Poor metabolic health may lead to subsequent gastrointestinal cancers

Individuals with long-term metabolic syndrome (MetS) are at increased risk of developing gastrointestinal cancer overall, including colorectal and pancreatic cancers and hepatocellular carcinoma (HCC), with the risk increase independent of genetic predisposition, a study has found.

Researchers looked at 366,016 UK Biobank participants with comprehensive serum biomarker and genotype data. Of these, 116,624 had MetS, yielding a prevalence rate of 31.9 percent. Participants with vs without MetS were more likely to be men, have higher body mass index (BMI), engage less in physical activity, and use tobacco.

Over a median follow-up of 7.1 years, a total of 4,238 incident cases of gastrointestinal cancers were documented. Of these, 2,525 were colorectal cancers, 478 pancreatic cancers, 290 oesophageal adenocarcinomas, 100 oesophageal squamous cell carcinomas, 111 stomach cardia cancers, 74 stomach noncardia cancers, 112 HCC, and 108 intrahepatic bile duct cancer.

In multivariable Cox proportional hazards models, MetS at baseline conferred a 21-percent increase in the risk of overall gastrointestinal cancer by any definition (hazard ratio, 1.21, 95 percent confidence interval, 1.13–1.29).

MetS was also associated with increased risks of colorectal cancer, colon cancer, rectal cancer, hepatocellular carcinoma, pancreatic cancer in women, and oesophageal adenocarcinoma in men.

The increase in the risks of colorectal cancer and pancreatic cancer associated with MetS did not differ by polygenic risk score, and 80 percent of participants with MetS remained at risk at the repeat assessment (median follow-up of 4.3 years).

The present data suggest that maintaining good metabolic health may play an important role in reducing the burden of gastrointestinal cancers, irrespective of genetic predisposition.