{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:00:54Z","timestamp":1791428454437,"version":"4.3.3"},"reference-count":44,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","award":["R327\u2010A19070"],"award-info":[{"award-number":["R327\u2010A19070"]}],"id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Obesity may exacerbate colorectal cancer (CRC) prognosis, yet previous studies have shown inconsistent findings due to methodological limitations. In this nationwide cohort study, we investigated the association between body mass index (BMI) on CRC recurrence and mortality, while examining the influence of demographic, clinical, and socioeconomic characteristics. From the Danish Colorectal Cancer Group database and population\u2010based registries, we assembled a cohort of stage I\u2013III CRC patients who underwent curative intent surgery between 2002 and 2020. We identified 5\u2010year CRC recurrence and mortality using validated algorithms and registries. We estimated cumulative incidence functions (CIFs) and applied Cox regression modeling BMI via splines and categorically. We examined synergistic effects via stratification and interaction analyses. Median follow\u2010up was 4.4\u2009years for recurrence and 4.5\u2009years for mortality; 5877 patients experienced CRC recurrence (CIF\u2009=\u200918.4%) and 6568 died (CIF\u2009=\u200921.8%). BMI was not associated with the recurrence of colon or rectal cancer. Underweight (BMI &lt;18.5\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ) and class II\u2013III obesity (BMI &gt;35\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ) were associated with increased mortality, especially for rectal cancer. For rectal cancer, class II\u2013III obesity was associated with excess mortality, particularly in younger patients (30\u201350\u2009years) and males. For colon and rectal cancer, male sex, young age and comorbidities interacted to increase mortality in patients with underweight, whereas short education and smoking did so for colon cancer, and alcohol consumption for rectal cancer. Type 2 diabetes had minor influence on the associations. BMI\u2010related mortality in CRC may be modified by demographic, clinical and socioeconomic characteristics. Targeted interventions considering the high\u2010risk subgroups may help improve CRC outcomes.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70248","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T07:28:38Z","timestamp":1763796518000},"page":"2111-2119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Body mass index and colorectal cancer recurrence and mortality: A nationwide cohort study in Denmark"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4378-8531","authenticated-orcid":false,"given":"Cathrine F.","family":"Hjorth","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine Aarhus University Hospital, Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6027-5717","authenticated-orcid":false,"given":"Maja H.","family":"Olsen","sequence":"additional","affiliation":[{"name":"Cancer Survivorship Danish Cancer Institute  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8679-5163","authenticated-orcid":false,"given":"Sinna P.","family":"Ulrichsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine Aarhus University Hospital, Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9104-7263","authenticated-orcid":false,"given":"Jesper","family":"Nors","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Surgery Randers Regional Hospital  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1447-0313","authenticated-orcid":false,"given":"Jannik","family":"Wheler","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine Aarhus University Hospital, Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7938-8893","authenticated-orcid":false,"given":"Signe","family":"Borgquist","sequence":"additional","affiliation":[{"name":"Department of Oncology, Department of Clinical Medicine Aarhus University Hospital, Aarhus University  Aarhus Denmark"},{"name":"Department of Oncology, Clinical Sciences Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2336-2923","authenticated-orcid":false,"given":"Lene H.","family":"Iversen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine Aarhus University Hospital, Aarhus University  Aarhus Denmark"},{"name":"Department of Gastrointestinal Surgery Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5485-2730","authenticated-orcid":false,"given":"Susanne O.","family":"Dalton","sequence":"additional","affiliation":[{"name":"Cancer Survivorship Danish Cancer Institute  Copenhagen Denmark"},{"name":"Department of Clinical Oncology and Palliative Care Zealand University Hospital  N\u00e6stved Denmark"},{"name":"Institute of Clinical Medicine, Faculty of Health Copenhagen University  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9738-2284","authenticated-orcid":false,"given":"Deirdre","family":"Cronin\u2010Fenton","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine Aarhus University Hospital, Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2023.5098"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2023.11.041"},{"key":"e_1_2_11_4_1","unstructured":"Colorectal Cancer Survival Rates | Colorectal Cancer Prognosis.https:\/\/www.cancer.org\/cancer\/types\/colon\u2010rectal\u2010cancer\/detection\u2010diagnosis\u2010staging\/survival\u2010rates.html. 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