• Department of Epidemiology, University of Washington, Seattle, WA.
• Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
• Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT.
• Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
• Dana-Farber Cancer Institute, Boston, MA.
• Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN.
• Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY.
• Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA.
• Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL.
• Division of Research, Kaiser Permanente Northern California, Oakland, CA.

Higher body mass index (BMI) is a well-established risk factor for colorectal cancer (CRC), but is inconsistently associated with CRC survival. In 6 prospective studies participating in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), 2,249 non-Hispanic white CRC cases were followed for a median 4.5 years after diagnosis, during which 777 died, 554 from CRC-related causes. Associations between prediagnosis BMI and survival (overall and CRC-specific) were evaluated using Cox regression models adjusted for age at diagnosis, sex, study and smoking status (current/former/never). The association between BMI category and CRC survival varied by cancer stage at diagnosis (I-IV) for both all-cause (p-interaction = 0.03) and CRC-specific mortality (p-interaction = 0.04). Compared to normal BMI (18.5-24.9 kg/m(2) ), overweight (BMI 25.0-29.9) was associated with increased mortality among those with Stage I disease, and decreased mortality among those with Stages II-IV disease. Similarly, obesity (BMI ≥30) was associated with increased mortality among those with Stages I-II disease, and decreased mortality among those with Stages III-IV disease. These results suggest the relationship between BMI and survival after CRC diagnosis differs by stage at diagnosis, and may emphasize the importance of adequate metabolic reserves for colorectal cancer survival in patients with late-stage disease.