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 Lagiou; Salvatore 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

doi:10.1158/1055-9965.EPI-16-0886

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 language	English
Pages (from-to)	895-904
Number of pages	10
Journal	Cancer Epidemiology Biomarkers and Prevention
Volume	26
Issue number	6
Early online date	9 Feb 2017
DOIs	https://doi.org/10.1158/1055-9965.EPI-16-0886
Publication status	Published - 1 Jun 2017

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Petra Wark
- Centre for Healthcare and Communities - Professor
Person: Teaching and Research

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Ward, H. A., Wark, P. A., Muller, D. C., Steffen, A., Johansson, M., Norat, T., Gunter, M. J., Overvad, K., Dahm, C. C., Halkjær, J., Tjønneland, A., Boutron-Ruault, M.-C., Fagherazzi, G., Mesrine, S., Brennan, P., Freisling, H., Li, K., Kaaks, R., Trichopoulou, A., ... Riboli, E. (2017). Measured adiposity in relation to head and neck cancer risk in the European Prospective Investigation into Cancer and Nutrition. Cancer Epidemiology Biomarkers and Prevention, 26(6), 895-904. https://doi.org/10.1158/1055-9965.EPI-16-0886

Ward, HA, Wark, PA, Muller, DC, Steffen, A, Johansson, M, Norat, T, Gunter, MJ, Overvad, K, Dahm, CC, Halkjær, J, Tjønneland, A, Boutron-Ruault, M-C, Fagherazzi, G, Mesrine, S, Brennan, P, Freisling, H, Li, K, Kaaks, R, Trichopoulou, A, Lagiou, P, Panico, S, Grioni, S, Tumino, R, Vineis, P, Palli, D, Peeters, PHM, Bueno-de-Mesquita, HB, Weiderpass, E, Agudo, A, Ramon Quiros, J, Larrañaga, N, Ardanaz, E, Huerta, JM, Sánchez, M-J, Laurell, G, Johansson, I, Westin, U, Wallstrom, P, Bradbury, KE, Wareham, NJ, Khaw, K-T, Pearson, C, Boeing, H & Riboli, E 2017, 'Measured adiposity in relation to head and neck cancer risk in the European Prospective Investigation into Cancer and Nutrition', Cancer Epidemiology Biomarkers and Prevention, vol. 26, no. 6, pp. 895-904. https://doi.org/10.1158/1055-9965.EPI-16-0886

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

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.",

author = "Ward, {Heather A} and Wark, {Petra A} and Muller, {David C} and Annika Steffen and Mattias Johansson and Teresa Norat and Gunter, {Marc J} and Kim Overvad and Dahm, {Christina C} and Jytte Halkj{\ae}r and Anne Tj{\o}nneland and Marie-Christine Boutron-Ruault and Guy Fagherazzi and Sylvie Mesrine and Paul Brennan and Heinz Freisling and Kuanrong Li and Rudolf Kaaks and Antonia Trichopoulou and Pagona Lagiou and Salvatore Panico and Sara Grioni and Rosario Tumino and Paolo Vineis and Domenico Palli and Peeters, {Petra H M} and Bueno-de-Mesquita, {H Bas} and Elisabete Weiderpass and Antonio Agudo and {Ramon Quiros}, Jose and Nerea Larra{\~n}aga and Eva Ardanaz and Huerta, {Jos{\'e} Mar{\'i}a} and Mar{\'i}a-Jos{\'e} S{\'a}nchez and Goran Laurell and Ingegerd Johansson and Ulla Westin and Peter Wallstrom and Bradbury, {Kathryn E} and Wareham, {Nicholas J} and Kay-Tee Khaw and Clare Pearson and Heiner Boeing and Elio Riboli",

note = "Copyright {\textcopyright}2017, American Association for Cancer Research.",

year = "2017",

month = jun,

day = "1",

doi = "10.1158/1055-9965.EPI-16-0886",

language = "English",

volume = "26",

pages = "895--904",

journal = "Cancer Epidemiology Biomarkers and Prevention",

issn = "1055-9965",

publisher = "American Association for Cancer Research",

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TY - JOUR

T1 - Measured adiposity in relation to head and neck cancer risk in the European Prospective Investigation into Cancer and Nutrition

AU - Ward, Heather A

AU - Wark, Petra A

AU - Muller, David C

AU - Steffen, Annika

AU - Johansson, Mattias

AU - Norat, Teresa

AU - Gunter, Marc J

AU - Overvad, Kim

AU - Dahm, Christina C

AU - Halkjær, Jytte

AU - Tjønneland, Anne

AU - Boutron-Ruault, Marie-Christine

AU - Fagherazzi, Guy

AU - Mesrine, Sylvie

AU - Brennan, Paul

AU - Freisling, Heinz

AU - Li, Kuanrong

AU - Kaaks, Rudolf

AU - Trichopoulou, Antonia

AU - Lagiou, Pagona

AU - Panico, Salvatore

AU - Grioni, Sara

AU - Tumino, Rosario

AU - Vineis, Paolo

AU - Palli, Domenico

AU - Peeters, Petra H M

AU - Bueno-de-Mesquita, H Bas

AU - Weiderpass, Elisabete

AU - Agudo, Antonio

AU - Ramon Quiros, Jose

AU - Larrañaga, Nerea

AU - Ardanaz, Eva

AU - Huerta, José María

AU - Sánchez, María-José

AU - Laurell, Goran

AU - Johansson, Ingegerd

AU - Westin, Ulla

AU - Wallstrom, Peter

AU - Bradbury, Kathryn E

AU - Wareham, Nicholas J

AU - Khaw, Kay-Tee

AU - Pearson, Clare

AU - Boeing, Heiner

AU - Riboli, Elio

PY - 2017/6/1

Y1 - 2017/6/1

N2 - 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.

AB - 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.

U2 - 10.1158/1055-9965.EPI-16-0886

DO - 10.1158/1055-9965.EPI-16-0886

M3 - Article

C2 - 28183827

SN - 1055-9965

VL - 26

SP - 895

EP - 904

JO - Cancer Epidemiology Biomarkers and Prevention

JF - Cancer Epidemiology Biomarkers and Prevention

IS - 6

ER -

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

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