Measured adiposity in relation to head and neck cancer risk in the European Prospective Investigation into Cancer and Nutrition

Heather A Ward, Petra A Wark, David C Muller, Annika Steffen, Mattias Johansson, Teresa Norat, Marc J Gunter, Kim Overvad, Christina C Dahm, Jytte Halkjær, Anne Tjønneland, Marie-Christine Boutron-Ruault, Guy Fagherazzi, Sylvie Mesrine, Paul Brennan, Heinz Freisling, Kuanrong Li, Rudolf Kaaks, Antonia Trichopoulou, Pagona LagiouSalvatore Panico, Sara Grioni, Rosario Tumino, Paolo Vineis, Domenico Palli, Petra H M Peeters, H Bas Bueno-de-Mesquita, Elisabete Weiderpass, Antonio Agudo, Jose Ramon Quiros, Nerea Larrañaga, Eva Ardanaz, José María Huerta, María-José Sánchez, Goran Laurell, Ingegerd Johansson, Ulla Westin, Peter Wallstrom, Kathryn E Bradbury, Nicholas J Wareham, Kay-Tee Khaw, Clare Pearson, Heiner Boeing, Elio Riboli

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    Abstract

    BACKGROUND: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer (HNC). However, most studies have used self-reported anthropometry which is prone to error.

    METHODS: Among 363 094 participants in the European Prospective Investigation into Cancer and Nutrition study (EPIC) with measured anthropometry, there were 837 incident cases of HNC. HNC risk was examined in relation to body mass index (BMI) [lean: < 22.5 kg/m2, normal weight (reference): 22.5-24.9 kg/m2, overweight 25-29.9 kg/m2, obese: > 30 kg/m2], waist circumference (WC), hip circumference (HC) and waist to hip ratio (WHR) using Cox proportional hazards models.

    RESULTS: Among men, a BMI < 22.5 kg/m2 was associated with higher HNC risk [hazard ratio (HR) 1.62, 95% confidence interval (CI) 1.23 - 2.12)]; BMI was not associated with HNC among women. WC and WHR were associated with greater risk of HNC among women, (WC per 5 cm: HR 1.08, 95% CI 1.02 - 1.15; WHR per 0.1 unit: HR 1.64, 95% CI 1.38 - 1.93). After stratification by smoking status, the association for WHR was present only among smokers (p interaction 0.004). Among men, WC and WHR were associated with HNC only upon additional adjustment for BMI (WC per 5 cm: HR 1.16, 95% CI 1.07 - 1.26; WHR per 0.1 unit: HR 1.42, 95% CI 1.21 - 1.65).

    CONCLUSION: Central adiposity, particularly among women, may have a stronger association with HNC risk than previously estimated.

    IMPACT: Strategies to reduce obesity may beneficially impact HNC incidence.

    Original languageEnglish
    Pages (from-to)895-904
    Number of pages10
    JournalCancer Epidemiology Biomarkers and Prevention
    Volume26
    Issue number6
    Early online date9 Feb 2017
    DOIs
    Publication statusPublished - 1 Jun 2017

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