Background: Body mass index (BMI) is inversely associated with lung cancer risk, while residual confounding by smoking or weight change is controversial. Evidence on height and lung cancer is scarce. Methods: We investigated the associations between anthropometrics, BMI, and height, and incidence of lung cancer among 92,098 study subjects (44,158 men and 47,940 women) in the Japan Public Health Center–based Prospective Study. Cox proportional hazards regression was performed with adjustment for potential confounders and by cancer subtypes and smoking status. Information on weight and height was self-reported at baseline, and validated using measured health check-up data. Results: During follow-up between 1990 and 2013 (average, 19.1 years), a total of 2,152 lung cancer cases were newly diagnosed. In a multivariate regression model, lower BMI was positively associated with overall lung cancer risk [<19 kg/m2 HR = 1.48; 95% confidence interval (CI) = 1.18–1.85 and 19–22.9 kg/m2; HR = 1.19; 95% CI = 1.05–1.35; P trend = <0.001] in men. The risk estimate was also elevated for adenocarcinoma in the BMI <19 kg/m2 category and for squamous cell carcinoma among men in the 19–22.9 kg/m2 BMI category. An association was also observed between low BMI, weight decrease, and squamous cell carcinoma in women. No significant associations were observed for other weight categories, height, weight change and lung cancer, adenocarcinoma, squamous and small cell carcinoma. Conclusions: Our prospective study suggests that lower BMI may be associated with an increased risk of smoking-related lung cancer in Japan, irrespective of gender. Impact: This study highlights the association between lower BMI and the risk of lung cancer in men.

中文翻译：

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体重指数、身高、体重变化和随后的肺癌风险：基于日本公共卫生中心的前瞻性研究

背景：体重指数（BMI）与肺癌风险呈负相关，而吸烟或体重变化造成的残余混杂因素存在争议。关于身高和肺癌的证据很少。方法：我们在基于日本公共卫生中心的前瞻性研究中调查了 92,098 名研究对象（44,158 名男性和 47,940 名女性）的人体测量学、BMI 和身高与肺癌发病率之间的关联。Cox 比例风险回归进行了调整潜在混杂因素和癌症亚型和吸烟状况。体重和身高信息在基线时自我报告，并使用测量的健康检查数据进行验证。结果：1990-2013年随访期间（平均19.1年），共新诊断肺癌2152例。在多元回归模型中，较低的 BMI 与总体肺癌风险呈正相关 [<19 kg/m2 HR = 1.48；95% 置信区间 (CI) = 1.18–1.85 和 19–22.9 kg/m2；人力资源 = 1.19; 95% CI = 1.05–1.35；P 趋势 = <0.001] 在男性中。对于 BMI <19 kg/m2 类别的腺癌和 19-22.9 kg/m2 BMI 类别的男性鳞状细胞癌的风险估计也有所提高。还观察到女性的低 BMI、体重减轻和鳞状细胞癌之间存在关联。未观察到其他体重类别、身高、体重变化与肺癌、腺癌、鳞状细胞癌和小细胞癌的显着相关性。结论：我们的前瞻性研究表明，无论性别如何，在日本，较低的 BMI 可能与吸烟相关肺癌的风险增加有关。影响：