Myeloma risk factors

Prevention

Preventable cases of myeloma, UK

Occupational exposures

Myeloma cases linked to occupational exposures, UK

Not well understood

Myeloma risk factors are not well understood, mainly because this cancer is relatively rare

Less than 1% of myeloma cases each year in the UK are linked to major lifestyle and other risk factors.[1]

Myeloma is associated with a number of risk factors.[2,3]

Myeloma Risk Factors

Increases risk ('sufficient' or 'convincing' evidence) May increase risk ('limited' or 'probable' evidence) Decreases risk ('sufficient' or 'convincing' evidence) May decrease risk ('limited' or 'probable' evidence)
-
  • Benzene
  • Ethylene oxide
  • X-radiation, gamma radiation
 - -

International Agency for Research on Cancer (IARC) classification. World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classification does not include myeloma because the evidence is very limited. Find out more about IARC and WCRF/AICR classifications.

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

Use our interactive tool to explore risk factors for myeloma

References

  1. Parkin DM, Boyd L, Walker LC. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Summary and conclusions. Br J Cancer 2011;105 (S2):S77-S81.
  2. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from http://monographs.iarc.fr/ENG/Classification/index.php. Accessed May 2014.
  3. World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR; 2007. 
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Myeloma risk is 2.3 times higher in people with a first-degree relative (parent, sibling or child) with myeloma compared with the general population, a cohort study showed.[1]

This may be due to shared genetic or environmental factors , or a combination of these.

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

View our health information on inherited genes and cancer risk

 

References

  1. Frank C, Fallah M, Ji J, et al. The population impact of familial cancer, a major cause of cancer. Int J Cancer. 2014; 134(8):1899-906
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Myeloma risk is 50% higher in people with pernicious anaemia, versus those without the disease, meta-analyses have shown.[1] Monoclonal gammopathy of undetermined significance (MGUS) - a precursor for myeloma risk is 67% higher in people with pernicious anaemia.[1]

Myeloma risk is higher in people with ankylosing spondylitis,[1] autoimmune haemolytic anaemia,[2] or systemic lupus erythematosus;[3,4] and lower in people with psoriasis,[2] meta-analyses have shown.

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

References

  1. McShane CM, Murray LJ, Landgren O, et al. Prior autoimmune disease and risk of monoclonal gammopathy of undetermined significance and multiple myeloma: a systematic review. Cancer Epidemiol Biomarkers Prev. 2014;23(2):332-42.
  2. Shen K, Xu G, Wu Q, et al. Risk of multiple myeloma in rheumatoid arthritis: a meta-analysis of case-control and cohort studies. PLoS One. 2014;9(3):e91461
  3. Apor E, O'Brien J, Stephen M, Castillo JJ. Systemic lupus erythematosus is associated with increased incidence of hematologic malignancies: a meta-analysis of prospective cohort studies. Leuk Res 2014;38(9):1067-71.
  4. Cao L, Tong H, Xu G, et al. Systemic lupus erythematous and malignancy risk: a meta-analysis. PLoS One. 2015 Apr 17;10(4):e0122964.
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Myeloma risk is around 40% higher in solid organ transplant recipients versus the general population, a cross-sectional study showed.[1] Post-transplant myeloma develops in less than 1% of organ recipients.[2]

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

References

  1. Engels EA, Clarke CA, Pfeiffer RM, et al. Plasma cell neoplasms in US solid organ transplant recipients. Am J Transplant. 2013 Jun;13(6):1523-32.
  2. Caillard S, Agodoa LY, Bohen EM, et al. Myeloma, Hodgkin disease, and lymphoid leukemia after renal transplantation: characteristics, risk factors and prognosis. Transplantation 2006;81(6):888-95. 
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Body fatness is classified by the International Agency for Research on Cancer (IARC) as a cause of multiple myeloma.[1]

Myeloma risk is 12% higher per 5-unit body mass index (BMI) increment, a meta-analysis showed.[2] however, the association may be limited to males.[3]

Obese people may produce more of the protein interleukin-6 (IL-6), affecting proliferation and development of normal and malignant plasma cells.[4]

