Body mass index change in adulthood and lung and upper aerodigestive tract cancers

Tarleton, Heather P.; Park, Sungshim Lani; Zhu, Wei; Lee, Yuan Chin Amy; Hashibe, Mia; Morgenstern, Hal; Tashkin, Donald P.; Mao, Jenny T.; Cozen, Wendy; Mack, Thomas M.; Zhang, Zuo‐Feng

doi:10.1002/ijc.27383

Cited by 13 publications

(14 citation statements)

References 43 publications

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“…Similar results have been reported in a population-based case–control study [31]. BMI gain of more than 25% was associated with a lower risk for lung cancer (OR 0.53, 95% CI 0.33-0.84) and UADT cancers (OR 0.44, 95% CI 0.27-0.71), especially in cigarette smokers and alcohol drinkers [31]. In our study, we have found that every 1-kg/m 2 increment in BMI was inversely associated with risk for synchronous esophageal neoplasia (OR 0.87, 95% CI 0.76-0.99) in H&N cancer patients (Table 2).…”

Section: Discussionsupporting

confidence: 91%

Risk factors for second primary neoplasia of esophagus in newly diagnosed head and neck cancer patients: a case–control study

Chung

Liao

et al. 2013

BMC Gastroenterol

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BackgroundThe prevalence of esophageal neoplasia in head and neck (H&N) cancer patients is not low; however, routine esophageal surveillance is not included in staging of newly-diagnosed H&N cancers. We aimed to investigate the risk factors for synchronous esophageal neoplasia and the impact of endoscopy on management of H&N cancer patients.MethodsA total of 129 newly diagnosed H&N cancer patients who underwent endoscopy with white-light imaging, narrow-band imaging (NBI) with magnifying endoscopy (ME), and chromoendoscopy with 1.5% Lugol’s solution, before definite treatment were enrolled prospectively.Results60 esophageal lesions were biopsied from 53 (41.1%) patients, including 11 low-grade, 14 high-grade intraepithelial neoplasia and 12 invasive carcinoma in 30 (23.3%) patients. Alcohol consumption [odds ratio (OR) 5.90, 95% confidence interval (CI) 1.23-26.44], advanced stage (stage III and IV) of index H&N cancers (OR 2.98, 95% CI 1.11-7.99), and lower body mass index (BMI) (every 1-kg/m2 increment with OR 0.87, 95% CI 0.76-0.99) were independent risk factors for synchronous esophageal neoplasia. NBI with ME was the ideal screening tool (sensitivity, specificity, and accuracy of 97.3%, 94.1%, and 96.3%, respectively, for detection of dysplastic and cancerous esophageal lesions). The treatment strategy was modified after endoscopy in 20 (15.5%) patients. The number needed to screen was 6.45 (95% CI 4.60-10.90).ConclusionsNBI-ME surveillance of esophagus should be done in newly-diagnosed H&N cancer patients, especially those with alcohol drinking, lower BMI, and advanced stage of primary tumor.

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Section: Discussionsupporting

confidence: 91%

Risk factors for second primary neoplasia of esophagus in newly diagnosed head and neck cancer patients: a case–control study

Chung

Liao

et al. 2013

BMC Gastroenterol

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“…Regarding the demographic risk factors, we found that ABCs were strong determinants that led to a lower BMI, indicating poor nutritional status. This finding of the inverse association with UADT cancer risk was keeping with previous reports …”

Section: Discussionsupporting

confidence: 93%

“…This finding of the inverse association with UADT cancer risk was keeping with previous reports. 38,39…”

Section: Main Findings Of Our Studymentioning

confidence: 99%

Tag single nucleotide polymorphisms of alcohol-metabolizing enzymes modify the risk of upper aerodigestive tract cancers: HapMap database analysis

