Anthropometric characteristics and non-Hodgkin's lymphoma and multiple myeloma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).
BACKGROUND
The incidences of non-Hodgkin's lymphoma and multiple myeloma are increasing steadily. It has been hypothesized that this may be due, in part, to the parallel rising prevalence of obesity. It is biologically plausible that anthropometric characteristics can infuence the risk of non-Hodgkin's lymphoma and multiple myeloma.


METHODS
In the context of the European Prospective Investigation into Cancer and Nutrition (EPIC), anthropometric characteristics were assessed in 371,983 cancer-free individuals at baseline. During the 8.5 years of follow-up, 1,219 histologically confirmed incident cases of non-Hodgkin's lymphoma and multiple myeloma occurred in 609 men and 610 women. Gender-specific proportional hazards models were used to estimate relative risks and 95% confidence intervals (95% CI) of development of non-Hodgkin's lymphoma and multiple myeloma in relation to the anthropometric characteristics.


RESULTS
Height was associated with overall non-Hodgkin's lymphoma and multiple myeloma in women (RR 1.50, 95% CI 1.14-1.98) for highest versus lowest quartile; p-trend < 0.01) but not in men. Neither obesity (weight and body mass index) nor abdominal fat (waist-to-hip ratio, waist or hip circumference) measures were positively associated with overall non-Hodgkin's lymphoma and multiple myeloma. Relative risks for highest versus lowest body mass index quartile were 1.09 (95% CI 0.85-1.38) and 0.92 (95% CI 0.71-1.19) for men and women, respectively. Women in the upper body mass index quartile were at greater risk of diffuse large B-cell lymphoma (RR 2.18, 95% CI 1.05-4.53) and taller women had an elevated risk of follicular lymphoma (RR 1.25, 95% CI 0.59-2.62). Among men, height and body mass index were non-significantly, positively related to follicular lymphoma. Multiple myeloma risk alone was elevated for taller women (RR 2.34, 95% CI 1.29-4.21) and heavier men (RR 1.77, 95% CI 1.02-3.05).


CONCLUSIONS
The EPIC analyses support an association between height and overall non-Hodgkin's lymphoma and multiple myeloma among women and suggest heterogeneous subtype associations. This is one of the first prospective studies focusing on central adiposity and non-Hodgkin's lymphoma subtypes.
Department of Epidemiology and Public Health, Imperial College London, Room 151, St Mary's Campus, Norfolk Place W2 1PG, London, UK. p.vineis@imperial.ac.uk.
Julie A
JA
Britton
Aneire E
AE
Khan
Sabine
S
Rohrmann
Nikolaus
N
Becker
Jakob
J
Linseisen
Alexandra
A
Nieters
Rudolf
R
Kaaks
Anne
A
Tjønneland
Jytte
J
Halkjaer
Marianne Tang
MT
Severinsen
Kim
K
Overvad
Tobias
T
Pischon
Heiner
H
Boeing
Antonia
A
Trichopoulou
Victoria
V
Kalapothaki
Dimitrios
D
Trichopoulos
Amalia
A
Mattiello
Giovanna
G
Tagliabue
Carlotta
C
Sacerdote
Petra H M
PH
Peeters
H Bas
HB
Bueno-de-Mesquita
Eva
E
Ardanaz
Carmen
C
Navarro
Paula
P
Jakszyn
Jone M
JM
Altzibar
Göran
G
Hallmans
Beatrice
B
Malmer
Göran
G
Berglund
Jonas
J
Manjer
Naomi
N
Allen
Timothy
T
Key
Sheila
S
Bingham
Hervé
H
Besson
Pietro
P
Ferrari
Mazda
M
Jenab
Paolo
P
Boffetta
Paolo
P
Vineis
Elio
E
Riboli
D000886:Anthropometry / Q000379:methods*; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016393:Lymphoma, B-Cell / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology*; D008297:Male; D009101:Multiple Myeloma / Q000453:epidemiology*; D009369:Neoplasms / Q000453:epidemiology; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D012307:Risk Factors; D012727:Sex Characteristics; D049629:Waist-Hip Ratio