4.6 Review

Is the association of overweight and obesity with colorectal cancer underestimated? An umbrella review of systematic reviews and meta-analyses

期刊

EUROPEAN JOURNAL OF EPIDEMIOLOGY
卷 38, 期 2, 页码 135-144

出版社

SPRINGER
DOI: 10.1007/s10654-022-00954-6

关键词

Colorectal cancer; Body mass index; Prediagnostic weight loss; Obesity

向作者/读者索取更多资源

This study aimed to assess if and to what extent potential bias from prediagnostic weight loss has been considered in available epidemiological evidence on the BMI-CRC association. After searching for systematic reviews and meta-analyses, it was found that none of them thoroughly considered or discussed prediagnostic weight loss as a potential source of bias. Results from individual cohort studies included in the latest review were reported heterogeneously, but effect estimates mostly increased with increasing length of exclusion of initial years of follow-up. The impact of overweight and obesity on CRC risk may be larger than suggested by the existing epidemiological evidence.
Although high body-mass index (BMI) is associated with increased risk of developing colorectal cancer (CRC), many CRC patients lose weight before diagnosis. BMI is often reported close to diagnosis, which may have led to underestimation or even reversal of direction of the BMI-CRC association. We aimed to assess if and to what extent potential bias from prediagnostic weight loss has been considered in available epidemiological evidence. We searched PubMed and Web of Science until May 2022 for systematic reviews and meta-analyses investigating the BMI-CRC association. Information on design aspects and results was extracted, including if and how the reviews handled prediagnostic weight loss as a potential source of bias. Additionally, we analyzed how individual cohort studies included in the latest systematic review handled the issue. Overall, 18 reviews were identified. None of them thoroughly considered or discussed prediagnostic weight loss as a potential source of bias. The majority (15/21) of cohorts included in the latest review did not exclude any initial years of follow-up from their main analysis. Although the majority of studies reported having conducted sensitivity analyses in which initial years of follow-up were excluded, results were reported very heterogeneously and mostly for additional exclusions of 1-2 years only. Where explicitly reported, effect estimates mostly increased with increasing length of exclusion. The impact of overweight and obesity on CRC risk may be larger than suggested by the existing epidemiological evidence.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据