Measured Adiposity in Relation to Head and Neck Cancer Risk in the European Prospective Investigation into Cancer and Nutrition.
Background:Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer. However, most studies have used self-reported anthropometry which is prone to error.Methods:Among 363,094 participants in the European Prospective Investigation into Cancer and Nutrition study (EPIC) with measured anthropometry, there were 837 incident cases of head and neck cancer. Head and neck cancer risk was examined in relation to body mass index (BMI) [lean: <22.5 kg/m2, normal weight (reference): 22.5-24.9 kg/m2, overweight 25-29.9 kg/m2, obese: ≥30 kg/m2], waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) using Cox proportional hazards models.Results:Among men, a BMI < 22.5 kg/m2was associated with higher head and neck cancer risk [HR 1.62; 95% confidence interval (CI), 1.23-2.12)]; BMI was not associated with head and neck cancer among women. WC and WHR were associated with greater risk of head and neck cancer among women (WC per 5 cm: HR, 1.08; 95% CI, 1.02-1.15; WHR per 0.1 unit: HR, 1.64; 95% CI, 1.38-1.93). After stratification by smoking status, the association for WHR was present only among smokers (Pinteraction= 0.004). Among men, WC and WHR were associated with head and neck cancer only upon additional adjustment for BMI (WC per 5 cm: HR 1.16; 95% CI, 1.07-1.26; WHR per 0.1 unit: HR, 1.42; 95% CI, 1.21-1.65).Conclusions:Central adiposity, particularly among women, may have a stronger association with head and neck cancer risk than previously estimated.Impact:Strategies to reduce obesity may beneficially impact head and neck cancer incidence.Cancer Epidemiol Biomarkers Prev; 26(6); 895-904. ©2017 AACR.
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom. heather.ward@imperial.ac.uk.
Heather A
HA
Ward
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom.
Petra A
PA
Wark
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom.
David C
DC
Muller
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
Annika
A
Steffen
International Agency for Research on Cancer (IARC-WHO), Lyon, Cedex, France.|Department of Biobank Research, Umeå University, Umeå, Sweden.
Mattias
M
Johansson
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom.
Teresa
T
Norat
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom.|International Agency for Research on Cancer (IARC-WHO), Lyon, Cedex, France.
Marc J
MJ
Gunter
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.|Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Kim
K
Overvad
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
Christina C
CC
Dahm
Danish Cancer Society Research Centre, Diet, Genes and Environment, Copenhagen, Denmark.
Jytte
J
Halkjær
Danish Cancer Society Research Centre, Diet, Genes and Environment, Copenhagen, Denmark.
Anne
A
Tjønneland
Université Paris-Saclay, Univ. Paris-Sud, UVSQ, INSERM, CESP, Generations and Health, Villejuif, France.|Gustave Roussy, Villejuif, France.
Marie-Christine
MC
Boutron-Ruault
Université Paris-Saclay, Univ. Paris-Sud, UVSQ, INSERM, CESP, Generations and Health, Villejuif, France.|Gustave Roussy, Villejuif, France.
Guy
G
Fagherazzi
Université Paris-Saclay, Univ. Paris-Sud, UVSQ, INSERM, CESP, Generations and Health, Villejuif, France.|Gustave Roussy, Villejuif, France.
Sylvie
S
Mesrine
International Agency for Research on Cancer (IARC-WHO), Lyon, Cedex, France.
Paul
P
Brennan
International Agency for Research on Cancer (IARC-WHO), Lyon, Cedex, France.
Heinz
H
Freisling
International Agency for Research on Cancer (IARC-WHO), Lyon, Cedex, France.
Kuanrong
K
Li
Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany.
Rudolf
R
Kaaks
Hellenic Health Foundation, Athens, Greece.|Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.
Antonia
A
Trichopoulou
Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.|Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.|Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
Pagona
P
Lagiou
Department of Clinical Medicine and Surgery, Section of Endocrinology, Federico II University, Naples, Italy.
Salavatore
S
Panico
Epidemiology and Prevention Unit, Fondazione IRCCS National Cancer Institute, Milano, Italy.
Sara
S
Grioni
Cancer Registry and Histopathology Unit, Civic-M.P.Arezzo Hospital, Contrada Rito, ASP Ragusa, Italy.
Rosario
R
Tumino
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom.|HuGeF Foundation, Torino, Italy.
Paolo
P
Vineis
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute ISPO, Florence, Italy.
Domenico
D
Palli
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom.|Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands.
Petra H M
PHM
Peeters
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom.|National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
H Bas
HB
Bueno-de-Mesquita
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.|Cancer Registry of Norway-Institute of Population-Based Cancer Research, Oslo, Norway.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.|Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
Elisabete
E
Weiderpass
Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain.
Antonio
A
Agudo
Public Health Directorate, Asturias, Spain.
Jose Ramón
JR
Quirós
Public Health Division of Gipuzkoa-BIODONOSTIA, Basque Regional Health Department, Donostia, Spain.|CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Nerea
N
Larrañaga
CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Navarre Public Health Institute, Pamplona, Spain.
Eva
E
Ardanaz
CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
José María
JM
Huerta
CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Andalucian School of Public Health, Research Institute Biosanitary Granada, Universitario de Cartuja, Granada, Spain.
María-José
MJ
Sánchez
Department of Surgical Sciences, Uppsala University, University Hospital, Uppsala, Sweden.
Göran
G
Laurell
Department of Odontology, Umeå University, Umeå, Sweden.
Ingegerd
I
Johansson
Ear Nose and Throat Department, Lund University, Department of Otorhinolaryngology, University Hospital, Malmö, Sweden.
Ulla
U
Westin
Nutrition Epidemiology Research Group, Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
Peter
P
Wallström
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Kathryn E
KE
Bradbury
MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom.
Nicholas J
NJ
Wareham
University of Cambridge, Clinical Gerontology Unit, Addenbrooke's Hospital, Cambridge, United Kingdom.
Kay-Tee
KT
Khaw
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom.|Cancer Research UK/Public Health England, London, United Kingdom.
Clare
C
Pearson
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
Heiner
H
Boeing
School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom.
Elio
E
Riboli
D050154:Adiposity / Q000208:ethnology*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D012307:Risk Factors; D044465:White People