Associations of body mass index at different ages with early-onset colorectal cancer

Hengjing Li, Daniel Boakye, Xuechen Chen, Lina Jansen, Jenny Chang-Claude, Michael Hoffmeister, Hermann Brenner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background and Aims
Incidence of colorectal cancer (CRC) in younger adults is increasing in many countries. Given the established association of body mass index (BMI) with CRC risk and the increasing obesity prevalence among younger generations, we aimed to evaluate the association of BMI at different ages during early adulthood with early-onset CRC.

Among 6602 CRC patients and 7950 matched controls who were recruited in 2003-2020 in the DACHS study, a population-based case-control study from Germany, 747 patients and 621 controls were below age 55 and included in this analysis. Self-reported height and weight at ages 20 and 30 years, and at approximately 10 years before diagnosis or interview were recorded in personal interviews. Associations of BMI with early-onset CRC were estimated using multiple logistic regression.

Compared to participants with BMI <25 kg/m2, those with BMI ≥30 kg/m2 (obesity) at age 20 and 30 years and approximately 10 years before diagnosis/interview had 2.56 (95% CI 1.20-5.44), 2.06 (1.25-3.40), and 1.88 (1.30-2.73) fold risk of early-onset CRC. The association of BMI with early-onset CRC risk was particularly pronounced among and essentially restricted to the majority of participants with no previous colonoscopy.

Obesity at early adulthood is strongly associated with increased risk of early- onset CRC.
Original languageEnglish
Publication statusPublished - 13 Dec 2021
Externally publishedYes


  • colorectal cancer
  • body mass index
  • early-onset colorectal cancer
  • obesity


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