Skip to main content
Top
Published in: Cancer Causes & Control 7/2013

01-07-2013 | Original paper

Anthropometric, behavioral, and female reproductive factors and risk of multiple myeloma: a pooled analysis

Authors: Sophia S. Wang, Jenna Voutsinas, Ellen T. Chang, Christina A. Clarke, Yani Lu, Huiyan Ma, Dee West, James V. Lacey Jr., Leslie Bernstein

Published in: Cancer Causes & Control | Issue 7/2013

Login to get access

Abstract

Background

Risk of developing multiple myeloma (MM) rises with age and is greater among men and blacks than among women and whites, respectively, and possibly increased among obese persons. Other risk factors remain poorly understood. By pooling data from two complementary epidemiologic studies, we assessed whether obesity, smoking, or alcohol consumption alters MM risk and whether female reproductive history might explain the lower occurrence of MM in females than in males.

Methods

The Los Angeles County MM Case–Control Study (1985–1992) included 278 incident cases and 278 controls, matched on age, sex, race, and neighborhood of residence at case’s diagnosis. We estimated MM risk using conditional logistic regression to calculate odds ratios (ORs) and 95 % confidence intervals (CIs). In the prospective California Teachers Study (CTS), 152 women were diagnosed with incident MM between 1995 and 2009; we calculated hazard ratios using Cox proportional hazards analysis. Data from the two studies were pooled using a stratified, nested case–control sampling scheme (10:1 match) for the CTS; conditional logistic regression among 430 cases and 1,798 matched controls was conducted.

Results

Obesity and smoking were not associated with MM risk in the individual or combined studies. Alcohol consumption was associated with decreased MM risk among whites only (pooled OR = 0.66, 95 % CI = 0.49–0.90) for ever versus never drinking. Higher gravidity and parity were associated with increased MM risk, with pooled ORs of 1.38 (95 % CI = 1.01–1.90) for ≥3 versus 1–2 pregnancies and 1.50 (95 % CI = 1.09–2.06) for ≥3 versus 1–2 live births.

