Anthropometry and the Risk of Lung Cancer in EPIC

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Title: Anthropometry and the Risk of Lung Cancer in EPIC
Authors: Dewi, NU
Boshuizen, HC
Johansson, M
Vineis, P
Kampman, E
Steffen, A
Tjønneland, A
Halkjær, J
Overvad, K
Severi, G
Fagherazzi, G
Boutron-Ruault, MC
Kaaks, R
Li, K
Boeing, H
Trichopoulou, A
Bamia, C
Klinaki, E
Tumino, R
Palli, D
Mattiello, A
Tagliabue, G
Peeters, PH
Vermeulen, R
Weiderpass, E
Torhild Gram, I
Huerta, JM
Agudo, A
Sánchez, MJ
Ardanaz, E
Dorronsoro, M
Quirós, JR
Sonestedt, E
Johansson, M
Grankvist, K
Key, T
Khaw, KT
Wareham, N
Cross, AJ
Norat, T
Riboli, E
Fanidi, A
Muller, D
Bueno-de-Mesquita, HB
Item Type: Journal Article
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.
Issue Date: 1-Jul-2016
Date of Acceptance: 22-Oct-2015
ISSN: 1476-6256
Publisher: Oxford University Press
Start Page: 129
End Page: 139
Journal / Book Title: American Journal of Epidemiology
Volume: 184
Issue: 2
Copyright Statement: © 2015 Oxford University Press. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in American Journal of Epidemiology following peer review. The definitive publisher-authenticated version is available online at:
Sponsor/Funder: Imperial College Trust
Funder's Grant Number: P47328
Keywords: Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
body mass index
lung cancer
waist circumference
waist to hip ratio
waist-to-height ratio
11 Medical And Health Sciences
01 Mathematical Sciences
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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