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.
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Acknowledgments
This research was supported in part by federal funds from the NCI, NIH, under R01CA036388, R01CA077398, and K05CA136967 and by the City of Hope. We are indebted to the late Ronald K. Ross, MD, who was the original principal investigator for the Los Angeles County Multiple Myeloma Case–Control Study and a former principal investigator for the California Teachers Study. We are grateful to the participants in the case–control study, to the women of the California Teachers Study for their continued participation and enthusiasm for the study, and to the California Teachers Study Steering Committee for their scientific guidance and insight. The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement U58DP003862-01 awarded to the California Department of Public Health. The ideas and opinions expressed herein are those of the author(s), and endorsement by the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred.
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Wang, S.S., Voutsinas, J., Chang, E.T. et al. Anthropometric, behavioral, and female reproductive factors and risk of multiple myeloma: a pooled analysis. Cancer Causes Control 24, 1279–1289 (2013). https://doi.org/10.1007/s10552-013-0206-0
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DOI: https://doi.org/10.1007/s10552-013-0206-0