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PMID: 18483121 Published · ppublish English Journal Article Research Support, N.I.H., Extramural

Body mass index and waist circumference in relation to lung cancer risk in the Women's Health Initiative.

American journal of epidemiology ·Vol. 168 ·No. 2 ·2008-07-15 ·Pages 158-69

Kabat GC, Kim M, Hunt JR, Chlebowski RT, Rohan TE

Abstract

Investigators in several epidemiologic studies have observed an inverse association between body mass index (BMI) and lung cancer risk, while others have not. The authors used data from the Women's Health Initiative to study the association of anthropometric factors with lung cancer risk. Over 8 years of follow-up (1998-2006), 1,365 incident lung cancer cases were ascertained among 161,809 women. Cox proportional hazards models were used to estimate hazard ratios adjusted for covariates. Baseline BMI was inversely associated with lung cancer in current smokers (highest quintile vs. lowest: hazard ratio (HR) = 0.62, 95% confidence interval (CI): 0.42, 0.92). When BMI and waist circumference were mutually adjusted, BMI was inversely associated with lung cancer risk in both current smokers and former smokers (HR = 0.40 (95% CI: 0.22, 0.72) and HR = 0.61 (95% CI: 0.40, 0.94), respectively), and waist circumference was positively associated with risk (HR = 1.56 (95% CI: 0.91, 2.69) and HR = 1.50 (95% CI: 0.98, 2.31), respectively). In never smokers, height showed a borderline positive association with lung cancer. These findings suggest that in smokers, BMI is inversely associated with lung cancer risk and that waist circumference is positively associated with risk.

