Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Association between Metabolically Healthy Status and Risk of Gastrointestinal Cancer: Haozhe Cui, Fei Tian, Yongliang Chen, Xiangming Ma; Cancer Res Treat. 2024;56(1):238-246. Published online August 2, 2023; DOI: https://doi.org/10.4143/crt.2023.539

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Purpose
Although obesity is associated with numerous diseases, the risks of disease may depend on metabolically healthy status. Nevertheless, it is unclear to whether metabolically healthy status affects risk of gastrointestinal (GI) cancer in general Chinese population.
Materials and Methods
A total of 114,995 participants who met the criteria were included from the Kailuan Study. The study participants were divided into four groups according to body mass index (BMI)/waist circumference (WC) and metabolic status. Incident of GI cancer (esophageal cancer, gastric cancer, liver cancer, biliary cancer, pancreatic cancer, and colorectal cancer) during 2006-2020 were confirmed by review of medical records. The Cox proportional hazard regression models were used to assess the association metabolically healthy status with the risk of GI cancer by calculating the hazard ratios (HR) and 95% confidence interval (CI).
Results
During a mean 13.76 years of follow-up, we documented 2,311 GI cancers. Multivariate Cox regression analysis showed that compared with the metabolically healthy normal-weight group, metabolically healthy obese (MHO) participants demonstrated an increased risk of developing GI cancer (HR, 1.54; 95% CI, 1.11 to 2.13) by BMI categories. However, such associations were not found for WC category. These associations were moderated by age, sex, and anatomical site of the tumor. Individuals with metabolic unhealthy normal-weight or metabolic unhealthy obesity phenotype also have an increased risk of GI cancer.
Conclusion
MHO phenotype was associated with increased risk of GI cancer. Moreover, individuals who complicated by metabolic unhealthy status have an increased risk of developing GI cancer. Hence, clinicians should consider the risk of incident GI cancer in people with abnormal metabolically healthy status and counsel them about metabolic fitness and weight control.

Citations

Citations to this article as recorded by

Metabolic Phenotype and Risk of Obesity-Related Cancers in the Women’s Health Initiative
Prasoona Karra, Sheetal Hardikar, Maci Winn, Garnet L. Anderson, Benjamin Haaland, Aladdin H. Shadyab, Marian L. Neuhouser, Rebecca A. Seguin-Fowler, Cynthia A. Thomson, Mace Coday, Jean Wactawski-Wende, Marcia L. Stefanick, Xiaochen Zhang, Ting-Yuan Davi
Cancer Prevention Research.2025; 18(2): 63. CrossRef
Associations of Social Vulnerability and Race‐Ethnicity With Gastrointestinal Cancers in the United States
David J. Fei‐Zhang, David J. Bentrem, Jeffrey D. Wayne, Lifang Hou, Peiwen Fei, Timothy M. Pawlik
Cancer Medicine.2025;[Epub] CrossRef
Association between metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction subtypes and risk of colorectal cancer: A prospective cohort study
Yuan Li, Xiang-ming Ma, Jian-guo Jia, Li-ying Cao
Clinics and Research in Hepatology and Gastroenterology.2025; 49(5): 102573. CrossRef
Association between transitions in metabolic health and colorectal cancer across categories of body size phenotype: a prospective cohort study
Qian Liu, Fei Si, Yuntao Wu, Jing Yu
Obesity.2024; 32(10): 1948. CrossRef
Gastric Cancer - Epidemiology, Modifiable and Non-modifiable Risk Factors, Challenges and Opportunities: An Updated Review
Tajul Islam Mamun, Sabrina Younus, Md. Hashibur Rahman
Cancer Treatment and Research Communications.2024; : 100845. CrossRef
Research Progress of Scutellaria baicalensis in the Treatment of Gastrointestinal Cancer
Lankang Wang, Baoyi Ni, Jia Wang, Jilai Zhou, Junyi Wang, Jiakang Jiang, Yutong Sui, Yaoyao Tian, Feng Gao, Yufeng Lyu
Integrative Cancer Therapies.2024;[Epub] CrossRef

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The Clinical Significance of Occult Gastrointestinal Primary Tumours in Metastatic Cancer: A Population Retrospective Cohort Study: Malek B. Hannouf, Eric Winquist, Salaheddin M. Mahmud, Muriel Brackstone, Sisira Sarma, George Rodrigues, Peter K. Rogan, Jeffrey S. Hoch, Gregory S. Zaric; Cancer Res Treat. 2018;50(1):183-194. Published online March 21, 2017; DOI: https://doi.org/10.4143/crt.2016.532

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to estimate the incidence of occult gastrointestinal (GI) primary tumours in patients with metastatic cancer of uncertain primary origin and evaluate their influence on treatments and overall survival (OS).
Materials and Methods
We used population heath data from Manitoba, Canada to identify all patients initially diagnosed with metastatic cancer between 2002 and 2011. We defined patients to have “occult” primary tumour if the primary was found at least 6 months after initial diagnosis. Otherwise, we considered primary tumours as “obvious.” We used propensity-score methods to match each patient with occult GI tumour to four patients with obvious GI tumour on all known clinicopathologic features. We compared treatments and 2-year survival data between the two patient groups and assessed treatment effect on OS using Cox regression adjustment.
Results
Eighty-three patients had occult GI primary tumours, accounting for 17.6% of men and 14% of women with metastatic cancer of uncertain primary. A 1:4 matching created a matched group of 332 patients with obvious GI primary tumour. Occult cases compared to the matched group were less likely to receive surgical interventions and targeted biological therapy, and more likely to receive cytotoxic empiric chemotherapeutic agents. Having an occult GI tumour was associated with reduced OS and appeared to be a nonsignificant independent predictor of OS when adjusting for treatment differences.
Conclusion
GI tumours are the most common occult primary tumours in men and the second most common in women. Patients with occult GI primary tumours are potentially being undertreated with available GI site-specific and targeted therapies.

Citations

Citations to this article as recorded by

Relationship between metastasis and second primary cancers in women with breast cancer
Chaofan Li, Mengjie Liu, Jia Li, Xixi Zhao, Yusheng Wang, Xi Chen, Weiwei Wang, Shiyu Sun, Cong Feng, Yifan Cai, Fei Wu, Chong Du, Yinbin Zhang, Shuqun Zhang, Jingkun Qu
Frontiers in Oncology.2022;[Epub] CrossRef
The Potential Clinical and Economic Value of Primary Tumour Identification in Metastatic Cancer of Unknown Primary Tumour: A Population-Based Retrospective Matched Cohort Study
Malek B. Hannouf, Eric Winquist, Salaheddin M. Mahmud, Muriel Brackstone, Sisira Sarma, George Rodrigues, Peter K. Rogan, Jeffrey S. Hoch, Gregory S. Zaric
PharmacoEconomics - Open.2018; 2(3): 255. CrossRef

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