title: Anthropometry and the Risk of Lung Cancer in EPIC.
abstract: The associations of body mass index (BMI) and other anthropometric measurements with lung cancer were examined in 348,108 participants in the European Investigation Into Cancer and Nutrition (EPIC) between 1992 and 2010. The study population included 2,400 case patients with incident lung cancer, and the average length of follow-up was 11 years. Hazard ratios were calculated using Cox proportional hazard models in which we modeled smoking variables with cubic splines. Overall, there was a significant inverse association between BMI (weight (kg)/height (m)(2)) and the risk of lung cancer after adjustment for smoking and other confounders (for BMI of 30.0-34.9 versus 18.5-25.0, hazard ratio = 0.72, 95% confidence interval: 0.62, 0.84). The strength of the association declined with increasing follow-up time. Conversely, after adjustment for BMI, waist circumference and waist-to-height ratio were significantly positively associated with lung cancer risk (for the highest category of waist circumference vs. the lowest, hazard ratio = 1.25, 95% confidence interval: 1.05, 1.50). Given the decline of the inverse association between BMI and lung cancer over time, the association is likely at least partly due to weight loss resulting from preclinical lung cancer that was present at baseline. Residual confounding by smoking could also have influenced our findings.
authors.forename: Nikmah Utami
authors.initials: NU
authors.lastname: Dewi
authors.forename: Hendriek C
authors.initials: HC
authors.lastname: Boshuizen
authors.forename: Mattias
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authors.lastname: Johansson
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: Ellen
authors.initials: E
authors.lastname: Kampman
authors.forename: Annika
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authors.lastname: Steffen
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Jytte
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authors.lastname: Halkjær
authors.forename: Kim
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authors.lastname: Overvad
authors.forename: Gianluca
authors.initials: G
authors.lastname: Severi
authors.forename: Guy
authors.initials: G
authors.lastname: Fagherazzi
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Rudolf
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authors.lastname: Kaaks
authors.forename: Kuanrong
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authors.lastname: Li
authors.forename: Heiner
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authors.lastname: Boeing
authors.forename: Antonia
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authors.lastname: Trichopoulou
authors.forename: Christina
authors.initials: C
authors.lastname: Bamia
authors.forename: Eleni
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authors.lastname: Klinaki
authors.forename: Rosario
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authors.lastname: Tumino
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Amalia
authors.initials: A
authors.lastname: Mattiello
authors.forename: Giovanna
authors.initials: G
authors.lastname: Tagliabue
authors.forename: Petra H
authors.initials: PH
authors.lastname: Peeters
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.forename: Inger
authors.initials: I
authors.lastname: Torhild Gram
authors.forename: José María
authors.initials: JM
authors.lastname: Huerta
authors.forename: Antonio
authors.initials: A
authors.lastname: Agudo
authors.forename: María-José
authors.initials: MJ
authors.lastname: Sánchez
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Quirós
authors.forename: Emily
authors.initials: E
authors.lastname: Sonestedt
authors.forename: Mikael
authors.initials: M
authors.lastname: Johansson
authors.forename: Kjell
authors.initials: K
authors.lastname: Grankvist
authors.forename: Tim
authors.initials: T
authors.lastname: Key
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nick
authors.initials: N
authors.lastname: Wareham
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Cross
authors.forename: Teresa
authors.initials: T
authors.lastname: Norat
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Anouar
authors.initials: A
authors.lastname: Fanidi
authors.forename: David
authors.initials: D
authors.lastname: Muller
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authors.initials: HB
authors.lastname: Bueno-de-Mesquita
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D004032:Diet / Q000009:adverse effects; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009765:Obesity / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D055105:Waist Circumference / Q000502:physiology*; D049629:Waist-Hip Ratio / Q000706:statistics & numerical data*
keywords: body mass index; lung cancer; obesity; smoking; waist circumference; waist to hip ratio; waist-to-height ratio