Body mass index, height, weight change, and subsequent lung cancer risk: the Japan Public Health Center-based Prospective Study
Menée à partir des données d'une étude japonaise portant sur 44 158 hommes et 47 940 femmes (durée moyenne de suivi : 19 ans), cette étude analyse l'association entre l'indice de masse corporelle, la taille ou les variations du poids et l'incidence du cancer du poumon (2 152 cas)
Background: BMI is inversely associated with lung cancer risk, while residual confounding by smoking or weight change is controversial. Evidence on height and lung cancer is scarce. Methods: We investigated the associations between anthropometrics, body mass index (BMI) and height, and incidence of lung cancer among 92,098 study subjects (44,158 men and 47,940 women) in the Japan Public Health Center-based Prospective Study. Cox proportional hazards regression was performed with adjustment for potential confounders and by cancer subtypes and smoking status. Information on weight and height was self-reported at baseline, and validated using measured health check-up data. Results: During follow-up between 1990-2013 (average 19.1 years), a total of 2,152 lung cancer cases were newly diagnosed. In a multivariate regression model, lower BMI was positively associated with overall lung cancer risk (<19 kg/m2 HR = 1.48; 95% CI = 1.18-1.85 and 19 to 22.9kg/m2 HR=1.19; 95% CI=1.05-1.35; ptrend = <0.001) in men. The risk estimate was also elevated for adenocarcinoma in the BMI <19kg/m2 category and Squamous cell carcinoma 19-22.9kg/m2 BMI among men. An association was also observed between low BMI, weight decrease and squamous cell carcinoma in women. No significant associations were observed for other weight categories, height, weight change and lung cancer, adenocarcinoma, squamous and small cell carcinoma. Conclusions: Our prospective study suggests that lower BMI may be associated with an increased risk of smoking-related lung cancer in Japan, irrespective of gender. Impact: This study highlights the association between lower BMI and the risk of lung cancer in men.