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While adiposity is an established risk factor for colorectal cancer, the relevance of fat\u2010free mass and early\u2010adulthood adiposity remains to be explored. The prospective China Kadoorie Biobank study included 0.5\u2009million adults (aged 30\u201379\u2009years) from 10 areas in China. Participants' body size and composition were measured at baseline and at resurveys (amongst a subset). After &gt;10\u2009years of follow\u2010up, 2350, 3345 and 3059 incident cases of oesophageal (EC), stomach (SC) and colorectal (CRC) cancers\u00a0were recorded, respectively. Cox regression was used to estimate hazard ratios (HRs) for these cancers in relation to different adiposity traits. General and central adiposity were inversely associated with EC (primarily ESCC) risk, with HRs of 0.81 (95% CI 0.77\u20130.85), 0.76 (0.72\u20130.81) and 0.87 (0.83\u20130.92) per SD increase in usual levels of BMI, body fat percentage (BF%) and waist circumference (WC), respectively. Adiposity was also inversely associated with SC risk [HR\u2009=\u20090.79 (0.75\u20130.83) and 0.88 (0.84\u20130.92) per SD increase in usual BF% and WC], with heterogeneity by cardia and non\u2010cardia subsites, and positively associated with CRC [HR\u2009=\u20091.09 (1.03\u20131.15) and 1.17 (1.12\u20131.22) per SD higher usual BF% and WC]. Fat\u2010free mass was inversely associated with EC [HR\u2009=\u20090.93 (0.89\u20130.98) per SD increase] but positively associated with CRC [1.09 (1.04\u20131.14)], while BMI at age 25 was positively associated with all three cancers. After mutual adjustment, general adiposity remained inversely associated with EC and SC, while central adiposity remained positively associated with CRC.<\/jats:p>","DOI":"10.1002\/ijc.35303","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T06:58:57Z","timestamp":1735628337000},"page":"2094-2106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adiposity and risks of gastrointestinal cancers: A 10\u2010year prospective study of 0.5\u2009million Chinese adults"],"prefix":"10.1002","volume":"156","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7090-6551","authenticated-orcid":false,"given":"Wing Ching","family":"Chan","sequence":"first","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0807-0682","authenticated-orcid":false,"given":"Iona","family":"Millwood","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiana","family":"Kartsonaki","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaidong","family":"Du","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Stevens","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junshi","family":"Chen","sequence":"additional","affiliation":[{"name":"China National Center For Food Safety Risk Assessment  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Pei","sequence":"additional","affiliation":[{"name":"Peking University Center for Public Health and Epidemic Preparedness &amp; 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