American Association for Cancer Research, Cancer Epidemiology, Biomarkers & Prevention, 3(21), p. 497-503, 2012
DOI: 10.1158/1055-9965.epi-11-0935
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Abstract Background: Results of a pooled analysis of case–control studies show a higher risk of head and neck cancer (HNC) associated with a low body mass index (BMI) and a lower risk associated with being overweight or obese compared with being normal weight. However, these results are prone to bias due to residual confounding by smoking, a strong risk factor, and possible weight loss prior to diagnosis. Using prospectively collected data from the Cancer Prevention Study-II cohort and the Nutrition cohort, we examined the association of BMI with HNC mortality and incidence, overall and by smoking status. Methods: Mortality analyses included 1,383 cases among 1,059,153 participants; incidence analyses included 340 cases among 150,262 participants. Multivariable Cox proportional hazard models were used to estimate HRs and 95% confidence intervals (CI) for the association of BMI with HNC incidence and mortality. Results: Overall, compared with the category of BMI 22.5–24.9 kg/m2, the categories of BMI 25.0–29.9 kg/m2 and ≥30.0 kg/m2 were associated with a lower risk of HNC mortality but not incidence. In never smokers, there were no associations of BMI with HNC incidence or mortality. In smokers, BMI < 22.5 kg/m2 was associated with a higher risk of HNC mortality (HR = 1.42, 95% CI, 1.20–1.67). Conclusions: In this prospective cohort, there was no association between BMI and HNC incidence, although BMI was inversely associated with HNC mortality in smokers. Impact: These suggest that there is no etiologic relationship between BMI and HNC. Cancer Epidemiol Biomarkers Prev; 21(3); 497–503. ©2012 AACR.