MeSH Terms
Abdomen/anatomy & histology Adiposity Aged Body Height Body Mass Index Body Weight Female Humans Incidence Lung Neoplasms/epidemiology,etiology Middle Aged Multivariate Analysis Proportional Hazards Models Risk Factors Smoking/adverse effects,epidemiology United States/epidemiology Waist-Hip Ratio
Authors & Affiliations
5 authors, click to expand affiliations / ORCID
Kabat Geoffrey C
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461, USA. gkabat@aecom.yu.edu
Kim Mimi
Hunt Julie R
Chlebowski Rowan T
Rohan Thomas E
References (51)
51 references, click to expand
  1. Effect of smoking on the paradox of high waist-to-hip ratio and low body mass index.
    Obes Res. 2002 Sep;10(9):891-5 PMID: 12226137
  2. Response error in self-reported current smoking frequency by black and white established smokers.
    Ann Epidemiol. 1996 Nov;6(6):483-9 PMID: 8978878
  3. Height, weight and mortality. The Norwegian experience.
    Acta Med Scand Suppl. 1984;679:1-56 PMID: 6585126
  4. Body mass index as a predictor of cancer in men.
    J Natl Cancer Inst. 1985 Feb;74(2):319-23 PMID: 3856045
  5. Body fat distribution in relation to physical activity and smoking habits in 38-year-old European men. The European Fat Distribution Study.
    Am J Epidemiol. 1991 Feb 1;133(3):257-65 PMID: 2000843
  6. The association between benzo[a]pyrene-DNA adducts and body mass index, calorie intake and physical activity.
    Biomarkers. 2007 Mar-Apr;12(2):123-32 PMID: 17536763
  7. Relation of body size and the risk of lung cancer.
    Nutr Cancer. 1993;20(2):179-86 PMID: 8233983
  8. Esophageal cancer and body mass index: results from a prospective study of 220,000 men in China and a meta-analysis of published studies.
    Int J Cancer. 2008 Apr 1;122(7):1604-10 PMID: 18059032
  9. Body weight and mortality: what is the shape of the curve?
    Epidemiology. 1998 May;9(3):227-8 PMID: 9583410
  10. Diet, metabolic polymorphisms and dna adducts: the EPIC-Italy cross-sectional study.
    Int J Cancer. 2000 Aug 1;87(3):444-51 PMID: 10897053
  11. Body mass index and the risk of male cancer mortality of various sites: 17-year follow-up of the Basel cohort study.
    Swiss Med Wkly. 2005 Jan 8;135(1-2):27-33 PMID: 15662577
  12. Outcomes ascertainment and adjudication methods in the Women's Health Initiative.
    Ann Epidemiol. 2003 Oct;13(9 Suppl):S122-8 PMID: 14575944
  13. Diet, smoking, social class, and body mass index in the Caerphilly Heart Disease Study.
    Am J Clin Nutr. 1984 Oct;40(4):827-33 PMID: 6486090
  14. Body mass index, waist girth, and waist-to-hip ratio as indexes of total and regional adiposity in women: evaluation using receiver operating characteristic curves.
    Am J Clin Nutr. 1998 Jan;67(1):44-9 PMID: 9440374
  15. Re: "Body mass index and lung cancer risk".
    Am J Epidemiol. 1992 Dec 1;136(11):1417-9 PMID: 1488969
  16. Body mass index and lung cancer: a case-control study of subjects participating in a mass-screening program.
    Chest. 2005 Sep;128(3):1490-6 PMID: 16162748
  17. Measurement of self reported active exposure to cigarette smoke.
    J Epidemiol Community Health. 2001 Sep;55(9):674-80 PMID: 11511648
  18. Polycyclic aromatic hydrocarbons in human fat and liver.
    Bull Environ Contam Toxicol. 1981 Jul;27(1):23-7 PMID: 7296033
  19. Are lean smokers at increased risk of lung cancer? The Israel Civil Servant Cancer Study.
    Arch Intern Med. 1995 Dec 11-25;155(22):2409-16 PMID: 7503599
  20. Fatness and mortality in the West of Scotland.
    Am J Clin Nutr. 1983 Aug;38(2):313-9 PMID: 6881085
  21. Design of the Women's Health Initiative clinical trial and observational study. The Women's Health Initiative Study Group.
    Control Clin Trials. 1998 Feb;19(1):61-109 PMID: 9492970
  22. Smoking and its effects on body weight and the systems of caloric regulation.
    Am J Clin Nutr. 1982 Feb;35(2):366-80 PMID: 7039293
  23. The Women's Health Initiative Observational Study: baseline characteristics of participants and reliability of baseline measures.
    Ann Epidemiol. 2003 Oct;13(9 Suppl):S107-21 PMID: 14575943
  24. Associations between smoking and body weight in the US population: analysis of NHANES II.
    Am J Public Health. 1987 Apr;77(4):439-44 PMID: 3493709
  25. The role of tobacco, alcohol use, and body mass index in oral and pharyngeal cancer.
    Int J Epidemiol. 1994 Dec;23(6):1137-44 PMID: 7721514
  26. Cause-specific excess deaths associated with underweight, overweight, and obesity.
    JAMA. 2007 Nov 7;298(17):2028-37 PMID: 17986696
  27. A prospective study of weight, body mass index and other anthropometric measurements in relation to site-specific cancers.
    Int J Cancer. 1994 May 1;57(3):313-7 PMID: 8168989
  28. Differential association of body mass index and fat distribution with three major histologic types of lung cancer: evidence from a cohort of older women.
    Am J Epidemiol. 2002 Oct 1;156(7):606-15 PMID: 12244029
  29. Association of body mass index and body fat distribution with risk of lung cancer in older women.
    Am J Epidemiol. 1995 Sep 15;142(6):600-7 PMID: 7653468
  30. A comparison of nicotine dose estimates in smokers between filter analysis, salivary cotinine, and urinary excretion of nicotine metabolites.
    Psychopharmacology (Berl). 2006 Dec;189(3):345-54 PMID: 17028908
  31. Body mass index modulates aromatic DNA adduct levels and their persistence in smokers.
    Cancer Epidemiol Biomarkers Prev. 2002 Aug;11(8):790-3 PMID: 12163336
  32. Leanness and lung-cancer risk.
    Int J Cancer. 1991 Sep 9;49(2):208-13 PMID: 1879966
  33. Leanness and lung cancer risk: fact or artifact?
    Epidemiology. 2002 May;13(3):268-76 PMID: 11964927
  34. Dietary habits and lung cancer risk among non-smoking women.
    Eur J Cancer Prev. 2004 Dec;13(6):471-80 PMID: 15548939
  35. Studies in the distribution of body fat. III. Effects of cigarette smoking.
    JAMA. 1989 Feb 24;261(8):1169-73 PMID: 2915440
  36. Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat.
    Am J Clin Nutr. 2002 Apr;75(4):683-8 PMID: 11916754
  37. DNA adducts as markers of exposure to carcinogens and risk of cancer.
    Int J Cancer. 2000 Nov 1;88(3):325-8 PMID: 11054658
  38. Relationships between cigarette smoking, body size and body shape.
    Int J Obes (Lond). 2005 Feb;29(2):236-43 PMID: 15505632
  39. Obesity in relation to smoking: a population study of women in Göteborg, Sweden.
    Prev Med. 1980 Jul;9(4):534-43 PMID: 7403022
  40. Cigarette smoking and fat distribution in 21,828 British men and women: a population-based study.
    Obes Res. 2005 Aug;13(8):1466-75 PMID: 16129730
  41. Body mass index and lung cancer risk.
    Am J Epidemiol. 1992 Apr 1;135(7):769-74 PMID: 1595676
  42. Is residual confounding a reasonable explanation for the apparent protective effects of beta-carotene found in epidemiologic studies of lung cancer in smokers?
    Am J Epidemiol. 2002 Apr 1;155(7):622-8 PMID: 11914189
  43. Implementation of the Women's Health Initiative study design.
    Ann Epidemiol. 2003 Oct;13(9 Suppl):S5-17 PMID: 14575938
  44. Relation between body mass index and lung cancer risk in men and women never and former smokers.
    Am J Epidemiol. 2000 Sep 15;152(6):506-13 PMID: 10997540
  45. Obesity and mortality in a prospective study of a middle-aged industrial population.
    J Occup Environ Med. 2006 Jan;48(1):22-7 PMID: 16404206
  46. Lifestyle correlates of anthropometric estimates of body adiposity in an Italian middle-aged and elderly population: a covariance analysis.
    Int J Obes (Lond). 2006 Jun;30(6):926-34 PMID: 16432539
  47. Leanness as early marker of cancer of the oral cavity and pharynx.
    Ann Oncol. 2001 Mar;12(3):331-6 PMID: 11332144
  48. Body mass index and lung cancer risk in women.
    Epidemiology. 2007 Sep;18(5):607-12 PMID: 17879428
  49. Variations in mortality by weight among 750,000 men and women.
    J Chronic Dis. 1979;32(8):563-76 PMID: 468958
  50. Total energy intake: implications for epidemiologic analyses.
    Am J Epidemiol. 1986 Jul;124(1):17-27 PMID: 3521261
  51. Racial differences in exposure and glucuronidation of the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK).
    Cancer. 2005 Apr 1;103(7):1420-6 PMID: 15726545
Article Info
Journal
American journal of epidemiology
Abbr.
Am J Epidemiol
ISSN
1476-6256
DOI
10.1093/aje/kwn109
Email
gkabat@aecom.yu.edu
Published
2008-07-15
Epub
2008-00-15
Pages
158-69
Language
English
Region
United States
NLM ID
7910653
PMCID
PMC2878097
Subset
IM
External Links
PubMed source DOI: 10.1093/aje/kwn109 PMC Full Text View journal details
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