title: Body mass index and risk of head and neck cancer by race: the Carolina Head and Neck Cancer Epidemiology Study.
abstract: OBJECTIVE
  Most studies, primarily conducted in populations of European ancestry, reported increased risk of head and neck cancer (HNC) associated with leanness (body mass index [BMI] <18.5 kg/m(2)) and decreased for overweight or obesity (25.0 to <30.0 and >30 kg/m(2), respectively), compared with normal weight (18.5 to <25.0 kg/m(2)).
  
  
  METHODS
  The Carolina Head and Neck Cancer Epidemiology Study is a population-based, racially diverse case-control study of 1289 incident HNC cases (330 African Americans) and 1361 controls (261 African Americans). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between BMI 1 year prediagnosis and HNC risk stratified by race and adjusted for age, sex, smoking, alcohol, and education.
  
  
  RESULTS
  Multiplicative interaction between BMI and race was evident (Pint = .00007). Compared with normal weight, ORs for leanness were increased for African Americans (OR, 3.91; 95% CI, 0.72-21.17) and whites (OR, 1.48; 95% CI, 0.60-3.65). For overweight and obesity, ORs were decreased in African Americans (OR, 0.51; 95% CI, 0.32-0.83 and OR, 0.47; 95% CI, 0.28-0.79, respectively) but in not whites. The increased risk associated with leanness was greater for smokers than nonsmokers (Pint = .02).
  
  
  CONCLUSIONS
  These data, which require replication, suggest that leanness is associated with increased HNC risk among African Americans to a greater extent than whites and overweight and obesity is associated with decreased HNC risk only among African Americans.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC. Electronic address: jessica.petrick@unc.edu.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Petrick
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, GA.
authors.forename: Mia M
authors.initials: MM
authors.lastname: Gaudet
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina, Chapel Hill, NC.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Weissler
authors.affiliation: Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC.
authors.forename: William K
authors.initials: WK
authors.lastname: Funkhouser
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC; Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Olshan
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology*; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Cancer of the head and neck; Case-control studies; Epidemiology; Race