Colorectal Cancer: Open Access

Does Targeting BMI Help Reduce Racial Disparities and Improve Outcomes in Stage III Colorectal Cancer Patients?: A Retrospective Study

Objective: In this study, we determined the association of BMI with stage 3 colorectal cancer (CRC) outcomes by ethnicity. We tested the hypothesis that obesity is associated with worsening CRC survival in the minority ethnicity groups. The study was intended to evaluate the role of BMI in the minority groups in accounting for these differing outcomes, in which case, results from this study may influence preventive risk strategies in the high risk ethnicity groups by targeting modifiable risk factors such as high BMI.
Methods: We utilized the cancer registry database and included the following data: age, sex, ethnicity, chemotherapy regimen, BMI. Outcome variables of recurrence time and overall survival were censored at 10 years and survival curves with Kaplan-Meier estimates were used to compare recurrence and survival between various BMI categories in the major racial/ ethnic study groups. Cox regression models were used to determine if BMI is a predictor of CRC recurrence and survival for each ethnicity group.
Results: Across the BMI categories, we did not find any significant association between categorical BMI and TTR (HR 2.1(0.76-5.83), p=0.15), (HR 0.91(0.68- 1.21), p=0.52), (HR 1.13(0.43-2.86), p=0.83) or overall survival (HR 1.39(0.6-3.1), p=0.41), (HR 0.88(0.65-1.20), p=0.43), (HR 3.7(0.14-12.48), p=0.49) in African Americans, Caucasians and Hispanics respectively.
Conclusions: Overweight and obese patients were not associated with increased risk of recurrence or decreased overall survival in either of the three major ethnic study groups. Targeting BMI as potential risk strategy, may not affect the final outcomes in stage III colorectal cancer irrespective of underlying ethnicity. However, it is important to encourage a healthy lifestyle and promote weight reduction. The prevalence of obesity and its impact on survival outcomes needs to be studied in the lower stage groups and younger aged minority populations to help inform preventive risk strategies and potentially reduce existing racial disparities.

Author(s):

Prajwal Boddu, Mebea Aklilu and Dana Villines

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