Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2015; 21(5): 1371-1376
Published online Feb 7, 2015. doi: 10.3748/wjg.v21.i5.1371
Body mass index and colon cancer screening: The road ahead
Kanwarpreet Tandon, Mohamad Imam, Bahaa Eldeen Senousy Ismail, Fernando Castro
Kanwarpreet Tandon, Bahaa Eldeen Senousy Ismail, Fernando Castro, Department of Gastroenterology, Cleveland Clinic Florida, Weston, FL 33331, United States
Mohamad Imam, Department of Internal Medicine, University of North Dakota, Fargo, ND 58202, United States
Author contributions: Castro F contributed to topic selection, title selection, manuscript drafting, writing, critical revision and editing; Tandon K contributed to title selection, manuscript drafting, writing and editing and table formulation; Imam M contributed to manuscript drafting, writing and editing; and Ismail BES contributed to manuscript drafting, writing and editing and table formulation.
Conflict-of-interest: All authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fernando Castro, MD, Department of Gastroenterology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, United States. castrof@ccf.org
Telephone: +1-954-6595646 Fax: +1-954-6595647
Received: September 29, 2014
Peer-review started: September 30, 2014
First decision: October 29, 2014
Revised: November 6, 2014
Accepted: January 8, 2015
Article in press: January 8, 2015
Published online: February 7, 2015
Processing time: 133 Days and 5.1 Hours
Abstract

Screening for colorectal cancer (CRC) has been associated with a decreased incidence and mortality from CRC. However, patient adherence to screening is less than desirable and resources are limited even in developed countries. Better identification of individuals at a higher risk could result in improved screening efforts. Over the past few years, formulas have been developed to predict the likelihood of developing advanced colonic neoplasia in susceptible individuals but have yet to be utilized in mass screening practices. These models use a number of clinical factors that have been associated with colonic neoplasia including the body mass index (BMI). Advances in our understanding of the mechanisms by which obesity contributes to colonic neoplasia as well as clinical studies on this subject have proven the association between BMI and colonic neoplasia. However, there are still controversies on this subject as some studies have arrived at different conclusions on the influence of BMI by gender. Future studies should aim at resolving these discrepancies in order to improve the efficiency of screening strategies.

Keywords: Body mass index; Colorectal cancer; Colon cancer screening; Adenomas; Adipokines; Obesity

Core tip: Colorectal cancer has been associated with various risk factors like gender, race, smoking, obesity, diet, but these have not been utilized to refine our screening practices. The available evidence, the suggested role of inflammatory markers and the practical ease of use suggests that incorporation of body mass index accounting for gender and age differences can be used to supplement risk calculators for predicting the occurrence of colorectal adenomas and hence fine tune our screening practices.