Anthropometry and head and neck cancer: A pooled analysis of cohort data

Mia M Gaudet, Cari M. Kitahara, Christina C. Newton, Leslie Bernstein, Peggy Reynolds, Elisabete Weiderpass, Aimée R. Kreimer, Gong Yang, Hans Olov Adami, Michael C. Alavanja, Laura E. Beane Freeman, Heiner Boeing, Julie E Buring, Anil Chaturvedi, Yu Chen, Aimee A. D'Aloisio, Michal Freedman, Yu-Tang Gao, J. Michael Gaziano, Graham G. GilesNiclas Håkansson, Wen Yi Huang, I-Min Lee, Martha S. Linet, Robert J. MacInnis, Yikyung Park, Anna Prizment, Mark P. Purdue, Elio B Riboli, Kim Robien, Dale P. Sandler, Catherine Schairer, Howard D. Sesso, Xiao-Ou Shu, Emily White, Alicja Wolk, Yong-Bing Xiang, Anne Zelenuich-Jacquotte, Wei Zheng, Alpa V. Patel, Patricia Hartge, Amy Berrington De González, Susan M. Gapstur

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30 Citations (Scopus)


Background: Associations between anthropometry and head and neck cancer (HNC) risk are inconsistent. We aimed to evaluate these associations while minimizing biases found in previous studies. Methods: We pooled data from 1 941 300 participants, including 3760 cases, in 20 cohort studies and used multivariable-adjusted Cox proportional hazard regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of anthropometric measures with HNC risk overall and stratified by smoking status. Results: Greater waist circumference (per 5cm: HR = 1.04, 95% CI 1.03-1.05, P-value for trend = < 0.0001) and waist-to-hip ratio (per 0.1 unit: HR = 1.07, 95% CI 1.05-1.09, P-value for trend = < 0.0001), adjusted for body mass index (BMI), were associated with higher risk and did not vary by smoking status (P-value for heterogeneity = 0.85 and 0.44, respectively). Associations with BMI (P-value for interaction = < 0.0001) varied by smoking status. Larger BMI was associated with higher HNC risk in never smokers (per 5 kg/m2: HR = 1.15, 95% CI 1.06-1.24, P-value for trend = 0.0006), but not in former smokers (per 5 kg/m2: HR = 0.99, 95% CI 0.93-1.06, P-value for trend = 0.79) or current smokers (per 5 kg/m2: HR = 0.76, 95% CI 0.71-0.82, P-value for trend = < 0.0001). Larger hip circumference was not associated with a higher HNC risk. Greater height (per 5cm) was associated with higher risk of HNC in never and former smokers, but not in current smokers. Conclusions: Waist circumference and waist-to-hip ratio were associated positively with HNC risk regardless of smoking status, whereas a positive association with BMI was only found in never smokers.

Original languageEnglish
Pages (from-to)673-681
Number of pages9
JournalInternational Journal of Epidemiology
Issue number2
Publication statusPublished - 6 Jun 2015
Externally publishedYes


  • Head and neck neoplasms
  • Obesity
  • Smoking
  • Waist circumference
  • Waist-hip ratio

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