Annals of Oncology 12:331-336, 2001
© 2001 European Society for Medical Oncology
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Leanness as early marker of cancer of the oral cavity and pharynx
1Servizio di Epidemiologia, Centro di Riferimento Oncologico Aviano (PN), Italy
2Institut Universitaire de Médicine Sociale et Préventive, Registre Vaudois des Tumeurs Lausanne, Switzerland
3Servizio di Epidemiologia e Oncogenesi, Istituto Regina Elena Rome
4Istituto di Ricerche Farmacologiche ‘Mario Negri’ Milan, Italy
5Istituto di Statistica Medica e Biometria, Universitá di Milano Milan, Italy
Correspondence to:Dr S. Franceschi, Field and Intervention Studies Unit, International Agency for Research on Cancer, 150 cours Albert-Thomas, 69732 Lyon Cedex 08, France
Background: It is not clear whether the purported association of leanness with cancer of the oral cavity and pharynx was due to cancer-related weight loss or to the influence of factors associated with leanness.
Patients and methods: Seven hundred fifty-four incident cases of cancers of the oral cavity and pharynx and 1775 controls, admitted to hospital for acute, non-neoplastic diseases, in Italy and Switzerland. Questionnaire included height, lifetime history of weight and of physical activity, waist and hip measurements, and a validated food-frequency section.
Results: Leanness at diagnosis was associated with elevated risk in men (adjusted odds ratio, OR for 5-unit decrease in body-mass index, BMI = 1.9; 95% confidence interval (CI): 1.6–2.2 in men). Male cases were significantly leaner than control subjects at the age of 30 and of 50. Thinner women also had an increased risk, but the inverse association with BMI was non linear. In both sexes, the association with leanness was restricted to smokers and moderate/heavy drinkers, but was not accounted for by drinking and smoking habits, nor by differences in physical activity or dietary habits.
Conclusions: Leanness appears to be an early marker of some unknown biological effect of smoking and/or of alcohol abuse, which may contribute to the prediction of cancers of the oral cavity and pharynx. Cessation of smoking and substantial reduction of alcohol intake may improve nutritional status, besides stopping carcinogen exposure.
body mass index, drinking, oral cancer, pharyngeal cancer, smoking
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