Body mass index and risk of head and neck cancer in a pooled analysis of case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium

Methods We pooled data from 17 case-control studies including 12 716 cases and the 17 438 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between body mass index (BMI) at different ages and HNC risk, adjusted for age, sex, centre, race, education, tobacco smoking and alcohol consumption. Results Adjusted ORs (95% CIs) were elevated for people with BMI at reference (date of diagnosis for cases and date of selection for controls) < 18.5 kg/m(2) (2.13, 1.75-2.58) and reduced for BMI > 25.0-30.0 kg/m(2) (0.52, 0.44-0.60) and BMI >= 30 kg/m(2) (0.43, 0.33-0.57), compared with BMI > 18.5-25.0 kg/m(2). These associations did not differ by age, sex, tumour site or control source. Although the increased risk among people with BMI < 18.5 kg/m(2) was not modified by tobacco smoking or alcohol drinking, the inverse association for people with BMI > 25 kg/m(2) was present only in smokers and drinkers. Conclusions In our large pooled analysis, leanness was associated with increased HNC risk regardless of smoking and drinking status, although reverse causality cannot be excluded. The reduced risk among overweight or obese people may indicate body size is a modifier of the risk associated with smoking and drinking. Further clarification may be provided by analyses of prospective cohort and mechanistic studies.

US National Institutes of Health (NIH)

National Cancer Institute (NCI/NIH)[R03CA113157]

Italian Association for Research on Cancer (AIRC)

Swiss League against Cancer[KFS1069-09-2000]

Fribourg League against Cancer[FOR381.88]

Swiss Cancer Research[AKT 617]

Gustave-Roussy Institute[88D28]

Swiss Research against Cancer/Oncosuisse[KFS-700]

Swiss Research against Cancer/Oncosuisse[OCS-1633]

World Cancer Research Fund

European Commission[IC15-CT98-0332]

European Commission[IC18-CT97-0222]

National Institutes of Health (NIH) US[P01CA068384]

National Institutes of Health (NIH) US[K07CA104231]

National Institutes of Health (NIH) US[R01CA048896]

National Institutes of Health (NIH) US[R01DE012609]

National Institutes of Health (NIH) US[R01CA078609]

National Institutes of Health (NIH) US[R01CA100679]

National Institutes of Health (NIH) US[NIDCR R01DE11979]

National Institutes of Health (NIH) US[NIDCR R01DE13110]

National Institutes of Health (NIH) US[NIH FIRCA TW01500]

National Institutes of Health (NIH) US[R01CA61188]

National Institutes of Health (NIH) US[R01DE13158]

National Institutes of Health (NIH) US[P50CA90388]

National Institutes of Health (NIH) US[R01DA11386]

National Institutes of Health (NIH) US[R03CA77954]

National Institutes of Health (NIH) US[T32CA09142]

National Institutes of Health (NIH) US[U01CA96134]

National Institutes of Health (NIH) US[R21ES011667]

National Institutes of Health (NIH) US[R01ES11740]

National Institutes of Health (NIH) US[R01CA100264]

National Institute of Environmental Health Sciences (NIH)[P30ES010126]

National Institutes of Health (NCI/NIH) US

Fondo para la Investigacion Cientifica y Tecnologica (FONCYT) Argentina

IMIM (Barcelona)

Fundacao de Amparo a Pesquisa no Estado de Sao Paulo (FAPESP)[01/01768-2]

Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government - Instituto de Salud Carlos III[FIS 97/0024]

Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government - Instituto de Salud Carlos III[FIS 97/0662]

Fondo de Investigaciones Sanitarias (FIS) of the Spanish Government - Instituto de Salud Carlos III[BAE 01/5013]

International Union Against Cancer (UICC)

YamagiwaYoshida Memorial International Cancer Study Grant

Italian League Against Cancer

Italian Ministry of Research

UCLA Jonsson Comprehensive Cancer Centre

NIDCR