The Impact of Body Mass Index and Waist Circumference on Health-related Quality of Life Among Colorectal Cancer Survivors: Results from the PROFILES Registry

ABSTRACT

Background: We aimed to assess the association of waist circumference (WC) and body mass index (BMI) with health-related quality of life (HRQL) among colorectal cancer (CRC) survivors. Methods: CRC survivors diagnosed between 2000 and 2009 completed questionnaires in August 2013 (with self-reported weight, height, and self-assessed WC) and January 2014 (with HRQL using the EORTC-QLQ-C30). Clinical characteristics were retrieved from the Netherlands Cancer Registry. In multivariable linear regression analyses associations of BMI only, WC only and both BMI and WC with HRQL outcomes were assessed. Results: 1,111 CRC survivors were included of whom 34% had a normal weight (18.5 ≤ BMI < 25 kg/m²), 49% had overweight (25 ≤ BMI < 30 kg/m²), 17% had obesity (BMI ≥ 30 kg/m²), and 44% had an increased WC (i.e., >102 and >88 cm for men and women, respectively). Both BMI and WC were separately associated with worse global health status, functioning, and more symptoms of fatigue. Increased WC was associated with lower physical, role and emotional functioning, regardless of BMI, with average differences ranging between 3 and 5 points. Conclusion: Future research on HRQL among CRC survivors should consider both BMI and WC. Furthermore, weight reduction trials should not only focus on general weight loss but also on the loss of abdominal fat.

Funding

Data collection for this study was funded by the Netherlands Comprehensive Cancer Organisation; the Center of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, The Netherlands; an investment subsidy (#480-08-009) of the Netherlands Organization for Scientific Research (The Hague, The Netherlands) and by a VENI grant (#451-10-041) from the Netherlands Organization for Scientific Research (The Hague, The Netherlands) awarded to Floortje Mols. M.J.L. Bours is partly supported by a grant from the Stichting Alpe d'HuZes within the research program ‘Leven met kanker’ of the Dutch Cancer Society (Grant No. UM-2012-5653), and partly by a grant from Kankeronderzoekfonds Limburg (part of Health Foundation Limburg; Grant No. 00005739). The funding sources were neither involved in the collection, interpretation, and analysis of the data, nor in the decision for the writing and submission of this report for publication.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Acknowledgments

The authors thank all survivors and their doctors for their participation in the study. Special thanks to Dr. M van Bommel for her availability as an independent advisor and willingness to answer survivors' queries. In addition, we thank the following hospitals for their co-operation: Amphia Hospital (Breda), Bernhoven Hospital (Veghel and Oss), Catharina Hospital (Eindhoven), Elkerliek Hospital (Helmond), Jeroen Bosch Hospital ('s-Hertogenbosch), Maxima Medical Center (Eindhoven and Veldhoven), St Anna Hospital (Geldrop), St Elisabeth Hospital (Tilburg), Twee Steden Hospital (Tilburg and Waalwijk), and VieCuri Hospital (Venlo and Venray).