title: Body mass index, height and early-onset basal cell carcinoma in a case-control study.
abstract: Basal cell carcinoma (BCC) is the most common malignancy in the US. Body mass index (BMI) and height have been associated with a variety of cancer types, yet the evidence regarding BCC is limited. Therefore, we evaluated BMI and height in relation to early-onset BCC (under age 40) and explored the potential role of ultraviolet (UV) radiation exposure and estrogen-related exposures in the BMI-BCC relationship.
  
  
  
  BCC cases (n=377) were identified through a central dermatopathology facility in Connecticut. Control subjects (n=389) with benign skin conditions were randomly sampled from the same database and frequency matched to cases on age (median=36, interquartile range 33-39), gender, and biopsy site. Participants reported weight (usual adult and at age 18), adult height, sociodemographic, phenotypic, and medical characteristics, and prior UV exposures. We calculated multivariate odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression models.
  
  
  
  Adult BMI was inversely associated with early-onset BCC (obese vs. normal OR=0.43, 95% CI=0.26-0.71). A similar inverse association was present for BMI at age 18 (OR=0.54, 95% CI=0.34-0.85). Excluding UV exposures from the BMI models and including estrogen-related exposures among women only did not alter the association between BMI and BCC, indicating limited mediation or confounding. We did not observe an association between adult height and BCC (OR per cm=1.00, 95% CI=0.98-1.02).
  
  
  
  We found a significant inverse association between BMI and early-onset BCC, but no association between height and BCC. This association was not explained by UV exposures or estrogen-related exposures in women.
authors.affiliation: Yale School of Public Health, New Haven, CT, 06520, United States.
authors.forename: Yanchang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Yale School of Public Health, New Haven, CT, 06520, United States; Yale Cancer Center, New Haven, CT, 06520, United States.
authors.forename: Brenda
authors.initials: B
authors.lastname: Cartmel
authors.affiliation: Yale School of Public Health, New Haven, CT, 06520, United States.
authors.forename: Courtney C
authors.initials: CC
authors.lastname: Choy
authors.affiliation: UCSF Departments of Neurological Surgery and Epidemiology and Biostatistics, San Francisco, CA 94143, United States.
authors.forename: Annette M
authors.initials: AM
authors.lastname: Molinaro
authors.affiliation: Yale Cancer Center, New Haven, CT, 06520, United States; Yale University School of Medicine, New Haven, CT 06520, United States.
authors.forename: David J
authors.initials: DJ
authors.lastname: Leffell
authors.affiliation: Yale Cancer Center, New Haven, CT, 06520, United States; Yale University School of Medicine, New Haven, CT 06520, United States.
authors.forename: Allen E
authors.initials: AE
authors.lastname: Bale
authors.affiliation: Yale School of Public Health, New Haven, CT, 06520, United States; Yale Cancer Center, New Haven, CT, 06520, United States.
authors.forename: Susan T
authors.initials: ST
authors.lastname: Mayne
authors.affiliation: Yale School of Public Health, New Haven, CT, 06520, United States; Yale Cancer Center, New Haven, CT, 06520, United States. Electronic address: leah.ferrucci@yale.edu.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Ferrucci
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012878:Skin Neoplasms / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: Basal cell carcinoma; Body mass index; Epidemiology; Height; Non-melanoma skin cancer