Conclusions

Female reproductive history may modestly alter MM risk, but appears unlikely to explain the sex disparity in incidence. Further investigation in consortial efforts is warranted.
Appendix
Available only for authorised users
Literature
2.
go back to reference Tavani A, Pregnolato A, La Vecchia C et al (1997) A case-control study of reproductive factors and risk of lymphomas and myelomas. Leuk Res 21(9):885–888PubMedCrossRef Tavani A, Pregnolato A, La Vecchia C et al (1997) A case-control study of reproductive factors and risk of lymphomas and myelomas. Leuk Res 21(9):885–888PubMedCrossRef
3.
go back to reference Costas L, Casabonne D, Benavente Y et al (2012) Reproductive factors and lymphoid neoplasms in Europe: findings from the EpiLymph case-control study. Cancer Causes Control 23(1):195–206PubMedCrossRef Costas L, Casabonne D, Benavente Y et al (2012) Reproductive factors and lymphoid neoplasms in Europe: findings from the EpiLymph case-control study. Cancer Causes Control 23(1):195–206PubMedCrossRef
4.
go back to reference Morton LM, Wang SS, Richesson DA et al (2009) Reproductive factors, exogenous hormone use and risk of lymphoid neoplasms among women in the National Institutes of Health-AARP Diet and Health Study Cohort. Int J Cancer 124(11):2737–2743PubMedCrossRef Morton LM, Wang SS, Richesson DA et al (2009) Reproductive factors, exogenous hormone use and risk of lymphoid neoplasms among women in the National Institutes of Health-AARP Diet and Health Study Cohort. Int J Cancer 124(11):2737–2743PubMedCrossRef
5.
go back to reference Larsson SC, Wolk A (2007) Body mass index and risk of multiple myeloma: a meta-analysis. Int J Cancer 121(11):2512–2516PubMedCrossRef Larsson SC, Wolk A (2007) Body mass index and risk of multiple myeloma: a meta-analysis. Int J Cancer 121(11):2512–2516PubMedCrossRef
6.
go back to reference Wallin A, Larsson SC (2011) Body mass index and risk of multiple myeloma: a meta-analysis of prospective studies. Eur J Cancer 47(11):1606–1615PubMedCrossRef Wallin A, Larsson SC (2011) Body mass index and risk of multiple myeloma: a meta-analysis of prospective studies. Eur J Cancer 47(11):1606–1615PubMedCrossRef
7.
go back to reference Lu Y, Sullivan-Halley J, Henderson KD et al (2010) Anthropometric characteristics and multiple myeloma risk. Epidemiology 21(2):272–273PubMedCrossRef Lu Y, Sullivan-Halley J, Henderson KD et al (2010) Anthropometric characteristics and multiple myeloma risk. Epidemiology 21(2):272–273PubMedCrossRef
8.
go back to reference Chang ET, Clarke CA, Canchola AJ et al (2010) Alcohol consumption over time and risk of lymphoid malignancies in the California Teachers Study cohort. Am J Epidemiol 172(12):1373–1383PubMedCrossRef Chang ET, Clarke CA, Canchola AJ et al (2010) Alcohol consumption over time and risk of lymphoid malignancies in the California Teachers Study cohort. Am J Epidemiol 172(12):1373–1383PubMedCrossRef
9.
go back to reference Nelson RA, Levine AM, Bernstein L (2001) Reproductive factors and risk of intermediate- or high-grade B-Cell non-Hodgkin’s lymphoma in women. J Clin Oncol 19(5):1381–1387PubMed Nelson RA, Levine AM, Bernstein L (2001) Reproductive factors and risk of intermediate- or high-grade B-Cell non-Hodgkin’s lymphoma in women. J Clin Oncol 19(5):1381–1387PubMed
10.
go back to reference Bernstein L, Allen M, Anton-Culver H et al (2002) High breast cancer incidence rates among California teachers: results from the California Teachers Study (United States). Cancer Causes Control 13(7):625–635PubMedCrossRef Bernstein L, Allen M, Anton-Culver H et al (2002) High breast cancer incidence rates among California teachers: results from the California Teachers Study (United States). Cancer Causes Control 13(7):625–635PubMedCrossRef
11.
go back to reference Chang ET, Canchola AJ, Clarke CA et al (2011) Dietary phytocompounds and risk of lymphoid malignancies in the California Teachers Study cohort. Cancer Causes Control 22(2):237–249PubMedCrossRef Chang ET, Canchola AJ, Clarke CA et al (2011) Dietary phytocompounds and risk of lymphoid malignancies in the California Teachers Study cohort. Cancer Causes Control 22(2):237–249PubMedCrossRef
