The association between height and risk of lung cancer subtypes in men and women in the Netherlands Cohort Study

Objectives: Previous studies found no or weak positive associations between height and lung cancer (LC) risk, with differences between sexes. Few studies stratified the association by smoking status and LC subtype. This prospective study investigated the association between height and risks of overall LC and LC subtypes (i.e., adenocarcinoma, squamous cell carcinoma, small cell carcinoma, large cell carcinoma) in Dutch men and women, with comprehensive adjustment for smoking, and stratified by smoking status. Materials and methods: Data originate from 120,852 Dutch participants aged 55 -69 in 1986 in the Netherlands Cohort Study. Self-reported height and potential confounders were collected at baseline. After 20.3 years of follow-up, 3318 LC cases (2765 men; 553 women) and 4314 subcohort members were included in the multivariable Cox regression analysis. Results: There were no significant associations between height and risks of overall LC and LC subtypes in men and women, except for an increased adenocarcinoma risk in taller women (HR quartile4 vs quartile1 =1.62, 95% CI: 1.02 -2.55, P trend =0.031). This positive association was borderline statistically significant in female current smokers only when stratifying on smoking status. No interaction by smoking status was shown in women for any LC risk. In men, smoking modified the association between height and risks of overall LC, large cell and squamous cell carcinoma, with the p-values for interaction of 0.037, 0.007 and 0.050, respectively. Conclusion: Positive associations between height and LC subtypes were predominantly seen in smokers. Further studies should focus on LC subtypes and stratify the association by smoking status.