title: Body mass index and lung cancer risk: results from the ICARE study, a large, population-based case-control study.
abstract: BACKGROUND
  The association between body mass index (BMI) and lung cancer is still disputed because of possible residual confounding by smoking and preclinical weight loss in case-control studies. We examined this association using data from the multicenter ICARE study in France, a large, population-based case-control study.
  
  
  METHODS
  A total of 2,625 incident lung cancer cases and 3,381 controls were included. Weight was collected at interview, 2 years before the interview, and at age 30. Lifetime smoking exposure was calculated using the comprehensive smoking index (CSI). Adjusted odds ratios (aORs) and 95 % confidence intervals were estimated by unconditional logistic regression and controlled for age, area, education, CSI, occupational exposure, previous chronic bronchitis, and parental history of lung cancer. We also examined the role of weight change. Analyses were stratified by smoking status and sex.
  
  
  RESULTS
  When compared with that of men with normal BMI 2 years before the interview, lung cancer aORs (95 % CI) among men with BMIs of <18.5, 25-29.9, 30-32.4, and ≥32.5 kg/m(2) were 2.7 (95 % CI 1.2-6.2), 0.9 (95 % CI 0.7-1.1), 0.8 (95 % CI 0.6-1.1), and 0.8 (95 % CI 0.6-1.0), respectively (p(trend) = 0.02). Results were more pronounced among current smokers and were similar in men and women. Weight gain over time was associated with a significant decreased risk of lung cancer.
  
  
  CONCLUSIONS
  We found an inverse dose-dependent association between lung cancer risk and BMI 2 years prior to interview in current smokers. IMPACT STATEMENT: BMI might be an individual factor impacting the risk of lung cancer related to smoking's carcinogen-induced DNA damage.
authors.affiliation: Inserm, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer Team, UMRS, Villejuif, France.
authors.forename: Chloé
authors.initials: C
authors.lastname: Tarnaud
authors.forename: Florence
authors.initials: F
authors.lastname: Guida
authors.forename: Alexandra
authors.initials: A
authors.lastname: Papadopoulos
authors.forename: Sylvie
authors.initials: S
authors.lastname: Cénée
authors.forename: Diane
authors.initials: D
authors.lastname: Cyr
authors.forename: Annie
authors.initials: A
authors.lastname: Schmaus
authors.forename: Loredana
authors.initials: L
authors.lastname: Radoï
authors.forename: Sophie
authors.initials: S
authors.lastname: Paget-Bailly
authors.forename: Gwenn
authors.initials: G
authors.lastname: Menvielle
authors.forename: Antoine
authors.initials: A
authors.lastname: Buemi
authors.forename: Anne Sophie
authors.initials: AS
authors.lastname: Woronoff
authors.forename: Daniele
authors.initials: D
authors.lastname: Luce
authors.forename: Isabelle
authors.initials: I
authors.lastname: Stücker
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*