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.
Britton
Julie A
JA
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.
Khan
Aneire E
AE
Rohrmann
Sabine
S
Becker
Nikolaus
N
Linseisen
Jakob
J
Nieters
Alexandra
A
Kaaks
Rudolf
R
Tjønneland
Anne
A
Halkjaer
Jytte
J
Severinsen
Marianne Tang
MT
Overvad
Kim
K
Pischon
Tobias
T
Boeing
Heiner
H
Trichopoulou
Antonia
A
Kalapothaki
Victoria
V
Trichopoulos
Dimitrios
D
Mattiello
Amalia
A
Tagliabue
Giovanna
G
Sacerdote
Carlotta
C
Peeters
Petra H M
PH
Bueno-de-Mesquita
H Bas
HB
Ardanaz
Eva
E
Navarro
Carmen
C
Jakszyn
Paula
P
Altzibar
Jone M
JM
Hallmans
Göran
G
Malmer
Beatrice
B
Berglund
Göran
G
Manjer
Jonas
J
Allen
Naomi
N
Key
Timothy
T
Bingham
Sheila
S
Besson
Hervé
H
Ferrari
Pietro
P
Jenab
Mazda
M
Boffetta
Paolo
P
Vineis
Paolo
P
Riboli
Elio
E
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