title: Body mass index and risk of subtypes of head-neck cancer: the Netherlands Cohort Study.
abstract: Low body mass index (BMI) has been associated with risk of head-neck cancer (HNC), but prospective data are scarce. We investigated the association between BMI, BMI at age 20 years and change in BMI during adulthood with risk of HNC and HNC subtypes. 120,852 participants completed a questionnaire on diet and other cancer risk factors, including anthropometric measurements, at baseline in 1986. After 20.3 years of follow-up, 411 HNC (127 oral cavity cancer (OCC), 84 oro-/hypopharyngeal cancer (OHPC), and 197 laryngeal cancer (LC)) cases and 3,980 subcohort members were available for case-cohort analysis using Cox proportional hazards models. BMI at baseline was inversely associated with risk of HNC overall, with a multivariate rate ratio of 3.31 (95% CI 1.40-7.82) for subjects with a BMI < 18.5 kg/m(2), compared to participants with a BMI of 18.5 to 25 kg/m(2). Among HNC subtypes, this association was strongest for OCC and OHPC. The association between BMI at age 20 and HNC risk appeared to be positive. In this large prospective cohort study, we found an inverse association between BMI at baseline and HNC risk. For BMI at age 20, however, a positive rather than inverse association was found.
authors.affiliation: Department of Epidemiology, GROW - School for Oncology &Developmental Biology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Denise H E
authors.initials: DH
authors.lastname: Maasland
authors.affiliation: Department of Epidemiology, GROW - School for Oncology &Developmental Biology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.affiliation: Department of Otorhinolaryngology, Head &Neck Surgery, GROW - School for Oncology &Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Bernd
authors.initials: B
authors.lastname: Kremer
authors.affiliation: Department of Epidemiology, GROW - School for Oncology &Developmental Biology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schouten
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000145:classification* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000473:pathology; D009426:Netherlands; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000473:pathology; D016016:Proportional Hazards Models; D012307:Risk Factors