title: Body size and multiple myeloma mortality: a pooled analysis of 20 prospective studies.
abstract: Multiple myeloma (MM) is a rare but highly fatal malignancy. High body weight is associated with this cancer, but several questions remain regarding the aetiological relevance of timing and location of body weight. To address these questions, we conducted a pooled analysis of MM mortality using 1·5 million participants (including 1388 MM deaths) from 20 prospective cohorts in the National Cancer Institute Cohort Consortium. Proportional hazards regression was used to calculate pooled multivariate hazard ratios (HRs) and 95% confidence intervals (CIs). Associations with elevated MM mortality were observed for higher early-adult body mass index (BMI; HR = 1·22, 95% CI: 1·09-1·35 per 5 kg/m(2) ) and for higher cohort-entry BMI (HR 1·09, 95% CI: 1·03-1·16 per 5 kg/m(2) ) and waist circumference (HR = 1·06, 95% CI: 1·02-1·10 per 5 cm). Women who were the heaviest, both in early adulthood (BMI 25+) and at cohort entry (BMI 30+) were at greater risk compared to those with BMI 18·5 ≤ 25 at both time points (HR = 1·95, 95% CI: 1·33-2·86). Waist-to-hip ratio and height were not associated with MM mortality. These observations suggest that overall, and possibly also central, obesity influence myeloma mortality, and women have the highest risk of death from this cancer if they remain heavy throughout adulthood.
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA.
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Teras
authors.forename: Cari M
authors.initials: CM
authors.lastname: Kitahara
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Birmann
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Hartge
authors.forename: Sophia S
authors.initials: SS
authors.lastname: Wang
authors.forename: Kim
authors.initials: K
authors.lastname: Robien
authors.forename: Alpa V
authors.initials: AV
authors.lastname: Patel
authors.forename: Hans-Olov
authors.initials: HO
authors.lastname: Adami
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Pramil N
authors.initials: PN
authors.lastname: Singh
authors.forename: Michael
authors.initials: M
authors.lastname: Alavanja
authors.forename: Laura E
authors.initials: LE
authors.lastname: Beane Freeman
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
authors.forename: Gary E
authors.initials: GE
authors.lastname: Fraser
authors.forename: Susan M
authors.initials: SM
authors.lastname: Gapstur
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Hofmann
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.forename: Gila
authors.initials: G
authors.lastname: Neta
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Ulrike
authors.initials: U
authors.lastname: Peters
authors.forename: Philip S
authors.initials: PS
authors.lastname: Rosenberg
authors.forename: Catherine
authors.initials: C
authors.lastname: Schairer
authors.forename: Howard D
authors.initials: HD
authors.lastname: Sesso
authors.forename: Meir J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: Kala
authors.initials: K
authors.lastname: Visvanathan
authors.forename: Emily
authors.initials: E
authors.lastname: White
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.forename: Anne
authors.initials: A
authors.lastname: Zeleniuch-Jacquotte
authors.forename: Amy Berrington
authors.initials: AB
authors.lastname: de González
authors.forename: Mark P
authors.initials: MP
authors.lastname: Purdue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015992:Body Mass Index; D049628:Body Size; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: and anthropometry; body mass index; multiple myeloma; pooled analysis; prospective cohort study