Genetic Obesity Variants and Risk of Conventional Adenomas and Serrated Polyps

Background: Higher body mass index (BMI) is associated with increased risk of colorectal cancer. How genetically predicted BMI may be associated with colorectal cancer precursors is unknown. Aims: Our objective was to quantify the association of genetically predicted and measured BMI with risk of colorectal cancer precursors. Methods: We evaluated the association of genetically predicted and measured BMI with risk of conventional adenomas, serrated polyps, and synchronous polyps among 27,426 participants who had undergone at least one lower gastrointestinal endoscopy in the Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-up Study. Genetic risk score was derived from 97 BMI-related single nucleotide polymorphisms. Multivariable logistic regression evaluated each polyp subtype compared to non-polyps. Results: For conventional adenomas, the OR per 2-kg/m² increase was 1.03 (95% CI, 1.01–1.04) for measured BMI and 0.98 (95% CI, 0.88–1.10) for genetically predicted BMI; for serrated polyps, the OR was 1.06 (95% CI, 1.04–1.08) and 1.04 (95% CI, 0.90–1.20), respectively; for synchronous polyps, the OR was 1.10 (95% CI, 1.07–1.13) and 1.09 (95% CI, 0.89–1.34), respectively. Genetically predicted BMI was associated with synchronous polyps in women (OR = 1.37, 95% CI: 1.05–1.79). Conclusion: Genetically predicted BMI was not associated with colorectal cancer precursor lesions. The confidence intervals were wide and encompassed those for measured BMI, indicating that null findings may be due to insufficient power.