et al. 2012

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Although alcohol is associated with higher upper aerodigestive tract (UADT) cancer risk, only a small fraction of alcoholics develop cancers. There is a lack of evidence proving the association of tag single nucleotide polymorphisms of alcohol-metabolizing enzymes with cancer risk. The aim of this study was to determine the association of these genetic polymorphisms with UADT cancer risk in a Chinese population. It was a hospital-based case-control candidate gene study. The databases of the International HapMap Project were searched for haplotype tag single nucleotide polymorphisms of the genes alcohol dehydrogenase (ADH)1B, ADH1C, and aldehyde dehydrogenase (ALDH)2. The genotyping was performed by the Sequenom MassARRAY system. Totally, 120 head and neck squamous cell carcinoma, 138 esophageal squamous cell carcinoma patients, and 276 age- and gender-matched subjects were enrolled between June 2008 and June 2010.Minor alleles of ADH1B (rs1229984) and ALDH2(rs671) were not only associated with the risk of UADT cancers (odds ratio [OR] [95% confidence interval, CI]: 3.53 [2.14-5.80] and 2.59 [1.79-3.75], respectively) but also potentiated the carcinogenic effects of alcohol (OR [95% CI]: 53.44 [25.21-113.29] and 70.08 [33.65-145.95], respectively). Similar effects were observed for head/neck and esophageal cancer subgroups. Multivariate logistic regression analysis identified four significant risk factors, including habitual use of cigarettes, alcohol, betel quid, and lower body mass index (P < 0.001). The haplotypes GAGC (OR 1.61, 95% CI 1.08-2.40, P = 0.018) and CCAATG (OR 1.69, 95% CI 1.24-2.30, P < 0.001) on chromosomes 4 and 12, respectively, were associated with higher cancer risk. These findings suggested that risk allele or haplotype carriers who consume alcohol and other carcinogens should be advised to undergo endoscopy screening. The information can be used to determine the degree of susceptibility of each subject and can be combined with other environmental factors, like carcinogen consumption, in the screening analysis.

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“…[5][6][7]9,35,36 A decrease in BMI since age 20 has also been associated with an elevated risk for lung cancer mortality among current smokers in one study. 37 Similar to ours, these studies had information on weight at two points in time: at study enrollment and during early adulthood.…”

Section: Epidemiologymentioning

confidence: 96%

Body mass index, lifetime smoking intensity and lung cancer risk

El‐Zein

Parent

Nicolau

et al. 2013

Intl Journal of Cancer

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There is as yet no generally accepted explanation for the common finding that low body mass index (BMI) is associated with an increased risk of lung cancer. We investigated this association in a Canadian population-based case-control study (1996)(1997)(1998)(1999)(2000)(2001)(2002) with a particular view to assessing the hypothesis that the observed association was due to residual confounding by smoking. Analyses were based on 1,076 cases and 1,439 controls who provided their height at enrollment and their weight at two points in time, at age 20 and 2 years before enrollment. BMI, in kg/m 2 , was classified into underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9), and obese (30). Smoking history was synthesized into a comprehensive smoking index (CSI) that integrated duration, intensity and time since quitting. Odds ratios (ORs) and 95% confidence intervals (CIs) for BMI-lung cancer associations were estimated, adjusting for CSI as well as several sociodemographic, lifestyle and occupational factors. The normal BMI category was used as the reference. Among those who were underweight at age 20, there was a lower risk of lung cancer (OR 5 0.69, 95% CI: 0.50-0.95). Conversely, lung cancer risk was increased among those who were underweight 2 years before enrollment (OR 5 2.30, 95% CI: 1.30-4.10). The results were almost identical when stratifying analyses based on smoking history into never/lighter and heavier smokers. The inverse association between recent BMI and lung cancer is unlikely to be largely attributable to residual confounding by smoking. Reverse causality or a true relationship between BMI and lung cancer remain plausible.Elevated body mass index (BMI) has been associated with an increased risk of several cancers, including esophageal, pancreatic, colorectal, endometrial, postmenopausal breast, and prostate cancers.1 By contrast, BMI appears to be inversely related to lung cancer risk.2-16 However, the robustness and meaning of this ostensible inverse association has been challenged in some studies by the finding that such an inverse association was not present among nonsmokers. 4,9,10,12 Smoking is both a powerful risk factor for lung cancer, 17 and is also inversely associated with body weight. 18,19 Several explanations have been hypothesized regarding the observed inverse BMI-lung cancer association. First, a methodological argument, according to which residual confounding by smoking accounted for observing an inverse, or disguising a true positive, BMI-lung cancer relation. Second, reverse causality due to pre-clinical effects of lung cancer, especially for studies in which weight was documented shortly before cancer diagnosis. Third, an etiologic explanation, namely through carcinogenic DNA adducts 6 or effects of estrogens. 16 In any case, the interplay between BMI, smoking, and lung cancer remains uncertain.In the context of a large population-based case-control study on the environmental etiology of lung cancer, data on sociodemographic, anthropometric, and lifestyle factors were c...

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Body mass index change in adulthood and lung and upper aerodigestive tract cancers

Cited by 13 publications

References 43 publications

Risk factors for second primary neoplasia of esophagus in newly diagnosed head and neck cancer patients: a case–control study

Risk factors for second primary neoplasia of esophagus in newly diagnosed head and neck cancer patients: a case–control study

Tag single nucleotide polymorphisms of alcohol-metabolizing enzymes modify the risk of upper aerodigestive tract cancers: HapMap database analysis

Body mass index, lifetime smoking intensity and lung cancer risk

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