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Obesity and head and neck cancer risk and survival by human papillomavirus serology

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Abstract

Purpose

Previous studies examining the association of body mass index (BMI) with risk of and survival from head and neck squamous cell carcinoma (HNSCC) have been inconsistent, although an inverse association has been noted for obesity and risk of HNSCC in several studies. Previous studies have not examined whether these associations differ by human papillomavirus (HPV) status.

Methods

We utilized the resources of a population-based case–control study of HNSCC from the greater Boston area (959 cases and 1,208 controls were eligible for this analysis). Anthropometric history was collected through personal interviews, and HPV status was assessed using serology. We analyzed the association between BMI (assessed 5 years prior to disease incidence) and disease risk and survival using logistic regression and Cox proportional hazards regression, respectively.

Results

After adjusting for known risk factors, the association between obesity and overall risk of HNSCC was not significant (OR 0.79, 95 % CI 0.60–1.04). However, obesity (BMI ≥30 kg/m2) was inversely associated with HNSCC risk among HPV-seronegative cases (OR 0.48, 95 % CI 0.32–0.70), but not among HPV-seropositive cases (OR 0.91, 95 % CI 0.68–1.21). BMI was not associated with survival overall or by HPV status. However, being overweight (BMI 25–29.9 kg/m2) was associated with longer survival among HPV-seropositive smokers (HR 0.48, 95 % CI 0.31–0.74).

Conclusions

Our findings are consistent with previous observations that obesity is inversely associated with the risk of HNSCC; however, this association appears to be confined to HPV-seronegative cases. Overall, obesity was not associated with HNSCC survival overall or by HPV status.

Impact

Obesity is associated with risk of non-HPV HNSCC, but not HPV HNSCC.

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Acknowledgments

NIH [CA078609, CA100679] and Flight Attendants Medical Research Institute.

Conflict of interest

Authors have no potential conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Brown University School of Public Health, 121 S. Main St, 2nd Floor, Providence, RI, 02912, USA

    Xinmiao Tan, Karl T. Kelsey & Dominique S. Michaud

  2. Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA

    Heather H. Nelson

  3. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA

    Heather H. Nelson

  4. Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Scott M. Langevin

  5. Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA

    Michael McClean

  6. Department of Pharmacology and Toxicology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Carmen J. Marsit

  7. Research Program Infection and Cancer, German Cancer Research Center, DKFZ, Heidelberg, Germany

    Tim Waterboer & Michael Pawlita

  8. Department of Pathology and Laboratory Medicine, Brown University School of Medicine, Providence, RI, USA

    Karl T. Kelsey

  9. School of Public Health, Imperial College London, London, UK

    Dominique S. Michaud

Authors
  1. Xinmiao Tan
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  2. Heather H. Nelson
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  3. Scott M. Langevin
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  4. Michael McClean
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  6. Tim Waterboer
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  7. Michael Pawlita
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  8. Karl T. Kelsey
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  9. Dominique S. Michaud
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Corresponding author

Correspondence to Dominique S. Michaud.

Additional information

Karl T. Kelsey and Dominique S. Michaud: Shared senior authorship.

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Tan, X., Nelson, H.H., Langevin, S.M. et al. Obesity and head and neck cancer risk and survival by human papillomavirus serology. Cancer Causes Control 26, 111–119 (2015). https://doi.org/10.1007/s10552-014-0490-3

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  • DOI: https://doi.org/10.1007/s10552-014-0490-3

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