Race, age, and sex differences on the influence of obesity on colorectal cancer sidedness and mortality: A national cross-sectional study

• Authors: Mark B Ulanja, Christus Ochsner St. Patrick Hospital; Carnot Ntafam, Children's Hospital Los Angeles; Bryce D Beutler, University of Southern California; Daniel Antwi-Amoabeng, Christus Ochsner St. Patrick Hospital; Ganiyu A Rahman, University of Cape Coast; Reginald N Ulanja, University of Cape Coast; Tarig Mabrouk, Christus Ochsner St. Patrick Hospital; Samuel B Governor, St Louis University; Francis T Djankpa, University of Cape Coast; Olatunji Alese, Emory University
• Journal Title: JOURNAL OF SURGICAL ONCOLOGY
• Volume: Volume 127, Number 1
• Publisher: WILEY | 2022-09-16, Pages 109-118
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1002/jso.27096
• Keywords: Science & Technology; Life Sciences & Biomedicine; Oncology; Surgery; colon cancer laterality; colorectal cancer sidedness; epidemiology; obesity; overweight; racial disparities; BODY-MASS INDEX; MISMATCH REPAIR STATUS; AFRICAN-AMERICANS; RISK-FACTORS; CT COLONOGRAPHY; CROHNS-DISEASE; COLON; COLONOSCOPY; METAANALYSIS; STATISTICS

Abstract

Background and Objectives: Colorectal cancer (CRC) sidedness is recognized as a prognostic factor for survival; left-sided colorectal cancer is associated with better outcomes than right-sided colon cancer (RsCC). We aimed to evaluate the influence of obesity on CRC sidedness and determine how race, age, and sex affect mortality among overweight and obese individuals. Methods: A survey-weighted analysis was conducted using data obtained from the National Inpatient Sample between 2016 and 2019. Results: Of the 24 549 patients with a diagnosis of CRC and a reported body mass index (BMI), 13.6% were overweight and 49.9% were obese. The race distribution was predominantly non-Hispanic Whites (69.7%), followed by Black (15.6%), Hispanic (8.7%), and other race (6.1%). Overweight (BMI: 25−29.9) and obese (BMI: ≥30) individuals were more likely to have RsCC (adjusted OR [aOR] = 1.28; 95% CI: 1.17−1.39, p < 0.001 and aOR = 1.45; 95% CI: 1.37−1.54, p < 0.001, respectively). Obese Black individuals were more likely to have RsCC as compared to their White counterparts (aOR = 1.23; 95% CI: 1.09−1.38). Conclusions: Obesity is associated with an increased risk of RsCC. In addition, racial disparities in CRC sidedness and outcomes are most pronounced among obese patients.