 265–271.
Lee IM, Paffenbarger Jr RS . Quetelet's index and risk of colon cancer in college alumni. J Natl Cancer Inst 1992; 84: 1326–1331.
Winick M, Noble A . Cellular response in rats during malnutrition at various ages. J Nutr 1966; 89: 300–306.
Hirsch J, Ahrens EH, Blankenhorn DH . Measurement of the human intestinal length in vivo and some causes of variation. Gastroenterology 1956; 31: 274–284.
Niedhammer I, Bugel I, Bonenfant S, Goldberg M, Leclerc A . Validity of self-reported weight and height in the French GAZEL cohort. Int J Obes Relat Metab Disord 2000; 24: 1111–1118.
Palta M, Prineas RJ, Berman R, Hannan P . Comparison of self-reported and measured height and weight. Am J Epidemiol 1982; 115: 223–230.
Tamakoshi K, Yatsuya H, Kondo T, Hirano T, Hori Y, Yoshida T, Toyoshima H . The accuracy of long-term recall of past body weight in Japanese adult men. Int J Obes Relat Metab Disord 2003; 27: 247–252.
Acknowledgements
We express their sincere appreciation to Dr K Aoki, Professor Emeritus, Nagoya University School of Medicine and the former chairman of the JACC Study Group, and also to Dr H Sugano, the former Director of the Cancer Institute of the Japanese Foundation for Cancer Research, who greatly contributed to the initiation of the study.
The present members of the JACC Study and their affiliations are as follows: Dr A Tamakoshi (present chairman of the study group), Nagoya University Graduate School of Medicine; Dr M Mori, Sapporo Medical University School of Medicine; Dr Y Motohashi, Akita University School of Medicine; Dr I Tsuji, Tohoku University Graduate School of Medicine; Dr Y Nakamura, Jichi Medical School; Dr H Iso, Institute of Community Medicine, University of Tsukuba; Dr H Mikami, Chiba Cancer Center; Dr Y Inaba, Juntendo University School of Medicine; Dr Y Hoshiyama, Showa University School of Medicine; Dr H Suzuki, Niigata University Graduate School of Medical and Dental Sciences; Dr H Shimizu, Gifu University School of Medicine; Dr H Toyoshima, Nagoya University Graduate School of Medicine; Dr S Tokudome, Nagoya City University Graduate School of Medical Sciences; Dr Y Ito, Fujita Health University School of Health Sciences; Dr S Hashimoto, Fujita Health University School of Medicine; Dr S Kikuchi, Aichi Medical University School of Medicine; Dr A Koizumi, Graduate School of Medicine and Faculty of Medicine, Kyoto University; Dr T Kawamura, Kyoto University Center for Student Health; Dr Y Watanabe and Dr T Miki, Kyoto Prefectural University of Medicine Graduate School of Medical Science; Dr C Date, Faculty of Human Environmental Sciences, Mukogawa Women's University; Dr K Sakata, Wakayama Medical University; Dr T Nose, Tottori University Faculty of Medicine; Dr N Hayakawa, Research Institute for Radiation Biology and Medicine, Hiroshima University; Dr T Yoshimura, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan; Dr K Fukuda, Kurume University School of Medicine; Dr N Okamoto, Kanagawa Cancer Center; Dr H Shio, Moriyama Municipal Hospital; Dr Y Ohno (former chairman of the study group), Asahi Rosai Hospital; Dr T Kitagawa, Cancer Institute of the Japanese Foundation for Cancer Research; Dr T Kuroki, Gifu University; and Dr K Tajima, Aichi Cancer Center Research Institute.
The past investigators of the study group were listed in Ohno et al27 except for the following seven members (affiliations are those at the time they participated in the study): Dr T Shimamoto, Institute of Community Medicine, University of Tsukuba; Dr H Tanaka, Medical Research Institute, Tokyo Medical and Dental University; Dr S Hisamichi, Tohoku University Graduate School of Medicine; Dr M Nakao, Kyoto Prefectural University of Medicine; Dr T Suzuki, Research Institute, Osaka Medical Center for Cancer and Cardiovascular Diseases; Dr T Hashimoto, Wakayama Medical University; and Dr T Ishibashi, Asama General Hospital.
This work was supported by a Grant-in-Aid for Scientific Research on Priority Areas (2) (No. 14031222) from the Ministry of Education, Culture, Sports, Science and Technology of Japan. The JACC Study has also been supported by Grants-in-Aid for Scientific Research from the same ministry (Nos. 61010076, 62010074, 63010074, 1010068, 2151065, 3151064, 4151063, 5151069, 6279102, and 11181101).
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
Tamakoshi, K., Wakai, K., Kojima, M. et al. A prospective study of body size and colon cancer mortality in Japan: The JACC Study. Int J Obes 28, 551–558 (2004). https://doi.org/10.1038/sj.ijo.0802603
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0802603
Keywords
This article is cited by
-
Dietary patterns and colorectal cancer: results from a Canadian population-based study
Nutrition Journal (2015)
-
Excess body weight and colorectal cancer survival: the multiethnic cohort
Cancer Causes & Control (2015)
-
Dietary patterns and risk of colorectal cancer in Tehran Province: a case–control study
BMC Public Health (2013)
-
MONW Phenotype Is Associated With Advanced Colorectal Adenoma in Korean Men
Obesity (2012)
-
Understanding global nutrition dynamics as a step towards controlling cancer incidence
Nature Reviews Cancer (2007)