The role of body mass index at diagnosis of colorectal cancer on Black–White disparities in survival: a density regression mediation approach

Biostatistics ◽  
2020 ◽  
Author(s):  
Katrina L Devick ◽  
Linda Valeri ◽  
Jarvis Chen ◽  
Alejandro Jara ◽  
Marie-Abèle Bind ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Low Income ◽  
Ethnic Disparities ◽  
Black Population ◽  
Black Populations ◽  
The Impact ◽  
Density Regression ◽  
Racial Ethnic

Summary The study of racial/ethnic inequalities in health is important to reduce the uneven burden of disease. In the case of colorectal cancer (CRC), disparities in survival among non-Hispanic Whites and Blacks are well documented, and mechanisms leading to these disparities need to be studied formally. It has also been established that body mass index (BMI) is a risk factor for developing CRC, and recent literature shows BMI at diagnosis of CRC is associated with survival. Since BMI varies by racial/ethnic group, a question that arises is whether differences in BMI are partially responsible for observed racial/ethnic disparities in survival for CRC patients. This article presents new methodology to quantify the impact of the hypothetical intervention that matches the BMI distribution in the Black population to a potentially complex distributional form observed in the White population on racial/ethnic disparities in survival. Our density mediation approach can be utilized to estimate natural direct and indirect effects in the general causal mediation setting under stronger assumptions. We perform a simulation study that shows our proposed Bayesian density regression approach performs as well as or better than current methodology allowing for a shift in the mean of the distribution only, and that standard practice of categorizing BMI leads to large biases when BMI is a mediator variable. When applied to motivating data from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium, our approach suggests the proposed intervention is potentially beneficial for elderly and low-income Black patients, yet harmful for young or high-income Black populations.

scholarly journals Correlation of Body Mass Index with Oncologic Outcomes in Colorectal Cancer Patients: A Large Population-Based Study

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3592
Author(s):  
Chong-Chi Chiu ◽  
Chung-Han Ho ◽  
Chao-Ming Hung ◽  
Chien-Ming Chao ◽  
Chih-Cheng Lai ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Body Weight ◽  
Body Mass ◽  
Survival Rates ◽  
Normal Weight ◽  
P Value ◽  
Administrative Claims ◽  
The Impact

It has been acknowledged that excess body weight increases the risk of colorectal cancer (CRC); however, there is little evidence on the impact of body mass index (BMI) on CRC patients’ long-term oncologic results in Asian populations. We studied the influence of BMI on overall survival (OS), disease-free survival (DFS), and CRC-specific survival rates in CRC patients from the administrative claims datasets of Taiwan using the Kaplan–Meier survival curves and the log-rank test to estimate the statistical differences among BMI groups. Underweight patients (<18.50 kg/m2) presented higher mortality (56.40%) and recurrence (5.34%) rates. Besides this, they had worse OS (aHR:1.61; 95% CI: 1.53–1.70; p-value: < 0.0001) and CRC-specific survival (aHR:1.52; 95% CI: 1.43–1.62; p-value: < 0.0001) rates compared with those of normal weight patients (18.50–24.99 kg/m2). On the contrary, CRC patients belonging to the overweight (25.00–29.99 kg/m2), class I obesity (30.00–34.99 kg/m2), and class II obesity (≥35.00 kg/m2) categories had better OS, DFS, and CRC-specific survival rates in the analysis than the patients in the normal weight category. Overweight patients consistently had the lowest mortality rate after a CRC diagnosis. The associations with being underweight may reflect a reverse causation. CRC patients should maintain a long-term healthy body weight.

scholarly journals Mo1625 – Ethnic Disparities and Body Mass Index Trends in Colorectal Cancer Screening: Explorative Analysis of Southern Nevada and National Data

2019 ◽  
Vol 156 (6) ◽  
pp. S-807-S-808
Author(s):  
Ranjit S. Makar ◽  
Ying Zhang ◽  
Muthena Maklad ◽  
Hamza Aziz ◽  
Daisy S. Lankarani ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Body Mass ◽  
Ethnic Disparities ◽  
National Data ◽  
Southern Nevada

scholarly journals Multimorbidity Accumulation among Middle-Aged Americans: Differences by Race/Ethnicity and Body-Mass Index

2021 ◽  
Author(s):  
Anda Botoseneanu ◽  
Sheila Markwardt ◽  
Corey L Nagel ◽  
Heather G Allore ◽  
Jason T Newsom ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Chronic Diseases ◽  
Body Mass ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Later Life ◽  
Overweight And Obesity ◽  
Obese Class ◽  
Class 1 ◽  
Racial Ethnic

