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 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 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

Research output: Contribution to journalArticlepeer-review


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 (US)
Pages (from-to)673-681
Number of pages9
JournalInternational Journal of Epidemiology
Issue number2
StatePublished - May 27 2015


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

ASJC Scopus subject areas

  • Epidemiology


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