title: A Pooled Analysis of Reproductive Factors, Exogenous Hormone Use, and Risk of Multiple Myeloma among Women in the International Multiple Myeloma Consortium.
abstract: BACKGROUND
  Female sex hormones are known to have immunomodulatory effects. Therefore, reproductive factors and exogenous hormone use could influence the risk of multiple myeloma in women. However, the role of hormonal factors in multiple myeloma etiology remains unclear because previous investigations were underpowered to detect modest associations.
  
  
  METHODS
  We conducted a pooled analysis of seven case-control studies included in the International Multiple Myeloma Consortium, with individual data on reproductive factors and exogenous hormone use from 1,072 female cases and 3,541 female controls. Study-specific odds ratios and corresponding 95% confidence intervals (CI) were estimated using logistic regression and pooled analyses were conducted using random effects meta-analyses.
  
  
  RESULTS
  Multiple myeloma was not associated with reproductive factors, including ever parous [OR = 0.92; 95% confidence interval (CI), 0.68-1.25], or with hormonal contraception use (OR = 1.04; 95% CI, 0.80-1.36). Postmenopausal hormone therapy users had nonsignificantly reduced risks of multiple myeloma compared with never users, but this association differed across centers (OR = 0.65; 95% CI, 0.37-1.15, I(2) = 76.0%, Pheterogeneity = 0.01).
  
  
  CONCLUSIONS
  These data do not support a role for reproductive factors or exogenous hormones in myelomagenesis.
  
  
  CONCLUSIONS
  Incidence rates of multiple myeloma are higher in men than in women, and sex hormones could influence this pattern. Associations with reproductive factors and exogenous hormone use were inconclusive despite our large sample size, suggesting that female sex hormones may not play a significant role in multiple myeloma etiology.
authors.affiliation: Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain. Department of Medicine, University of Barcelona, Barcelona, Spain. CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain. lcostas@iconcologia.net.
authors.forename: Laura
authors.initials: L
authors.lastname: Costas
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Brice H
authors.initials: BH
authors.lastname: Lambert
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Birmann
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York.
authors.forename: Kirsten B
authors.initials: KB
authors.lastname: Moysich
authors.affiliation: Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, Pennsylvania.
authors.forename: Anneclaire J
authors.initials: AJ
authors.lastname: De Roos
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Rockville, Maryland.
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Hofmann
authors.affiliation: Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Rockville, Maryland.
authors.forename: Dalsu
authors.initials: D
authors.lastname: Baris
authors.affiliation: Division of Cancer Etiology, Department of Population Sciences, City of Hope and Beckman Research Institute, Duarte, California.
authors.forename: Sophia S
authors.initials: SS
authors.lastname: Wang
authors.affiliation: Division of Hematology and Hematologic Malignancies, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah.
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Camp
authors.affiliation: Department of Internal Medicine, University of Iowa, Iowa City, Iowa.
authors.forename: Guido
authors.initials: G
authors.lastname: Tricot
authors.affiliation: Division of Hematology and Hematologic Malignancies, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah.
authors.forename: Djordje
authors.initials: D
authors.lastname: Atanackovic
authors.affiliation: IARC, International Agency for Research on Cancer, Lyon, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.affiliation: Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Cagliari, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Cocco
authors.affiliation: Center for Chronic Immunodeficiency, Molecular Epidemiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nieters
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Becker
authors.affiliation: Biological Hematology Unit, CRB Ferdinand Cabanne, Universitary Hospital of Dijon and EA4184, University of Burgundy, Dijon, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Maynadié
authors.affiliation: Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and MF MU, Brno, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Foretová
authors.affiliation: Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.affiliation: Public Health University College, Dublin, Ireland.
authors.forename: Anthony
authors.initials: A
authors.lastname: Staines
authors.affiliation: Department of Pathology, University of Alabama at Birmingham, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama.
authors.forename: Elisabeth E
authors.initials: EE
authors.lastname: Brown
authors.affiliation: Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain. Department of Medicine, University of Barcelona, Barcelona, Spain. CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: de Sanjosé
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009101:Multiple Myeloma / Q000209:etiology*; D009367:Neoplasm Staging; D017698:Postmenopause; D011379:Prognosis; D017584:Reproductive History; D012307:Risk Factors; D055815:Young Adult