Measured adiposity in relation to head and neck cancer risk in the European Prospective Investigation into Cancer and Nutrition

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BACKGROUND: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer (HNC). 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 HNC. HNC 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/m2 was associated with higher HNC risk [hazard ratio (HR) 1.62, 95% confidence interval (CI) 1.23 - 2.12)]; BMI was not associated with HNC among women. WC and WHR were associated with greater risk of HNC 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 (p interaction 0.004). Among men, WC and WHR were associated with HNC 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).

CONCLUSION: Central adiposity, particularly among women, may have a stronger association with HNC risk than previously estimated.

IMPACT: Strategies to reduce obesity may beneficially impact HNC incidence.


  • Heather A. Ward
  • Petra A. Wark
  • David C Muller
  • Annika Steffen
  • Mattias Johansson
  • Teresa Norat
  • Marc J. Gunter
  • Kim Overvad
  • Christina Dahm
  • Jytte Halkjær
  • Anne Tjønneland
  • Marie-Christine Boutron-Ruault
  • Guy Fagherazzi
  • Sylvie Mesrine
  • Paul Brennan
  • Heinz Freisling
  • Kuanrong Li
  • Rudolf Kaaks
  • Antonia Trichopoulou
  • Pagona Lagiou
  • Salvatore Panico
  • Sara Grioni
  • Rosario Tumino
  • Paolo Vineis
  • Domenico Palli
  • Petra H. M. Peeters
  • H. Bas Bueno-de-Mesquita
  • Elisabete Weiderpass
  • Antonio Agudo
  • Jose Ramon Quiros
  • Nerea Larrañaga
  • Eva Ardanaz
  • José María Huerta
  • María-José Sánchez
  • Goran Laurell
  • Ingegerd Johansson
  • Kathryn E Bradbury
  • Nicholas J Wareham
  • Kay Tee Khaw
  • Clare Pearson
  • Heiner Boeing
  • Elio Riboli
Enheter & grupper
Externa organisationer
  • German Institute of Human Nutrition
  • International Agency for Research on Cancer, World Health Organization
  • Danish Cancer Society Research Center
  • Istituto Nazionale dei Tumori
  • Civic and M.P.Arezzo Hospital
  • Cancer Research and Prevention Institute
  • Catalan Institute of Oncology
  • Public Health Directorate
  • Instituto BIO-Donostia
  • Health Research Institute of Navarra (IDISNA)
  • Andalucian School of Public Health
  • University of Cambridge
  • Addenbrooke's Hospital
  • Imperial College London
  • Aarhus University
  • University of Paris-Saclay
  • German Cancer Research Centre
  • Academy of Athens
  • University of Naples Federico II
  • UiT The Arctic University of Norway, Tromsø
  • Uppsala University Hospital
  • Umeå University
  • Skåne University Hospital
  • University of Oxford

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Cancer och onkologi
  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Sidor (från-till)895-904
TidskriftCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Tidigt onlinedatum2017 feb 9
StatusPublished - 2017
Peer review utfördJa