12.
go back to reference Prescott J, Lu Y, Chang ET et al (2009) Reproductive factors and non-Hodgkin lymphoma risk in the California Teachers Study. PLoS One 4(12):e8135PubMedCrossRef Prescott J, Lu Y, Chang ET et al (2009) Reproductive factors and non-Hodgkin lymphoma risk in the California Teachers Study. PLoS One 4(12):e8135PubMedCrossRef
13.
go back to reference Marshall SF, Clarke CA, Deapen D et al (2010) Recent breast cancer incidence trends according to hormone therapy use: the California Teachers Study cohort. Breast Cancer Res 12(1):R4PubMedCrossRef Marshall SF, Clarke CA, Deapen D et al (2010) Recent breast cancer incidence trends according to hormone therapy use: the California Teachers Study cohort. Breast Cancer Res 12(1):R4PubMedCrossRef
14.
go back to reference Reynolds P, Hurley S, Goldberg DE et al (2004) Regional variations in breast cancer among California teachers. Epidemiology 15(6):746–754PubMedCrossRef Reynolds P, Hurley S, Goldberg DE et al (2004) Regional variations in breast cancer among California teachers. Epidemiology 15(6):746–754PubMedCrossRef
15.
go back to reference Fernberg P, Odenbro A, Bellocco R et al (2007) Tobacco use, body mass index, and the risk of leukemia and multiple myeloma: a nationwide cohort study in Sweden. Cancer Res 67(12):5983–5986PubMedCrossRef Fernberg P, Odenbro A, Bellocco R et al (2007) Tobacco use, body mass index, and the risk of leukemia and multiple myeloma: a nationwide cohort study in Sweden. Cancer Res 67(12):5983–5986PubMedCrossRef
16.
go back to reference Britton JA, Khan AE, Rohrmann S et al (2008) Anthropometric characteristics and non-Hodgkin’s lymphoma and multiple myeloma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Haematologica 93(11):1666–1677PubMedCrossRef Britton JA, Khan AE, Rohrmann S et al (2008) Anthropometric characteristics and non-Hodgkin’s lymphoma and multiple myeloma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Haematologica 93(11):1666–1677PubMedCrossRef
17.
go back to reference Birmann BM, Giovannucci E, Rosner B et al (2007) Body mass index, physical activity, and risk of multiple myeloma. Cancer Epidemiol Biomarkers Prev 16(7):1474–1478PubMedCrossRef Birmann BM, Giovannucci E, Rosner B et al (2007) Body mass index, physical activity, and risk of multiple myeloma. Cancer Epidemiol Biomarkers Prev 16(7):1474–1478PubMedCrossRef
18.
go back to reference Calle EE, Rodriguez C, Walker-Thurmond K et al (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348(17):1625–1638PubMedCrossRef Calle EE, Rodriguez C, Walker-Thurmond K et al (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348(17):1625–1638PubMedCrossRef
19.
go back to reference Lichtman MA (2010) Obesity and the risk for a hematological malignancy: leukemia, lymphoma, or myeloma. Oncologist 15(10):1083–1101PubMedCrossRef Lichtman MA (2010) Obesity and the risk for a hematological malignancy: leukemia, lymphoma, or myeloma. Oncologist 15(10):1083–1101PubMedCrossRef
20.
go back to reference Landgren O, Rajkumar SV, Pfeiffer RM et al (2010) Obesity is associated with an increased risk of monoclonal gammopathy of undetermined significance among black and white women. Blood 116(7):1056–1059PubMedCrossRef Landgren O, Rajkumar SV, Pfeiffer RM et al (2010) Obesity is associated with an increased risk of monoclonal gammopathy of undetermined significance among black and white women. Blood 116(7):1056–1059PubMedCrossRef
21.
go back to reference Alexander DD, Mink PJ, Adami HO et al (2007) Multiple myeloma: a review of the epidemiologic literature. Int J Cancer 120(Suppl 12):40–61PubMedCrossRef Alexander DD, Mink PJ, Adami HO et al (2007) Multiple myeloma: a review of the epidemiologic literature. Int J Cancer 120(Suppl 12):40–61PubMedCrossRef
22.
