Postmenopausal Normal-Weight Women With Poor Metabolic Health May Have Higher Risk for Colorectal Cancer

Key Points

  • Among postmenopausal women who were normal weight, those who were metabolically unhealthy had more than a twofold higher risk for colorectal cancer than those who were metabolically healthy.
  • Although poor metabolic health is usually associated with obesity, 30% of normal-weight adults are believed to be metabolically unhealthy worldwide.
  • Normal-weight postmenopausal women should be evaluated for metabolic health and the use of preventive strategies to reduce their risk for colorectal cancer.

Few studies have explored the association between metabolic phenotype and colorectal cancer incidence in normal-weight individuals. Now, a study comparing the risk of colorectal cancer in normal-weight postmenopausal women with a metabolically unhealthy phenotype vs those with a metabolically healthy phenotype has found that the women who were metabolically unhealthy had more than a twofold higher risk for colorectal cancer. The findings suggest that normal-weight postmenopausal women should be evaluated for metabolic health and the use of preventive strategies to reduce their risk of colorectal cancer. The study by Liang et al was published in Cancer Epidemiology, Biomarkers & Prevention.

Study Methodology

The researchers analyzed data from the Women’s Health Initiative Observational Study and Clinical Trial. The analytic sample included 5,068 postmenopausal women with a body mass index (BMI) of 18.5 to < 25 kg/m2. Metabolic phenotype was defined using the Adult Treatment Panel-III (ATP-III) definition, excluding waist circumference. Therefore, women with one or none of the four other components included in the ATP-III definition—elevated triglycerides, low high-density lipoprotein, elevated blood pressure, and elevated fasting glucose—were classified as metabolically healthy.

Multivariable Cox proportional hazards regression was used to estimate adjusted hazard ratios (HRs) for the association between metabolic phenotype and risk of colorectal cancer.

Study Results

The researchers found that among normal-weight women, those who were metabolically unhealthy had higher risks of colorectal cancer (HR = 1.49; 95% confidence interval [CI]: 1.02–2.18) compared with those who were metabolically healthy.

“Our finding that normal-weight U.S. women who are metabolically unhealthy have an increased risk of colorectal cancer compared with those who are metabolically healthy highlights how important it is for women to be aware of their metabolic health status, which can be assessed using standard clinical tests,” said Xiaoyun Liang, MD, PhD, Associate Professor at Beijing Normal University in China and lead author of this study, in a statement. “Colorectal cancer is the third most commonly diagnosed cancer for women in the United States. Recognition that normal-weight women who are metabolically unhealthy may have an increased risk for colorectal cancer could result in more timely use of preventive interventions and reduce the burden of this deadly disease.”

Funding for this study was provided by the National Cancer Institute and the Youth Scholars Program of Beijing Normal University.

No potential conflicts of interest were disclosed by the study authors. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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