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Maternal obesity linked to increased risk of colorectal cancer in offspring

The research team found that adult offspring whose mothers were obese during pregnancy faced a 100% greater risk of developing colorectal cancer than those whose mothers were not.

A recently published study has provided evidence that colorectal cancer, the 2nd most common cause of cancer related deaths, may be linked to maternal obesity. Although findings made by researchers failed to demonstrate a definitive relationship, there was a high correlation between colorectal cancer cases in adults born in the 1960’s whose mothers were obese within 6 months before delivery. 

Colorectal cancer rates have increased dramatically in young adults today compared to those of the 1950’s. There is no clear cause for this; however, recent findings at the University of Texas Health Science Center at Houston suggest that obesity in expecting mothers cuold be a great risk factor. 

Researchers at the institution analyzed data from the Child Health and Development Studies program (CDHS) which was collected between 1959 and 1966 in Oakland, California. The collection of data was gathered by experts and researchers who tracked the development of approximately 18,000 children over the course of multiple decades. These children came from a wide demographic and a myriad of cultural and financial backgrounds. The observations were made with the intention of finding which children would later be diagnosed with colorectal cancer in adulthood. The team found that adult offspring whose mothers were obese during pregnancy faced a 100% greater risk than those whose mothers were not.

Caitlin Murphy, Associate Professor in the Department of Health Promotion and Behavioral Sciences and UTHealth School of Public Health in Houston, stated, “Maternal obesity and pregnancy weight gain may be related to colorectal cancer in offspring in two different ways… First, these maternal characteristics increase risk of obesity in adult offspring, and obesity is a well-known risk factor of colorectal cancer. Second, they may affect the developing gastrointestinal tract in the womb, making offspring more sensitive to colorectal cancer later in life.”

Colorectal cancer, also commonly referred to as colon cancer or bowel cancer, is the primary cause of cancer-related morbidity and mortality in all populations. Obesity is already a well known risk factor of morbidity and cancer, but Murphy’s new study shows that it might also be related to the origin of colorectal cancer in adults originally born from obese mother’s. 

The researchers suggest, “Given population trends in maternal obesity, which has multiplied in prevalence by nearly six since the 1960s, we may see a growing burden of early-onset [bowel cancer] for decades to come.”

If the trend continues the amount of patients suffering from colorectal cancer is expected to increase by 60% to more than 2.2 million diagnoses and 1.1 million deaths by the year 2030. 

“Rates of colorectal cancer have increased rapidly in younger adults, but we know very little about what may explain this increase,” says Murphy. “These findings suggest that exposure in the womb—or in utero events—are important risk factors of colorectal cancer and may contribute to increasing rates of disease.” 


The study was published in Gut, on August 12th, 2021.

Abstract. Colorectal cancer (CRC) is a leading cause of cancer-related death worldwide. Obesity is a well-established risk factor for CRC, and fetal or developmental origins of obesity may underlie its effect on cancer in adulthood. We examined associations of maternal obesity, pregnancy weight gain, and birth weight and CRC in adult offspring. The Child Health and Development Studies is a prospective cohort of women receiving prenatal care between 1959 and 1966 in Oakland, California (N=18 751 live births among 14 507 mothers). Clinical information was abstracted from mothers’ medical records 6 months prior to pregnancy through delivery. Diagnoses of CRC in adult (age ≥18 years) offspring were ascertained through 2019 by linkage with the California Cancer Registry. We used Cox proportional hazards models to estimate adjusted HR (aHR); we examined effect measure modification using single-referent models to estimate the relative excess risk due to interaction (RERI). 68 offspring were diagnosed with CRC over 738 048 person-years of follow-up, and half (48.5%) were diagnosed younger than age 50 years. Maternal obesity (≥30 kg/m2) increased the risk of CRC in offspring (aHR 2.51, 95% CI 1.05 to 6.02). Total weight gain modified the association of rate of early weight gain (RERI −4.37, 95% CI −9.49 to 0.76), suggesting discordant growth from early to late pregnancy increases risk. There was an elevated association with birth weight (≥4000 g: aHR 1.95, 95% CI 0.8 to 4.38). Our results suggest that in utero events are important risk factors for CRC and may contribute to increasing incidence rates in younger adults.

Murphy, Caitlin C, et al. “Maternal Obesity, Pregnancy Weight Gain, and Birth Weight and Risk of Colorectal Cancer.” Gut, BMJ Publishing Group, 12 Aug. 2021, gut.bmj.com/content/early/2021/08/12/gutjnl-2021-325001.

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