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Anthropometry and the risk of lung cancer in EPIC

Dewi, Nikmah Utami; Boshuizen, Hendriek C.; Johansson, Mattias; Vineis, Paolo; Kampman, Ellen; Steffen, Annika; Tjønneland, Anne; Halkjær, Jytte; Overvad, Kim and Severi, Gianluca, et al. (2016) In American Journal of Epidemiology 184(2). p.129-139
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,... (More)

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.

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publication status
published
subject
keywords
body mass index, lung cancer, obesity, smoking, waist circumference, waist to hip ratio, waist-to-height ratio
in
American Journal of Epidemiology
volume
184
issue
2
pages
11 pages
publisher
Oxford University Press
external identifiers
  • Scopus:84980335837
ISSN
0002-9262
DOI
10.1093/aje/kwv298
language
English
LU publication?
yes
id
a1cd0ca4-866c-4d9a-898e-0f85597a20ae
date added to LUP
2016-08-15 16:18:07
date last changed
2016-11-14 11:58:13
@misc{a1cd0ca4-866c-4d9a-898e-0f85597a20ae,
  abstract     = {<p>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)<sup>2</sup>) 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.</p>},
  author       = {Dewi, Nikmah Utami and Boshuizen, Hendriek C. and Johansson, Mattias and Vineis, Paolo and Kampman, Ellen and Steffen, Annika and Tjønneland, Anne and Halkjær, Jytte and Overvad, Kim and Severi, Gianluca and Fagherazzi, Guy and Boutron-Ruault, Marie Christine and Kaaks, Rudolf and Li, Kuanrong and Boeing, Heiner and Trichopoulou, Antonia and Bamia, Christina and Klinaki, Eleni and Tumino, Rosario and Palli, Domenico and Mattiello, Amalia and Tagliabue, Giovanna and Peeters, Petra H. and Vermeulen, Roel and Weiderpass, Elisabete and Gram, Inger Torhild and Huerta, José María and Agudo, Antonio and Sánchez, María José and Ardanaz, Eva and Dorronsoro, Miren and Quirós, José Ramón and Sonestedt, Emily and Johansson, Mikael and Grankvist, Kjell and Key, Tim and Khaw, Kay Tee and Wareham, Nick and Cross, Amanda J. and Norat, Teresa and Riboli, Elio and Fanidi, Anouar and Muller, David and Bueno-De-Mesquita, H. Bas},
  issn         = {0002-9262},
  keyword      = {body mass index,lung cancer,obesity,smoking,waist circumference,waist to hip ratio,waist-to-height ratio},
  language     = {eng},
  month        = {07},
  number       = {2},
  pages        = {129--139},
  publisher    = {ARRAY(0xddcb180)},
  series       = {American Journal of Epidemiology},
  title        = {Anthropometry and the risk of lung cancer in EPIC},
  url          = {http://dx.doi.org/10.1093/aje/kwv298},
  volume       = {184},
  year         = {2016},
}