The evidence supporting obesity as a risk factor for colon cancer remains i
nconclusive, especially among women. The author studied the association bet
ween obesity and colon cancer in a nationally representative cohort of men
and women aged 25-74 years who participated in the First National Health an
d Nutrition Examination Survey from 1971 to 1975 and were subsequently foll
owed up through 1992. Among the 13,420 persons included in the analytic sam
ple. 222 incident cases of colon cancer were identified. Height and weight
were measured during the baseline examination. Compared with participants w
hose body mass index was less than 22 kg/m(2), the hazard ratios were 1.79
(95% confidence interval (CI): 0.87, 3.71), 1.86 (95% CI: 0.86, 4.03), 2.47
(95% CI: 1.14, 5.32), 3.72 (95% CI: 1.68, 8.22), and 2.79 (95% CI: 1.22, 6
.35) for participants with a body mass index of 22-<24 kg/m(2), 24-<26 kg/m
(2), 26-<28 kg/m(2), 28-<30 kg/m(2), and greater than or equal to 30 kg/m(2
), respectively. The hazard ratios were similar for men and women. Subscapu
lar skinfold thickness, but not triceps skinfold thickness, was positively
associated with colon cancer incidence among men but not women, after adjus
tment for body mass index and other possible confounders. These results str
ongly support the hypothesis that excess body weight is a risk factor for c
olon cancer among both men and women.