Inserm U1018, Epidemiology of Occupational and Social Determinants of Health, Centre for Research in Epidemiology and Population Health, Villejuif, France.
Cancer Causes Control. 2013 Jul;24(7):1437-48. doi: 10.1007/s10552-013-0223-z. Epub 2013 May 16.
The association between body mass index (BMI) and the risk of oral cavity cancer, suggested by the few available studies, is controversial because of weight loss preceding cancer diagnosis and possible confounding by tobacco and alcohol consumption. The aim of this study was to evaluate in France, a high-incidence country, the association between the risk of oral cavity cancer and body mass index at interview, 2 years before the interview and at age 30, as well as BMI change.
We used data from a population-based case-control study, the Investigation of occupational and environmental CAuses of REspiratory cancers study, with personal interviews and standardized questionnaires including 689 cases of oral cavity squamous cell carcinoma and 3,481 controls. Odds ratios (ORs) and 95% confidence intervals (95% CI) were estimated by unconditional logistic regression and were adjusted for gender, age, area of residence, education, tobacco smoking, and alcohol drinking.
ORs were increased in underweight subjects at interview (OR 6.25, 95% CI 3.74-10.45). No association with underweight 2 years before the interview and at age 30 was found. Overweight and obesity at interview, 2 years before the interview and at age 30 were associated with decreased ORs (ranging from 0.13 to 0.60). BMI gain greater than 5% between age 30 and 2 years before the interview was inversely associated with oral cavity cancer (OR 0.42, 95% CI 0.33-0.54). These associations were stronger in men, and in smokers and drinkers.
These results add further support to the existence of a reduced risk of oral cavity cancer among overweight and obese people or among people who increased their BMI in adulthood. The underlying mechanisms remain to be clarified.
少数现有研究表明，体重指数（BMI）与口腔癌风险之间存在关联，但由于癌症诊断前存在体重减轻以及可能受到烟草和酒精消费的混杂影响，这种关联存在争议。本研究旨在评估法国这一癌症高发国家，在访谈时、访谈前 2 年以及 30 岁时的 BMI 与口腔癌风险之间的关系，以及 BMI 变化与口腔癌风险之间的关系。
我们使用了一项基于人群的病例对照研究——职业和环境因素导致的呼吸系统癌症的调查（Investigation of occupational and environmental CAuses of REspiratory cancers study）的数据，该研究进行了个人访谈，并采用标准化问卷进行调查，共纳入 689 例口腔鳞状细胞癌病例和 3481 例对照。采用非条件 logistic 回归估计比值比（OR）及其 95%置信区间（95%CI），并调整了性别、年龄、居住地、受教育程度、吸烟和饮酒因素。
在访谈时体重过轻（OR 6.25，95%CI 3.74-10.45）的受试者中，OR 较高。在访谈前 2 年和 30 岁时体重过轻与口腔癌无关。在访谈时、访谈前 2 年和 30 岁时超重和肥胖与 OR 降低相关（范围为 0.13-0.60）。在 30 岁至访谈前 2 年期间 BMI 增加超过 5%与口腔癌呈负相关（OR 0.42，95%CI 0.33-0.54）。这些关联在男性、吸烟者和饮酒者中更为明显。
这些结果进一步支持超重和肥胖人群或成年后 BMI 增加的人群患口腔癌风险降低的观点。其潜在机制仍需进一步阐明。
