A prospective cohort study of body size and risk of head and neck cancers in the NIH-AARP diet and health study.
A prospective cohort study of body size and risk of head and neck cancers in the NIH-AARP diet and health study.
复制标题
NIH-AARP饮食和健康研究中的体型和头颈癌的风险的前瞻性队列研究。
DOI：
10.1158/1055-9965.epi-14-0709-t
复制
发表时间：
2014-11
期刊：
影响因子：
--
通讯作者：
Abnet CC
中科院分区：
文献类型：
--
作者：
Etemadi A;O'Doherty MG;Freedman ND;Hollenbeck AR;Dawsey SM;Abnet CC
体型与头颈癌（HNCA）之间的关系尚不清楚，部分原因是病例对照研究中的偏倚。在前瞻性NIH-AARP队列研究中，218，854名参与者（132，288名男性和86，566名女性）年龄在50-71岁之间，基线（1995年和1996年）无癌症，并有有效的人体测量数据。考克斯比例风险回归用于检查体型与HNCA之间的关联，调整当前和过去的吸烟习惯，饮酒，教育，种族和水果和蔬菜消费，并报告为风险比（HR）和95%置信区间（CI）。截至2006年12月31日，发生了779例HNCA事件：口腔342例，口咽和下咽120例，喉265例，鼻咽12例，重叠部位40例。HNCA与体重指数呈负相关，几乎只在当前吸烟者中存在（HR=0.76/每增加5个单位; 95%CI：0.63-0.93），并随着最初几年的随访被排除而减少。我们观察到与腰臀比直接相关（HR=1.16每增加0.1单位; 95%CI：1.03-1.31），特别是口腔癌（HR=1.40; 95%CI：1.17-1.67）。身高也与头颈部癌（p=0.02），口咽部癌（p<0.01）直接相关。在目前吸烟者中，头颈部癌症的风险与消瘦呈负相关，与腹部肥胖和身高呈直接相关。我们的研究提供的证据表明，瘦与头颈癌风险之间的联系可能是由于吸烟的影响。
The association between body size and head and neck cancers (HNCA) is unclear, partly because of the biases in case-control studies. In the prospective NIH-AARP cohort study, 218,854 participants (132,288 men and 86,566 women) aged 50–71, were cancer-free at baseline (1995 and 1996), and had valid anthropometric data. Cox proportional hazards regression was used to examine the associations between body size and HNCA, adjusted for current and past smoking habits, alcohol intake, education, race and fruit and vegetable consumption, and reported as hazard ratio (HR) and 95% confidence interval (CI). Until 31 December 2006, 779 incident HNCA occurred: 342 in the oral cavity, 120 in the oro- and hypo-pharynx, 265 in the larynx, 12 in the nasopharynx, and 40 at overlapping sites. There was an inverse association between HNCA and body mass index, which was almost exclusively among current smokers (HR=0.76 per each 5 unit increase; 95%CI: 0.63–0.93), and diminished as initial years of follow-up were excluded. We observed a direct association with waist-to-hip ratio (HR=1.16 per 0.1 unit increase; 95%CI: 1.03–1.31), particularly for cancers of the oral cavity (HR=1.40; 95%CI: 1.17–1.67). Height was also directly associated with total head and neck cancers (p=0.02), and oro-and hypopharyngeal cancers (p<0.01). The risk of head and neck cancers was associated inversely with leanness among current smokers, and directly with abdominal obesity and height. Our study provides evidence that the association between leanness and risk of head and neck cancers may be due to effect modification by smoking.