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

View our statistics on obesity and cancer

View our health information on obesity, weight and cancer

References

  1. Lauby-Secretan B, Scoccianti C, Loomis D, et al. Body Fatness and Cancer--Viewpoint of the IARC Working Group. N Engl J Med. 2016 Aug 25;375(8):794-8.
  2. Wallin A, Larsson SC. Body mass index and risk of multiple myeloma: a meta-analysis of prospective studies. Eur J Cancer. 2011; 47(11):1606-15
  3. Xue K, Li FF, Chen YW, et al. Body mass index and the risk of cancer in women compared with men: a meta-analysis of prospective cohort studies. Eur J Cancer Prev. 2017 Jan;26(1):94-105.
  4. Larsson SC, Wolk A. Body mass index and risk of multiple myeloma: A meta-analysis. Int J Cancer 2007.
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X radiation and gamma radiation are classified by the International Agency for Research on Cancer (IARC) as probable causes of myeloma, based on limited evidence.[1]

Myeloma is not associated with exposure to radiation from atomic bombs, a cohort study showed.[2] Myeloma is probably not associated with other sources of ionising radiation.[3]

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from http://monographs.iarc.fr/ENG/Classification/index.php. Accessed May 2014.
  2. Hsu WL, Preston DL, Soda M, et al. The incidence of leukemia, lymphoma and multiple myeloma among atomic bomb survivors: 1950-2001. Radiat Res. 2013; 179(3):361-82.
  3. United Nations Scientific Committee on the Effects of Atomic Radiation 2009. UNSCEAR 2006 Report to the General Assembly, with scientific annexes. Annex A.
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Benzene and ethylene oxide are classified by the International Agency for Research on Cancer (IARC) as probable causes of myeloma, based on limited evidence.[1] An estimated 0.3% of myeloma cases in the UK are linked to occupational exposures.[2]

Myeloma risk is not associated with occupational benzene exposure, a meta-analysis showed.[3]

Myeloma risk is not associated with occupational ethylene oxide exposure, a cohort study showed.[4]

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from http://monographs.iarc.fr/ENG/Classification/index.php. Accessed May 2014.
  2. Parkin DM, Boyd L, Walker LC. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Summary and conclusions. Br J Cancer 2011;105 (S2):S77-S81.
  3. Vlaanderen J1, Lan Q, Kromhout H, Rothman N, Vermeulen R. Occupational benzene exposure and the risk of lymphoma subtypes: a meta-analysis of cohort studies incorporating three study quality dimensions. Environ Health Perspect. 2011;119(2):159-67.
  4. Mikoczy Z, Tinnerberg H, Björk J, Albin M. Cancer incidence and mortality in Swedish sterilant workers exposed to ethylene oxide: updated cohort study findings 1972-2006. Int J Environ Res Public Health 2011;8(6):2009-19.
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Myeloma risk is not associated with the following factors, meta- and pooled analyses or systematic reviews have shown:

  • Tobacco smoking.[1]
  • Alcohol[2] (though some evidence of risk decrease at high intake levels[2,3] or in women[4]).
  • Physical activity.[5]
  • Rheumatoid arthritis.[6,7]
  • Diabetes.[8]
  • Pesticide/herbicide exposure.[9-11]
  • Diet (some evidence of lower risk in vegetarians[12]).[13]
  • Working with livestock.[14]
  • Working in the meat industry.[15]
  • Working as a metal processor, cleaner, or with high exposure to organic solvents.[11]
  • Hair dyes.[16,17]
  • Pneumonia (evidence of risk increase but unclear whether causal association).[18-20]
  • Trichloroethylene.[21]
  • Methylene chloride (though some evidence of risk increase in case-control studies).[22]
  • Reproductive and hormonal factors (female). [23]

