Abstract
Whether the association between body size or shape and nasopharyngeal carcinoma (NPC) risk exists or varies by age‐specific body size indicators is unclear. In a population‐based case–control study conducted in Southern China between 2010 and 2014, self‐reported height, weight, and body shape at age 20 and 10 years before interview were collected from 2448 histopathologically confirmed NPC cases and 2534 population‐based controls. Body mass index (BMI) was categorized according to the World Health Organization guidelines for Asian populations: underweight (<18.5 kg/m2), normal weight (18.5‐22.9 kg/m2), overweight (23.0‐27.4 kg/m2), and obese (≥27.5 kg/m2). Multivariate odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression. Furthermore, restricted cubic spline analysis was employed to examine nonlinear effects of BMI and body shape as continuous covariates. Underweight vs normal weight at age 20 years was associated with a 22% decreased NPC risk (OR, 0.78; 95% CI, 0.67, 0.90), whereas obesity was not significantly associated with NPC risk. Associations with BMI 10 years before the interview were similar. Having the leanest body shape at age 20 years, compared with the mode was not significantly associated with NPC risk (OR, 0.85; 95% CI, 0.62, 1.16), but having a larger body shape was associated with an elevated risk (OR, 1.25; 95% CI, 1.03, 1.52). Increasing BMI revealed positive trends with NPC risk. Despite some indication of significant findings, evidence for a strong association between BMI or body shape and NPC risk is still limited.
Highlights
Nasopharyngeal carcinoma (NPC) contributes relatively higher cancer burden in Southeast Asia, North Africa, the Arctic, and the Southern China than other areas in the world.[1,2] A growing number of studies suggest that the etiology of NPC is influenced by an interplay of genetics, Epstein–Barr virus (EBV) infection, and environmental factors.[3-5]
To the best of our knowledge, our study is the first to assess the associations of both body mass index (BMI) and body shape with risk of NPC, as well as the first population‐based case‐control study of either association
We found that being underweight at age 20 or 10 years prior to interview was significantly associated with a decreased risk of NPC, with a suggestion of a positive trend between increasing BMI and risk of NPC
Summary
Nasopharyngeal carcinoma (NPC) contributes relatively higher cancer burden in Southeast Asia, North Africa, the Arctic, and the Southern China than other areas in the world.[1,2] A growing number of studies suggest that the etiology of NPC is influenced by an interplay of genetics, Epstein–Barr virus (EBV) infection, and environmental factors.[3-5]. Because lower BMI predicts a worse NPC prognosis,[13-16] and weight loss may be a preclinical symptom of NPC, it is more appropriate to examine NPC risk in relation to body size in prospective studies with long follow‐up, or to assess body size in early adulthood, well before NPC onset. Another anthropometric indicator of interest is body shape, which can provide information on body fat distribution that is not captured by BMI. In our large‐scale, population‐based case–control study of NPC in Southern China, we evaluated the associations of BMI and body shape at age 20 and 10 years before interview with risk of incident NPC
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