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Epidemiology

Anthropometric traits and risk of multiple myeloma: a pooled prospective analysis

Abstract

Background

Obesity is a risk factor for multiple myeloma (MM), yet results of prior studies have been mixed regarding the importance of early and/or later adult obesity; other measures of body composition have been less well studied.

Methods

We evaluated associations of early adult (ages 18–21) and usual adult body mass index (BMI), waist circumference, and predicted fat mass with MM by pooling data from six U.S. prospective cohort studies comprising 544,016 individuals and 2756 incident diagnoses over 20–37 years of follow-up. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations, adjusted for age and other risk factors.

Results

Each 5 kg/m2 increase in usual adult BMI was associated with a 10% increased risk of MM (HR: 1.10; 95% CI: 1.05–1.15). Positive associations were also noted for early adult BMI (HR per 5 kg/m2: 1.14; 95% CI: 1.04–1.25), height (HR per 10 cm: 1.28; 95% CI: 1.20–1.37), waist circumference (HR per 15 cm: 1.09; 95% CI: 1.00–1.19), and predicted fat mass (HR per 5 kg: 1.06; 95% CI: 1.01–1.11).

Conclusions

These findings highlight the importance of avoidance of overweight/obesity and excess adiposity throughout adulthood as a potential MM risk-reduction strategy.

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Data availability

Data will be made available upon reasonable request to the senior author.

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Acknowledgements

The American Cancer Society funds the creation, maintenance, and updating of the Cancer Prevention Study-II cohort. The authors express sincere appreciation to all Cancer Prevention Study-II participants, and to the members of the study and biospecimen management group. The authors would also like to acknowledge the contribution from central cancer registries supported through the Centers for Disease Control and Prevention’s National Program of Cancer Registries and cancer registries supported by the National Cancer Institute’s Surveillance Epidemiology and End Results Program. The study protocol was approved by the institutional review boards of Emory University, and those of participating registries as required. The authors assume full responsibility for all analyses and interpretation of results. The views expressed here are those of the authors and do not necessarily represent the American Cancer Society or the American Cancer Society—Cancer Action Network. The collection of cancer incidence data used in the California Teachers Study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s National Program of Cancer Registries, under cooperative agreement 5NU58DP006344; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute. The opinions, findings, and conclusions expressed herein are those of the author(s) and do not necessarily reflect the official views of the State of California, Department of Public Health, the National Cancer Institute, the National Institutes of Health, the Centers for Disease Control and Prevention or their Contractors and Subcontractors, or the Regents of the University of California, or any of its programmes. The authors would like to thank the California Teachers Study Steering Committee that is responsible for the formation and maintenance of the Study within which this research was conducted. A full list of California Teachers Study team members is available at https://www.calteachersstudy.org/team. All of the data associated with this publication and in the California Teachers Study are available for research use. The California Teachers Study welcomes all such inquiries and encourages individuals to visit https://www.calteachersstudy.org/for-researchers. The authors would like to acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR) and/or the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. Central registries may also be supported by state agencies, universities, and cancer centres. Participating central cancer registries include the following: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Maine, Maryland, Michigan, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, Seattle SEER Registry, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wyoming. The authors assume full responsibility for the analyses and interpretation of these data. We would also like to thank the participants and staff of the Health Professionals Follow-up Study and Nurses’ Health Study for their valuable contributions. We thank the members of Kaiser Permanente for helping us improve care through the use of information collected through our electronic health record systems.

Funding

This work was supported by the National Institutes of Health (R01 CA202712, UM1 CA186107, P01 CA87969, U01 CA176726, U01 CA167552, U01 CA199277; P30 CA033572; P30 CA023100; UM1 CA164917; R01 CA077398; R01 CA207020). The Nurses’ Health Study II received additional funding from the Breast Cancer Research Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

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Contributions

All authors contributed data from their respective cohort studies. KAB, LRT and BMB developed the analytic plan with significant contributions from SSW and CRC. ELD conducted the majority of the statistical analyses with contributions from KW and consultation from BAR. KAB drafted the manuscript with input and revisions from LRT, SSW and BMB. All other authors (ELD, CRC, BAR, KW and CZ) provided critical revisions to the writing and analyses. All authors approved the final version of this manuscript.

Corresponding author

Correspondence to Kimberly A. Bertrand.

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The authors declare no competing interests.

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This study was approved by the Institutional Review Boards of City of Hope, Brigham and Women’s Hospital, Harvard T.H. Chan School of Public Health, Kaiser Permanente Southern California, and those of participating cancer registries as required. Informed consent was implied by the return of the baseline questionnaire. The study was performed in accordance with the Declaration of Helsinki.

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Bertrand, K.A., Teras, L.R., Deubler, E.L. et al. Anthropometric traits and risk of multiple myeloma: a pooled prospective analysis. Br J Cancer 127, 1296–1303 (2022). https://doi.org/10.1038/s41416-022-01907-2

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