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Therefore, we investigated associations of prediagnosis and pretreatment BMI and body shape on NPC mortality. From a population\u2010based patient cohort in southern China between 2010 and 2013, we included 2526 incident NPC cases with prospective follow\u2010up through 2018. We assessed the associations of BMI and body shape at age 20\u2009years, 10\u2009years before diagnosis, and at diagnosis with NPC mortality, combining strategies of stratification and statistical adjustment to minimize reverse causation. We observed 25% lower all\u2010cause mortality (hazard ratio [HR] 0.75, 95% confidence interval [CI]: 0.64\u20100.89) and 25% lower NPC\u2010specific mortality (HR 0.75, 95% CI: 0.61\u20100.91) among overweight vs normal\u2010weight NPC cases at diagnosis. Lean body shapes 1 and 2 at diagnosis were associated with 68% and 23% higher all\u2010cause mortality, respectively, compared to normal body shape 3. No effect modification by cancer stage was detected for associations with all\u2010cause or NPC\u2010specific mortality. Associations with BMI and body shape 10\u2009years before diagnosis were similar but attenuated, while body size and shape at age 20 were not associated with mortality. Being overweight at diagnosis decreased mortality, and thinner body shape increased mortality, compared to normal weight\/body shape. These associations may be due to poorer nutrition and treatment intolerance, resulting in treatment discontinuation and worse survival outcomes.<\/jats:p>","DOI":"10.1002\/ijc.34524","type":"journal-article","created":{"date-parts":[[2023,3,25]],"date-time":"2023-03-25T19:47:17Z","timestamp":1679773637000},"page":"290-301","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Body mass index and body shape before treatment and nasopharyngeal carcinoma prognosis: A population\u2010based patient cohort study in southern China"],"prefix":"10.1002","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8689-5375","authenticated-orcid":false,"given":"Yun","family":"Du","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm 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