TOPLINE

Metabolic syndrome (MetS) was associated with a higher risk for colorectal cancer (CRC) in men younger than 60 years, but no significant association was observed in women of the same age group. Elevated waist circumference was the sole MetS component consistently linked to a higher risk across most demographic groups.

METHODOLOGY

• Researchers analysed data of 379,173 UK Biobank participants aged 40-69 years who were recruited between 2006 and 2010 across England, Scotland, and Wales.
• Participants were stratified into four groups on the basis of sex and the age cutoff of 60 years: younger men (age < 60 years), older men (age ≥ 60 years), younger women (age < 60 years), and older women (age ≥ 60 years).
• MetS was defined according to the established criteria requiring at least three of the following five metabolic abnormalities: elevated waist circumference (≥ 102 cm in men and ≥ 88 cm in women), hypertriglyceridaemia (≥ 1.7 mmol/L), hyperglycaemia (A1c levels ≥ 42 mmol/mol or antidiabetic medication use), elevated blood pressure (systolic blood pressure ≥ 130 mm Hg, diastolic blood pressure ≥ 85 mm Hg, or antihypertensive medication use), and low high-density lipoprotein cholesterol (HDL-C) levels (< 1.03 mmol/L in men, < 1.29 mmol/L in women, or lipid-modifying medications).
• The researchers assessed the association between MetS and the risk for CRC, adjusting for age, sex, ethnicity, socioeconomic deprivation, education, smoking status, and other factors. The median follow-up duration was 11.8 years.

TAKEAWAY

• Overall, 4971 participants were diagnosed with CRC. MetS was most strongly associated with CRC in younger men (hazard ratio [HR], 1.31; 95% CI, 1.15-1.50), accounting for 8.9% (95% CI, 1.1%-16.7%) of the attributable risk in this subpopulation.
• Among older adults, significant but more modest associations were found in both older men (HR, 1.18; 95% CI, 1.07-1.30) and older women (HR, 1.18; 95% CI, 1.05-1.33); however, younger women showed no significant association (HR, 1.05; 95% CI, 0.89-1.25).
• Among younger men, those with all five metabolic abnormalities had more than double the risk for CRC compared to those with none (HR, 2.16; 95% CI, 1.44-3.23), demonstrating a consistent dose-response relationship (P for trend < .001).
• Elevated waist circumference significantly increased the risk for CRC in all subgroups except younger women, and hyperglycaemia, hypertension, and low HDL-C levels consistently predicted the risk in men (HR range, 1.25-1.47 in younger men and 1.16-1.17 in older men).

IN PRACTICE

"This large cohort study underscores critical age and sex disparities in the MetS-CRC risk association in White populations, highlighting younger males as a key subgroup that should be prioritised in targeted public health action," the authors concluded.

SOURCE

The study was led by Zilin Luo, German Cancer Research Center (DKFZ), Heidelberg, Germany. It was published online on July 30, 2026, in the British Journal of Cancer.

LIMITATIONS

The study did not account for the duration of MetS and temporal metabolic changes. Non-fasting blood samples were used, although the researchers employed the more stable A1c indicator for glucose metabolism assessment. The predominantly White cohort composition (> 90%) may have limited generalisability to other ethnic populations.

DISCLOSURES

Financial support for the work of Luo was provided by the China Scholarship Council. The UK Biobank received establishment funding from the Wellcome Trust, Medical Research Council, Public Health Scotland, and the Northwest Regional Development Agency, with additional support from the Welsh Government, British Heart Foundation, Cancer Research UK, Diabetes UK, and National Institute for Health and Care Research. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.