Taller adults may be at increased risk for colorectal cancer

Date:
March 3, 2022
Source:
Johns Hopkins Medicine
Summary:
A new meta-analysis, or data examination of several independent
studies, adds to evidence that taller adults may be more likely
than shorter ones to develop colorectal cancer or colon polyps
that can later become malignant.



FULL STORY ==========================================================================
A new meta-analysis, or data examination of several independent studies,
by Johns Hopkins Medicine researchers adds to evidence that taller adults
may be more likely than shorter ones to develop colorectal cancer or colon polyps that can later become malignant. While the association between
taller height and colorectal cancer has been previously investigated, the
Johns Hopkins Medicine researchers say those studies offered conflicting results, carried inconsistent measures of height and failed to include
the risk of adenomas, which are precancerous colon polyps.


========================================================================== "This is the largest study of its kind to date. It builds on evidence that taller height is an overlooked risk factor, and should be considered when evaluating and recommending patients for colorectal cancer screenings,"
says Gerard Mullin, M.D., associate professor in the Division of Gastroenterology and Hepatology at Johns Hopkins Medicine. He and his
team cautioned that the study does not prove causal effect, or that
taller stature is as dominant a risk factor as age or genetics. However,
the Johns Hopkins study strengthens long-observed links between taller
stature and colorectal cancer risk.

"One possible reason for this link is that adult height correlates
with body organ size. More active proliferation in organs of taller
people could increase the possibility of mutations leading to malignant transformation," says Elinor Zhou, M.D., co-first author of the published
study report.

The authors of the meta-analysis, published March 2 in Cancer
Epidemiology, Biomarkers & Prevention, a journal of the American
Association for Cancer Research, first identified 47 international, observational studies involving 280,660 cases of colorectal cancer and
14,139 cases of colorectal adenoma. They also included original data
from the Johns Hopkins Colon Biofilm study, which recruited 1,459 adult patients undergoing outpatient colonoscopies to explore the relationship between cancer and bacteria stuck to the walls of the colon, known
as biofilm.

Because the definition of tallness is different around the world,
the Johns Hopkins team compared the highest versus the lowest height
percentile of various study groups. "The findings suggest that, overall,
the tallest individuals within the highest percentile of height had a
24% higher risk of developing colorectal cancer than the shortest within
the lowest percentile.

Every 10-centimeter increase (about 4 inches) in height was found to
be associated with a 14% increased risk of developing colorectal cancer
and 6% increased odds of having adenomas," says Mullin.

According to the U.S. Centers for Disease Control and Prevention, the
average height in the U.S. for men is 5 feet, 9 inches, and for women
it is 5 feet, 4 inches. This means men who are 6 feet, 1 inch and women
who are 5 feet, 8 inches (4 inches/10 centimeters above the average
U.S. height) or taller are at a 14% increased risk of colorectal cancer
and a 6% increased risk of adenomas.



==========================================================================
The percentage results were adjusted for demographic, socioeconomic,
behavioral and other known risk factors of colorectal cancer. Those risk factors include so-called non-modifiable factors such as age, a personal
or family history of colorectal cancer or adenomas, and a personal history
of chronic inflammatory bowel disease. In the U.S., more than half
of all colorectal cancers are linked to modifiable lifestyle factors,
including unhealthy diet, insufficient physical activity, smoking and
high alcohol consumption. Although not directly comparable because of
the difference in measurement scale, tallness may impart an order of
magnitude of colorectal cancer risk similar to better-known modifiable
factors such as cigarette smoking, moderate alcohol consumption and high processed red meat intake. Currently, gastroenterologists focus on genetic
and age-related risks for recommending colorectal cancer screenings.

According to the American Cancer Society, colorectal cancer is the
third most common cancer diagnosed in both men and women in the United
States. The rate at which people are diagnosed with colorectal cancer each
year has dropped overall since the mid-1980s, mainly because of primary prevention such as lifestyle improvement and secondary prevention such
as early detection through screening.

However, the downward trend is mostly in older adults. Deaths from
colorectal cancer among individuals younger than 50 have increased 2%
per year from 2007 to 2016 for reasons that are not yet clear.

"Greater awareness by the public and government will help promote more
interest and funding for more research, which ultimately could change guidelines for physicians to consider height as a risk for cancer,"
says Mullin. "There are well-known modifiable dietary associations
for colorectal cancer, such as processed red meats and smoking, but
guidelines currently are fixated on family history, and height is
clinically neglected when it comes to risk screening." Zhou says more
research is needed to define particular taller populations at risk for
colon cancer. "For instance, tall athletes and individuals with inherited tallness, such as those with Marfan syndrome, could be screened earlier
and the impact of height further explored," she says. "We need more
studies before we can definitively say at what height you would need
earlier colorectal cancer screening." March is National Colorectal
Cancer Awareness Month; promoting early detection of colorectal cancer
is part of President Biden's Cancer Moonshot initiative, which aims to
reduce the cancer death rate by 50% in the next 25 years.

Other researchers involved in this study include Celina Santiago, Julie Nanavati, Emma Spence, Linda Hyland, Joell Gills, Julia Drewes, Cynthia
Sears and Francis Giardiello of the Johns Hopkins University School of Medicine; David Kafonek and David Cromwell of Johns Hopkins Health Care & Surgery Center -- Green Spring Station; Samara Rifkin of the University
of Michigan; and Louis La Luna of Digestive Disease Associates.

The authors report no conflicts of interest.

This study was supported by grants R01CA196845, Bloomberg Philanthropies, T32DK007632, intramural funds and the Johns Hopkins Cancer Center Support Grant, NCIP30CA006973.

========================================================================== Story Source: Materials provided by Johns_Hopkins_Medicine. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Elinor Zhou et al. Adult-Attained Height and Colorectal Cancer
Risk: A
Cohort Study, Systematic Review and Meta-Analysis. Cancer
Epidemiology, Biomarkers & Prevention, 2022 DOI:
10.1158/1055-9965.EPI-21-0398 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220303112205.htm

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