Weighing the Hazards: Body Mass Index and Recurrence in Early-Onset Colorectal Cancer

Continuous BMI is significantly associated with recurrence-free survival in early-onset colorectal cancer, but not in average-onset colorectal cancer, supporting an obesity-paradox pattern limited to EOCRC.

• Why it matters: The study addresses whether BMI relates to recurrence differently across early- versus average-onset colorectal cancer, where an “obesity paradox” has been reported but may not be universal.
• What they did: Using recurrence-free survival analyses, it tested continuous BMI and modeled non-linear effects with a spline, then performed an interaction analysis comparing EOCRC and AOCRC cohorts (LRT p=0.046).
• The result: In EOCRC, BMI shows a significant association with RFS, while in AOCRC the spline is flat and the continuous BMI test is not significant (LRT p=0.15), motivating biomarker- and body-composition–focused follow-up.

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