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Colorectal cancer: The longer you are overweight, the greater your risk of disease

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Colorectal cancer: The longer you are overweight, the greater your risk of disease

That excess weight increases the risk of colorectal cancer (and at least 12 other types of cancer) has long been known and proven by numerous international studies, but according to research published in Jama Oncology, this risk is time-dependent. That is: the longer you are overweight, the more you go up. For epidemiologists and oncologists at DKFZ, the German Cancer Research Center in Heidelberg, there is indeed a “cumulation effect” that has not been considered until now. For this reason the risk – they report – could be underestimated, since previous studies have not considered cumulative exposure to obesity over the course of a lifetime.

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Until now, the link between being overweight or obese and the development of cancer has essentially been based on body mass index (BMI), a measure of what a person’s healthy weight is relative to their height. In addition to having several limits, it is a punctual measure, firm in time. According to the Heidelberg researchers, on the other hand, excess weight should be considered a bit like cigarette smoking, that is, as a factor that conditions a person’s risk of getting sick for life, even if that same person, in a certain moment of his existence, he quits smoking.

A heavy legacy?

This study was conducted over two decades on a population of men and women with an average age of 68: 5,635 with colorectal cancer and 4,515 without disease. The researchers collected height and weight data and calculated body mass index annually starting in 2003. In doing so, they found that every BMI point above 25 (the limit beyond which one is considered overweight) , recorded in a person over the years, slightly increased the likelihood of developing colorectal cancer. And that, even when people lost weight to a BMI that was considered healthy, their previous history continued to have a noticeable impact on health. “Our study indicates that excess weight may have a significantly greater impact on colorectal cancer risk than other studies have revealed,” state the authors.

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How excess fat works

The new data therefore seem to contradict what had recently emerged in an observation study, according to which even a very slight weight loss could reduce the formation of polyps in the distal tract of the colon and, consequently, the risk of tumors. Which indicates that more investigations will be needed to better understand how overweight and obesity affect the likelihood of getting sick. Indeed, how being overweight plays a role in the development of colorectal cancers has not yet been fully understood and different mechanisms of carcinogenesis are being investigated in recent years. One was unearthed by Italian researchers and published in September 2021 on Nature Communications . The research, coordinated by the University of Palermo, demonstrated at the molecular level that adipose tissue, in addition to constituting a reserve of fat, functions as a real endocrine and metabolic organ, very active in producing numerous hormones, including estrogen, which regulate cell proliferation. And cancer is the result of “crazy” cell proliferation.

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Italy in contrast

In the United States, more than 100,000 cases of colorectal cancer are detected annually which is responsible for approximately 45,000 deaths annually, numbers that prompted the American Cancer Society to recommend early screening to begin at age 45 ( instead of 50, as we do). In Europe, the data on the increase in the incidence of under 30s are well known. In this context, however, our country represents an exception. The number of cases of colorectal cancer is in fact decreasing: in the last 7-8 years it has decreased by 20%, going from 53,000 to 43,000 diagnoses per year. Numbers that give hope and that according to oncologists are mainly due to the spread of screening that identify polyps before they turn into real tumors. Screening which unfortunately, due to the pandemic, has significantly decreased in the last two years.

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