go back to reference Nieters A, Deeg E, Becker N (2006) Tobacco and alcohol consumption and risk of lymphoma: results of a population-based case-control study in Germany. Int J Cancer 118(2):422–430PubMedCrossRef Nieters A, Deeg E, Becker N (2006) Tobacco and alcohol consumption and risk of lymphoma: results of a population-based case-control study in Germany. Int J Cancer 118(2):422–430PubMedCrossRef
23.
go back to reference Monnereau A, Orsi L, Troussard X et al (2008) Cigarette smoking, alcohol drinking, and risk of lymphoid neoplasms: results of a French case-control study. Cancer Causes Control 19(10):1147–1160PubMedCrossRef Monnereau A, Orsi L, Troussard X et al (2008) Cigarette smoking, alcohol drinking, and risk of lymphoid neoplasms: results of a French case-control study. Cancer Causes Control 19(10):1147–1160PubMedCrossRef
24.
go back to reference Psaltopoulou T, Sergentanis TN, Kanellias N et al (2012) Tobacco smoking and risk of multiple myeloma: a meta-analysis of 40 observational studies. Int J Cancer 132(10):2413–2431 Psaltopoulou T, Sergentanis TN, Kanellias N et al (2012) Tobacco smoking and risk of multiple myeloma: a meta-analysis of 40 observational studies. Int J Cancer 132(10):2413–2431
25.
go back to reference Morton LM, Zheng T, Holford TR et al (2005) Alcohol consumption and risk of non-Hodgkin lymphoma: a pooled analysis. Lancet Oncol 6(7):469–476PubMedCrossRef Morton LM, Zheng T, Holford TR et al (2005) Alcohol consumption and risk of non-Hodgkin lymphoma: a pooled analysis. Lancet Oncol 6(7):469–476PubMedCrossRef
26.
go back to reference Mor G, Cardenas I (2010) The immune system in pregnancy: a unique complexity. Am J Reprod Immunol 63(6):425–433PubMedCrossRef Mor G, Cardenas I (2010) The immune system in pregnancy: a unique complexity. Am J Reprod Immunol 63(6):425–433PubMedCrossRef
27.
go back to reference Priddy KD (1997) Immunologic adaptations during pregnancy. J Obstet Gynecol Neonatal Nurs 26(4):388–394PubMedCrossRef Priddy KD (1997) Immunologic adaptations during pregnancy. J Obstet Gynecol Neonatal Nurs 26(4):388–394PubMedCrossRef
28.
go back to reference Boyd KD, Ross FM, Chiecchio L et al (2011) Gender disparities in the tumor genetics and clinical outcome of multiple myeloma. Cancer Epidemiol Biomarkers Prev 20(8):1703–1707PubMedCrossRef Boyd KD, Ross FM, Chiecchio L et al (2011) Gender disparities in the tumor genetics and clinical outcome of multiple myeloma. Cancer Epidemiol Biomarkers Prev 20(8):1703–1707PubMedCrossRef
29.
go back to reference Everaus H, Hein M, Zilmer K (1993) Possible imbalance of the immuno-hormonal axis in multiple myeloma. Leuk Lymphoma 11(5–6):453–458PubMedCrossRef Everaus H, Hein M, Zilmer K (1993) Possible imbalance of the immuno-hormonal axis in multiple myeloma. Leuk Lymphoma 11(5–6):453–458PubMedCrossRef
30.
go back to reference Everaus H, Lehtmaa J (1993) Sex hormones and immune dysregulation in multiple myeloma. Cancer Immunol Immunother 36(3):205–209PubMedCrossRef Everaus H, Lehtmaa J (1993) Sex hormones and immune dysregulation in multiple myeloma. Cancer Immunol Immunother 36(3):205–209PubMedCrossRef
31.
go back to reference Glaser SL, Clarke CA, Keegan TH et al (2004) Attenuation of social class and reproductive risk factor associations for Hodgkin lymphoma due to selection bias in controls. Cancer Causes Control 15(7):731–739PubMedCrossRef Glaser SL, Clarke CA, Keegan TH et al (2004) Attenuation of social class and reproductive risk factor associations for Hodgkin lymphoma due to selection bias in controls. Cancer Causes Control 15(7):731–739PubMedCrossRef
Metadata
Title
Anthropometric, behavioral, and female reproductive factors and risk of multiple myeloma: a pooled analysis
Authors
Sophia S. Wang
Jenna Voutsinas
Ellen T. Chang
Christina A. Clarke
Yani Lu
Huiyan Ma
Dee West
James V. Lacey Jr.
Leslie Bernstein
Publication date
01-07-2013
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 7/2013
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-013-0206-0

Other articles of this Issue 7/2013

Cancer Causes & Control 7/2013 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine