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Body mass index and risk of head and neck cancer in a pooled analysis of case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium.


ABSTRACT:

Background

Head and neck cancer (HNC) risk is elevated among lean people and reduced among overweight or obese people in some studies; however, it is unknown whether these associations differ for certain subgroups or are influenced by residual confounding from the effects of alcohol and tobacco use or by other sources of biases.

Methods

We pooled data from 17 case-control studies including 12 716 cases and the 17 438 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between body mass index (BMI) at different ages and HNC risk, adjusted for age, sex, centre, race, education, tobacco smoking and alcohol consumption.

Results

Adjusted ORs (95% CIs) were elevated for people with BMI at reference (date of diagnosis for cases and date of selection for controls) < or =18.5 kg/m(2) (2.13, 1.75-2.58) and reduced for BMI >25.0-30.0 kg/m(2) (0.52, 0.44-0.60) and BMI > or =30 kg/m(2) (0.43, 0.33-0.57), compared with BMI >18.5-25.0 kg/m(2). These associations did not differ by age, sex, tumour site or control source. Although the increased risk among people with BMI < or =18.5 kg/m(2) was not modified by tobacco smoking or alcohol drinking, the inverse association for people with BMI > 25 kg/m(2) was present only in smokers and drinkers.

Conclusions

In our large pooled analysis, leanness was associated with increased HNC risk regardless of smoking and drinking status, although reverse causality cannot be excluded. The reduced risk among overweight or obese people may indicate body size is a modifier of the risk associated with smoking and drinking. Further clarification may be provided by analyses of prospective cohort and mechanistic studies.

SUBMITTER: Gaudet MM 

PROVIDER: S-EPMC2929351 | biostudies-literature | 2010 Aug

REPOSITORIES: biostudies-literature

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Publications

Body mass index and risk of head and neck cancer in a pooled analysis of case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium.

Gaudet Mia M MM   Olshan Andrew F AF   Chuang Shu-Chun SC   Berthiller Julien J   Zhang Zuo-Feng ZF   Lissowska Jolanta J   Zaridze David D   Winn Deborah M DM   Wei Qingyi Q   Talamini Renato R   Szeszenia-Dabrowska Neolilia N   Sturgis Erich M EM   Schwartz Stephen M SM   Rudnai Peter P   Eluf-Neto Jose J   Muscat Joshua J   Morgenstern Hal H   Menezes Ana A   Matos Elena E   Bucur Alexandru A   Levi Fabio F   Lazarus Philip P   La Vecchia Carlo C   Koifman Sergio S   Kelsey Karl K   Herrero Rolando R   Hayes Richard B RB   Franceschi Silva S   Wunsch-Filho Victor V   Fernandez Leticia L   Fabianova Eleonora E   Daudt Alexander W AW   Dal Maso Luigino L   Curado Maria Paula MP   Chen Chu C   Castellsague Xavier X   Benhamou Simone S   Boffetta Paolo P   Brennan Paul P   Hashibe Mia M  

International journal of epidemiology 20100201 4


<h4>Background</h4>Head and neck cancer (HNC) risk is elevated among lean people and reduced among overweight or obese people in some studies; however, it is unknown whether these associations differ for certain subgroups or are influenced by residual confounding from the effects of alcohol and tobacco use or by other sources of biases.<h4>Methods</h4>We pooled data from 17 case-control studies including 12 716 cases and the 17 438 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) w  ...[more]

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