期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 39, 期 4, 页码 1091-1102出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyp380
关键词
BMI; head and neck cancer; smoking
资金
- US National Institutes of Health (NIH)
- National Cancer Institute (NCI) [R03CA113157]
- Italian Association for Research on Cancer (AIRC)
- Swiss League against Cancer [KFS1069-09-2000]
- Fribourg League against Cancer [FOR381.88]
- Swiss Cancer Research [AKT 617]
- Gustave-Roussy Institute [88D28]
- Swiss Research against Cancer/Oncosuisse [KFS-700, OCS-1633]
- World Cancer Research Fund
- European Commission [IC15-CT98-0332, IC18-CT97-0222]
- National Institutes of Health (NIH) US [P01CA068384, K07CA104231, R01CA048896, R01DE012609, R01CA078609, R01CA100679, NIDCR R01DE11979, NIDCR R01DE13110, NIH FIRCA TW01500, R01CA61188, R01DE13158, P50CA90388, R01DA11386, R03CA77954, T32CA09142, U01CA96134, R21ES011667, R01ES11740, R01CA100264]
- National Institute of Environmental Health Sciences [P30ES010126]
- National Institutes of Health (NCI) US
- Fondo para la Investigacion Cientifica y Tecnologica (FONCYT) Argentina
- IMIM (Barcelona)
- Fundacao de Amparo a Pesquisa no Estado de Sao Paulo (FAPESP) [01/01768-2]
- Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government [FIS 97/0024, FIS 97/0662, BAE 01/5013]
- International Union Against Cancer (UICC)
- YamagiwaYoshida Memorial International Cancer Study Grant
- Italian League Against Cancer
- Italian Ministry of Research
- UCLA Jonsson Comprehensive Cancer Centre
- NIDCR
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) < 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 >= 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 < 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.
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