Abstract BACKGROUND Obesity and multimorbidity are more prevalent among U.S. racial/ethnic minority groups. Evaluating racial/ethnic disparities in disease accumulation according to body-mass index (BMI) may guide interventions to reduce multimorbidity burden in vulnerable racial/ethnic groups. METHODS We used data from the 1998-2016 Health & Retirement Study on 8,106 participants aged 51-55 at baseline. Disease burden and multimorbidity (≥2 co-occurring diseases) were assessed using seven chronic diseases: arthritis, cancer, heart disease, diabetes, hypertension, lung disease, and stroke. Four BMI categories were defined per convention: normal, overweight, obese class 1, and obese class 2/3. Generalized estimating equations models with inverse probability weights estimated the accumulation of chronic diseases. RESULTS Overweight and obesity were more prevalent in non-Hispanic Black (82.3%) and Hispanic (78.9%) than non-Hispanic White (70.9 %) participants at baseline. The baseline burden of disease was similar across BMI categories, but disease accumulation was faster in the obese class 2/3 and marginally in the obese class 1 categories compared with normal BMI. Black participants across BMI categories had a higher initial burden and faster accumulation of disease over time, while Hispanics had a lower initial burden and similar rate of accumulation, compared with Whites. Black participants, including those with normal BMI, reach the multimorbidity threshold 5-6 years earlier compared with White participants. CONCLUSIONS Controlling weight and reducing obesity early in the lifecourse may slow the progression of multimorbidity in later life. Further investigations are needed to identify the factors responsible for the early and progressing nature of multimorbidity in Blacks of non-obese weight.

The impact of body mass index on oncological outcomes in colorectal cancer patients with curative intent

2016 ◽  
Vol 21 (6) ◽  
pp. 1102-1110 ◽  
Author(s):  
Yuji Toiyama ◽  
Junichiro Hiro ◽  
Tadanobu Shimura ◽  
Hiroyuki Fujikawa ◽  
Masaki Ohi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Cancer Patients ◽  
Body Mass ◽  
Curative Intent ◽  
Oncological Outcomes ◽  
Colorectal Cancer Patients ◽  
The Impact

Impact of Body Mass Index on Survival After Colorectal Cancer Diagnosis: The Cancer Prevention Study-II Nutrition Cohort

2012 ◽  
Vol 30 (1) ◽  
pp. 42-52 ◽  
Author(s):  
Peter T. Campbell ◽  
Christina C. Newton ◽  
Ahmed N. Dehal ◽  
Eric J. Jacobs ◽  
Alpa V. Patel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Cancer Prevention ◽  
Body Mass ◽  
Cancer Diagnosis ◽  
Prevention Study ◽  
Risk Of Mortality ◽  
Incident Cancer ◽  
The Impact

Purpose The impact of body mass index (BMI) on survival after colorectal cancer diagnosis is poorly understood. This study assessed the association of pre- and postdiagnosis BMI with all-cause and cause-specific survival among men and women diagnosed with colorectal cancer in a prospective cohort. Patients and Methods Participants in the Cancer Prevention Study-II Nutrition Cohort reported weight and other risk factor information via a self-administered questionnaire at baseline in 1992 to 1993. Updated information on current weight and incident cancer was reported via periodic follow-up questionnaires. This analysis includes 2,303 cohort participants who were diagnosed with nonmetastatic colorectal cancer between baseline and mid 2007 and were observed for mortality from diagnosis through December 2008. Results A total of 851 participants with colorectal cancer died during the 16-year follow-up period, including 380 as a result of colorectal cancer and 153 as a result of cardiovascular disease (CVD). In analyses of prediagnosis BMI (weight reported at baseline in 1992 to 1993; mean, 7 years before colorectal cancer diagnosis), obese BMI (≥ 30 kg/m2) relative to normal BMI (18.5 to 24.9 kg/m2) was associated with higher risk of mortality resulting from all causes (relative risk [RR], 1.30; 95% CI, 1.06 to 1.58), colorectal cancer (RR, 1.35; 95% CI, 1.01 to 1.80), and CVD (RR, 1.68; 95% CI, 1.07 to 2.65). Postdiagnosis BMI (based on weight reported; mean, 1.5 years after diagnosis) was not associated with all-cause or cause-specific mortality. Conclusion This study suggests that prediagnosis BMI, but not postdiagnosis BMI, is an important predictor of survival among patients with nonmetastatic colorectal cancer.

scholarly journals THE IMPACT OF SOCIOECONOMIC STATUS ON AGE TRAJECTORY OF BODY MASS INDEX AMONG MIDDLE-AGED AND OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S148-S148
Author(s):  
Yu-Chun Lin ◽  
Yu-Hung Chang
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Socioeconomic Status ◽  
Body Mass ◽  
Low Income ◽  
Income Group ◽  
Primary Study ◽  
Annual Income ◽  
Middle Aged ◽  
The Impact

