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Body mass index throughout adulthood, physical activity, and risk of multiple myeloma: a prospective analysis in three large cohorts

British Journal of Cancervolume 118pages10131019 (2018) | Download Citation



Obesity is the only known modifiable multiple myeloma (MM) risk factor. However, the influence of obesity in earlier or later adulthood and the role of other energy balance correlates in MM development are unclear.


We leveraged repeatedly updated data from the Nurses’ Health Study, Health Professionals Follow-up Study, and Women’s Health Study cohorts to further explore energy balance measures in MM etiology. Exposures derived from questionnaires included young adult body mass index (BMI), cumulative average BMI, BMI change since young adulthood, and cumulative average physical activity and walking. We assessed MM risk related to those variables with Cox proportional hazard models.


We observed 575 incident MM cases in over five million person-years of follow-up across the cohorts. In pooled analyses, MM risk increased 17% per 5 kg/m2 increase in cumulative average BMI (95% confidence interval (CI): 1.05, 1.29) and 28% per 5 kg/m2 increase in young adult BMI (CI: 1.12, 1.47); adjustment for BMI change since young adulthood did not affect either association. BMI change since young adulthood and cumulative average physical activity and walking were not significantly associated with MM risk.


These findings suggest that a high BMI in early and later adulthood are risk factors for MM.

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This study was funded in part by the National Institutes of Health (K07 CA115687, R01 CA127435, P01 CA87969, UM1 CA186107, UM1 CA167552, R25 CA203650, R01 CA149445, CA047988, HL043851, and HL080467) and the American Cancer Society (RSG-11-020-01-CNE and Clinical Research Professorship (GAC)), and institutional funds from the Dana Farber Cancer Institute. We also gratefully acknowledge data preparation assistance from M.V. Moorthy and programming assistance from Ms. Catherine Suppan and Ms. Kelsey Lapenas. Lastly, we would like to thank the participants and staff of the Health Professionals Follow-up Study, Nurses’ Health Study and Women’s Health Study for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. The authors assume full responsibility for analyses and interpretation of these data. The funding sources had no role in the design, collection, analysis, interpretation or reporting of the study described herein, or in the decision to submit for publication.

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Author notes

  1. Catherine R. Marinac and Brenda M. Birmann contributed equally to this work.


  1. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 02115, USA

    • Catherine R. Marinac
    •  & Timothy R. Rebbeck
  2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA

    • Catherine R. Marinac
    • , I-Min Lee
    • , Edward Giovannucci
    • , Timothy R. Rebbeck
    • , Julie E. Buring
    •  & Graham A. Colditz
  3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 02115, USA

    • Brenda M. Birmann
    • , Bernard A. Rosner
    •  & Edward Giovannucci
  4. Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 02115, USA

    • I-Min Lee
    •  & Julie E. Buring
  5. Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    • Mary K. Townsend
  6. Department of Nutrition, Harvard School of Public Health, Boston, MA, 02115, USA

    • Edward Giovannucci
  7. Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, and Barnes Jewish Hospital, St. Louis, MO, 63110, USA

    • Graham A. Colditz


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The authors declare no competing interests.

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Correspondence to Brenda M. Birmann.

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