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

References

  1. Psaltopoulou T, Sergentanis TN, Kanellias N, et al. Tobacco smoking and risk of multiple myeloma: a meta-analysis of 40 observational studies. Int J Cancer. 2013 May 15;132(10):2413-31.
  2. Rota M, Porta L, Pelucchi C, et al. Alcohol drinking and multiple myeloma risk--a systematic review and meta-analysis of the dose-risk relationship. Eur J Cancer Prev. 2014 Mar;23(2):113-21.
  3. Ji J, Sundquist J, Sundquist K. Alcohol consumption has a protective effect against hematological malignancies: a population-based study in sweden including 420,489 individuals with alcohol use disorders. Neoplasia 2014;16(3):229-34.
  4. Psaltopoulou T, Sergentanis TN, Sergentanis IN, et al. Alcohol intake, alcoholic beverage type and multiple myeloma risk: a meta-analysis of 26 observational studies. Leuk Lymphoma 2014 20:1-18.
  5. Jochem C, Leitzmann MF, Keimling M, et al. Physical activity in relation to risk of hematologic cancers: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014;23(5):833-46.
  6. McShane CM, Murray LJ, Landgren O, et al. Prior autoimmune disease and risk of monoclonal gammopathy of undetermined significance and multiple myeloma: a systematic review. Cancer Epidemiol Biomarkers Prev. 2014 Feb;23(2):332-42.
  7. Shen K, Xu G, Wu Q, et al. Risk of multiple myeloma in rheumatoid arthritis: a meta-analysis of case-control and cohort studies. PLoS One. 2014;9(3):e91461
  8. Castillo JJ, Mull N, Reagan JL, et al. Increased incidence of non-Hodgkin lymphoma, leukemia, and myeloma in patients with diabetes mellitus type 2: a meta-analysis of observational studies. Blood. 2012;119(21):4845-50.
  9. Jones DR, Sutton AJ, Abrams KR, et al. Systematic review and meta-analysis of mortality in crop protection product manufacturing workers. Occup Environ Med 2009;66(1):7-15.
  10. Merhi M, Raynal H, Cahuzac E, et al. Occupational exposure to pesticides and risk of hematopoietic cancers: meta-analysis of case-control studies. Cancer Cause Control 2007;18(10):1209-26.
  11. Perrotta C, Kleefeld S, Staines A, et al. Multiple myeloma and occupation: a pooled analysis by the International Multiple Myeloma Consortium. Cancer Epidemiol. 2013;37(3):300-5.
  12. Key TJ, Appleby PN, Crowe FL, et al. Cancer in British vegetarians: updated analyses of 4998 incident cancers in a cohort of 32,491 meat eaters, 8612 fish eaters, 18,298 vegetarians, and 2246 vegans. Am J Clin Nutr 2014;100(Supplement 1):378S-385S.
  13. Alexander DD, Mink PJ, Adami HO, et al. Multiple myeloma: a review of the epidemiologic literature. Int J Cancer 2007;120 Suppl 12:40-61.
  14. Perrotta C, Staines A, Cocco P. Multiple myeloma and farming. A systematic review of 30 years of research. Where next? J Occup Med Toxicol 2008;3:27.
  15. Moore T, Brennan P, Becker N, et al. Occupational exposure to meat and risk of lymphoma: a multicenter case-control study from Europe. Int J Cancer 2007;121(12):2761-6.
  16. Takkouche B, Regueira-Mendez C, Montes-Martinez A. Risk of cancer among hairdressers and related workers: a meta-analysis. Int J Epidemiol 2009;38(6):1512-31.
  17. Rollison DE, Helzlsouer KJ, Pinney SM. Personal hair dye use and cancer: a systematic literature review and evaluation of exposure assessment in studies published since 1992. J Toxicol Env Heal B 2006;9(5):413-39.
  18. Brown LM, Gridley G, Check D, et al. Risk of multiple myeloma and monoclonal gammopathy of undetermined significance among white and black male United States veterans with prior autoimmune, infectious, inflammatory, and allergic disorders. Blood 2008;111(7):3388-94.
  19. Landgren O, Rapkin JS, Mellemkjaer L, et al. Respiratory tract infections in the pathway to multiple myeloma: a population-based study in Scandinavia. Haematologica 2006;91(12):1697-700
  20. Søgaard KK, Farkas DK, Pedersen L, et al. Pneumonia and the incidence of cancer: a Danish nationwide cohort study. J Intern Med. 2014.
  21. Karami S, Bassig B, Stewart PA, et al. Occupational trichloroethylene exposure and risk of lymphatic and haematopoietic cancers: a meta-analysis. Occup Environ Med. 2013 Aug;70(8):591-9.
  22. Liu T, Xu QE, Zhang CH, et al. Occupational exposure to methylene chloride and risk of cancer: a meta-analysis. Cancer Causes Control. 2013;24(12):2037-49.
  23. Costas L, Lambert BH, Birmann BM, et al. A Pooled Analysis of Reproductive Factors, Exogenous Hormone Use, and Risk of Multiple Myeloma among Women in the International Multiple Myeloma Consortium. Cancer Epidemiol Biomarkers Prev. 2016;25(1):217-21.
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