Metabolic syndrome and risks of colon and rectal cancer: The european prospective investigation into cancer and nutrition study

Krasimira Aleksandrova, Heiner Boeing, Mazda Jenab, H. Bas Bueno-de-Mesquita, Eugene Jansen, Fran̈zel J B Van Duijnhoven, Veronika Fedirko, Sabina Rinaldi, Isabelle Romieu, Elio Riboli, Dora Romaguera, Kim Overvad, Jane Nautrup Østergaard, Anja Olsen, Anne Tjnøneland, Marie Christine Boutron-Ruault, Franco̧ise Clavel-Chapelon, Sophie Morois, Giovanna Masala, Claudia AgnoliSalvatore Panico, Rosario Tumino, Paolo Vineis, Rudolf Kaaks, Annekatrin Lukanova, Antonia Trichopoulou, Androniki Naska, Christina Bamia, Petra H. Peeters, Laudina Rodriǵuez, Genevieve Buckland, Mariá José Sańchez, Miren Dorronsoro, Jose Mariá Huerta, Aurelio Barricarte, Gor̈an Hallmans, Richard Palmqvist, Kay Tee Khaw, Nicholas Wareham, Naomi E. Allen, Konstantinos K. Tsilidis, Tobias Pischon

Research output: Contribution to journalArticle


Metabolic syndrome (MetS) is purportedly related to risk of developing colorectal cancer; however, the association of MetS, as defined according to recent international criteria, and colorectal cancer has not been yet evaluated. In particular, it remains unclear to what extent the MetS components individually account for such an association. We addressed these issues in a nested case-control study that included 1,093 incident cases matched (1:1) to controls by using incidence density sampling. Conditional logistic regression was used to estimate relative risks (RR) and 95% CIs. MetS was defined according to the criteria of the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATPIII), the International Diabetes Federation (IDF), and the 2009 harmonized definition. Among individual components, abdominal obesity (RR = 1.51; 95% CI: 1.16-1.96) was associated with colon cancer, whereas abnormal glucose metabolism was associated with both colon (RR = 2.05; 95% CI: 1.57-2.68) and rectal cancer (RR = 2.07; 95% CI: 1.45-2.96). MetS, as defined by each of the definitions, was similarly associated with colon cancer (e.g., RR = 1.91; 95% CI: 1.47-2.42 for MetS by NCEP/ATPIII), whereas MetS by NCEP/ATPIII, but not IDF or harmonized definition, was associated with rectal cancer (RR = 1.45; 95% CI: 1.02-2.06). Overall, these associations were stronger in women than in men. However, the association between MetS and colorectal cancer was accounted for by abdominal obesity and abnormal glucose metabolism such that MetS did not provide risk information beyond these components (likelihood ratio test P = 0.10 for MetS by NCEP/ ATPIII). These data suggest that simple assessment of abnormal glucose metabolism and/or abdominal obesity to identify individuals at colorectal cancer risk may have higher clinical utility than applying more complex MetS definitions.

Original languageEnglish
Pages (from-to)1873-1883
Number of pages11
JournalCancer Prevention Research
Issue number11
Publication statusPublished - Nov 2011

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Aleksandrova, K., Boeing, H., Jenab, M., Bueno-de-Mesquita, H. B., Jansen, E., Van Duijnhoven, F. J. B., Fedirko, V., Rinaldi, S., Romieu, I., Riboli, E., Romaguera, D., Overvad, K., Østergaard, J. N., Olsen, A., Tjnøneland, A., Boutron-Ruault, M. C., Clavel-Chapelon, F., Morois, S., Masala, G., ... Pischon, T. (2011). Metabolic syndrome and risks of colon and rectal cancer: The european prospective investigation into cancer and nutrition study. Cancer Prevention Research, 4(11), 1873-1883.