Abstract Body weight tends to decrease along with age. Weight loss and low body mass index (BMI) in the elderly, associated with socioeconomic status, are both strong predictors of subsequent mortality.This study aims to investigate the relation between income and BMI changes in later life. We used data from the Taiwan Longitudinal Study in Aging (TLSA) from 1999 to 2007. There were 5,131 participants aged 50 and over, who were excluded for those without primary study variables. Income was evaluated by asking the amount of annual income, including salary, pension, rent, interest, welfare benefit, etc. Participants’ BMI were assessed in each survey. General estimating equation models were performed to examine the association between age, annual income, and their interaction with BMI adjusting for covariates including sex, education, marital status, smoking, exercise frequency, appetite, and number of comorbidities. Totaling 11,350 person-times was in three follow-up surveys, which left 9,723 person-times of observations after exclusion. After adjusted for covariates, the low income group compared to the higher income, would have higher estimated BMI at age of 50 (BMI= 24.75 kg/m2 and 24.19 kg/m2 respectively), and more rapid reduction (-0.08 kg/m2 per year), while relatively stable BMI was found in higher income group (0.01 kg/m2 per year, slope difference= 0.10 kg/m2 per year, 95% confidence interval [CI] = 0.03-0.17). In conclusion, compared to invariable BMI observed among individuals with higher financial status, the economically disadvantaged experienced BMI decline with age among middle-aged and older adults.

scholarly journals The Impact of Body Mass Index and Physical Activity on Mortality among Patients with Colorectal Cancer in Queensland, Australia

2011 ◽  
Vol 20 (7) ◽  
pp. 1410-1420 ◽  
Author(s):  
Peter D. Baade ◽  
Xingqiong Meng ◽  
Philippa H. Youl ◽  
Joanne F. Aitken ◽  
Jeff Dunn ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
The Impact

scholarly journals The Impact of Body Mass Index on the Clinicopathological and Prognostic Factors of Colorectal Cancer in Saudi Arabia

Cureus ◽  
2020 ◽  
Author(s):  
Saleh M Aldaqal ◽  
Abdulqader A Maqbul ◽  
Ahmed A Alhammad ◽  
Aseel S Alghamdi ◽  
Bandar A Alharbi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Saudi Arabia ◽  
Prognostic Factors ◽  
Body Mass ◽  
The Impact

Racial-ethnic differences in childhood higher body mass index: insurance status explanatory model

2015 ◽  
Vol 8 (1) ◽  
pp. 45-56 ◽  
Author(s):  
Laurens Holmes ◽  
Sequoia Jackson ◽  
Alexandra LaHurd ◽  
Pat Oceanic ◽  
Kelli Grant ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Race And Ethnicity ◽  
Pediatric Population ◽  
Insurance Coverage ◽  
Ethnic Disparities ◽  
Insurance Status ◽  
Cross Sectional ◽  
Content Type ◽  
Racial Ethnic

Purpose – The purpose of this paper is to examine the prevalence of obesity/overweight using higher body mass index (BMI), assess racial/ethnic variance in overweight/obese prevalence, and to determine whether or not insurance status explains the variance. Design/methodology/approach – A cross-sectional design was used to assess medical records of children in Nemours Healthcare System during 2011. The authors reviewed the records and extracted information on normal BMI, BMI percent, higher BMI, prevalence of overweight/obese and other variables as well as race and ethnicity. χ2 statistic, Fischer's exact and logistic regression model were used to examine the data. Findings – Overall, the prevalence of higher BMI as overweight/obese was comparable to that of the US pediatric population, 33.4 percent. Compared to Caucasian/white, Asians were less likely to have higher BMI, prevalence odd ratio (POR)=0.79, 95 percent CI=0.70-0.90, but Blacks/African Americans (POR=1.22, 95 percent CI=1.18-1.27) and Some other Race were more likely to have higher BMI, POR=1.61, 95 percent CI=1.92-1.71. After controlling for insurance status, the racial disparities in higher BMI persisted; p<0.0001. Research limitations/implications – Racial/ethnic disparities exist in childhood higher BMI, which were not removed after controlling for insurance coverage as a surrogate for socioeconomic status. These findings are indicative of assessing sex, religious, dietary patterns, physical activities level, environmental resources, social media resources; and geographic locale as confounders in race/ethnicity and higher BMI association. Originality/value – Understanding the predisposing factors to obesity/overweight among diverse populations is essential in developing and implementing intervention programs in addressing this epidemic in our nation.

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