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Multicenter Study
. 2018 Feb 23;18(1):220.
doi: 10.1186/s12885-018-4124-0.

Body mass index and lung cancer risk: a pooled analysis based on nested case-control studies from four cohort studies

Harinakshi Sanikini  1 , Jian-Min Yuan  2   3 , Lesley M Butler  2   3 , Woon-Puay Koh  4   5 , Yu-Tang Gao  6   7 , Annika Steffen  8 , Mattias Johansson  9 , Paolo Vineis  10 , Gary E Goodman  11 , Matt J Barnett  11 , Rayjean J Hung  12 , Chu Chen  13 , Isabelle Stücker  14
Affiliations
Multicenter Study

Body mass index and lung cancer risk: a pooled analysis based on nested case-control studies from four cohort studies

Harinakshi Sanikini et al. BMC Cancer. .

Abstract

Background: Obesity has been proposed as a potential protective factor against lung cancer. We examined the association between BMI and lung cancer risk in a pooled analysis based on nested case-control studies from four cohort studies.

Methods: A case-control study was nested within four cohorts in USA, Europe, China and Singapore that included 4172 cases and 8471 control subjects. BMI at baseline was calculated as weight in kilograms divided by height in meters squared (kg/m2), and classified into 4 categories: underweight (BMI < 18.5), normal weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30) and obese (≥30). Odds ratios (ORs) and 95% confidence intervals (CIs) for BMI-lung cancer associations were estimated using unconditional logistic regression, adjusting for potential confounders.

Results: Considering all participants, and using normal weight as the reference group, a decreased risk of lung cancer was observed for those who were overweight (OR 0.77, 95% CI: 0.68-0.86) and obese (OR 0.69, 95% CI: 0.59-0.82). In the stratified analysis by smoking status, the decreased risk for lung cancer was observed among current, former and never smokers (P for interaction 0.002). The adjusted ORs for overweight and obese groups were 0.79 (95% CI: 0.68-0.92) and 0.75 (95% CI: 0.60-0.93) for current smokers, 0.70 (95% CI: 0.53-0.93) and 0.55 (95% CI: 0.37-0.80) for former smokers, 0.77 (95% CI: 0.59-0.99), and 0.71 (95% CI: 0.44-1.14) for never smokers, respectively. While no statistically significant association was observed for underweight subjects who were current smokers (OR 1.24, 95% CI: 0.98-1.58), former smokers (OR 0.27, 95% CI: 0.12-0.61) and never smokers (OR 0.83, 95% CI: 0.5.-1.28).

Conclusion: The results of this study provide additional evidence that obesity is associated with a decreased risk of lung cancer. Further biological studies are needed to address this association.

Keywords: Body mass index; Lung cancer; Obesity; Overweight.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the ethics committee of French National Institute of Health and Medical Research (Inserm) (IRB00003888, FWA00005831). All subjects signed a written informed consent form.

Consent for publication

Not Applicable

Competing interests

The authors declared that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Adjusted dose-response association between BMI and risk of lung cancer: (a) All participants (b) Men (c) Women (d) Former smokers (e) Current smokers (f) Never smokers. BMI was coded using an RCS function with four knots arbitrarily located at the 5th, 10th, 20th and 40th percentiles. The y-axis represents the adjusted odds ratio for lung cancer risk for any value of BMI compared to individuals with a BMI of 22.0 kg/m2 (median value of BMI). Dashed lines are 95% CI. Knots are represented by dots
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