Smoking Is a Significant Mediator in the Association Between Metabolic Syndrome and Colorectal Cancer for Adults Under the Age of 50
Lin Zhu, PhD1; Areebah Rahman1; Grace X. Ma, PhD, CHES1,2
1Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
2Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
Introduction: Age 50 or above is associated with elevated risks of having metabolic syndrome (MetS) or colorectal cancer (CRC). However, recently evidence has indicated the risks to both conditions are increasing among adults under the age of 50. How are MetS and CRC related in this population? How do socioeconomic and modifiable lifestyle behaviors mediate the association? This study seeks to gain insights into these questions.
Methods: We used data from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) to define a case-control sample to examine the association between MetS and colorectal cancer and potential mediators. We used chi-square test and binary logistic regression to examine the MetS and cancer association. All analyses were conducted in Stata 14.
Results: From a total sample of 8,738 adults under the age of 50, we identified 8,730 non-CRC cases, and 8 CRC cases. Regression results showed that MetS was significantly associated with CRC risk (odds ratio = 4.43, p = .049), with age held constant. When we controlled for education, smoking, excessive drinking, and sleep duration, MetS was only marginally significant (odds ratio = 3.86, p = .076). Smoking was significantly associated with an elevated CRC risk (odds ratio = 9.50, p = .036).
Conclusion: Smoking is a significant mediator in the MetS-CRC association among adults under the age of 50. Public health education and prevention efforts should target the current smokers in this population. A larger study sample is needed to better explore gender and racial/ethnic disparities of the associations.
Acknowledgement: This project was supported by Center for Asian Health’s funds (PI: Grace X. Ma, PhD), and TUFCCC/HC Regional Comprehensive Cancer Health Disparity Partnership, Award Number U54 CA221704(5) (Contact PIs: Grace X. Ma, PhD and Olorunseun O. Ogunwobi, MD, PhD) from the National Cancer Institute of National Institutes of Health (NCI/NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NCI/NIH.
Email questions and comments about this abstract to tuj19958@temple.edu.
