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Obesity in relation to lung cancer incidence in African American women

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Abstract

Purpose

Although a number of studies have found an inverse association between body mass index (BMI) and risk of lung cancer, there is little information on this relation in African Americans, who experience a higher incidence of lung cancer.

Methods

We assessed the relation of BMI to incidence of lung cancer in the Black Women’s Health Study, an ongoing prospective follow-up of 59,000 women in the USA. Cox proportional hazard models were used to estimate hazard ratios for various levels of BMI relative to BMI 18.5–24.9 kg/m2 (“normal weight”) with adjustment for age, education, pack-years of smoking, and other covariates. Two other anthropometric measures, waist circumference (WC) and waist/hip ratio (WHR), were also assessed. A total of 323 primary lung cancer cases were identified from 1995 to 2011.

Results

The hazard ratio (HR) for BMI ≥30 relative to BMI 18.5–24.9 was 0.69 (95 % CI 0.51–0.92). As expected, cigarette smoking was strongly associated with increased risk of lung cancer. In analyses stratified by smoking status, the HR for BMI ≥30 relative to BMI 18.5–24.9 was 0.62 (0.38–1.00) among current smokers, 0.90 (0.56–1.42) among former smokers, and 0.83 (0.41–1.70) among never smokers (p for interaction = 0.28). Control for pack-years of smoking or age started smoking had little effect on the hazard ratios. WC and WHR were not materially associated with lung cancer risk.

Conclusion

Our results indicate that high BMI is associated with a lower risk of lung cancer in African American women, particularly among current smokers.

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Acknowledgments

This research was supported by a research grant from the US National Cancer Institute (R01CA058420). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Data on lung cancer pathology were obtained from several state cancer registries (Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia), and the results reported do not necessarily represent their views. The authors would like to thank the Black Women’s Health Study participants and staff. We also thank Deborah Boggs and Meghan O’Connor for assistance with statistical analyses and data cleaning.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Slone Epidemiology Center, Boston University, 1010 Commonwealth Avenue, Boston, MA, 02215, USA

    Traci N. Bethea, Lynn Rosenberg & Julie R. Palmer

  2. Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA

    Marjory Charlot & George T. O’Connor

  3. Georgetown Lombardi Comprehensive Cancer Center, 3800 Reservoir Road, N.W., Washington, DC, 20007, USA

    Lucile L. Adams-Campbell

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  1. Traci N. Bethea
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Correspondence to Traci N. Bethea.

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Bethea, T.N., Rosenberg, L., Charlot, M. et al. Obesity in relation to lung cancer incidence in African American women. Cancer Causes Control 24, 1695–1703 (2013). https://doi.org/10.1007/s10552-013-0245-6

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