Socioeconomic status, smoking, alcohol use, and obesity and risk of myeloma in connecticut women

Purpose We used data from a population-based case–control study conducted among women in Connecticut to examine the impact of educational attainment, income, body mass index (BMI), cigarette smoking, and alcohol use on multiple myeloma risk. Methods This population-based case–control study included 179 individuals with myeloma, aged 21 to 84 years, diagnosed between 1996 and 2002 and identified through the Yale Cancer Centerʹs Rapid Case Ascertainment Shared Resources. Population controls were recruited among Connecticut residents from two sources: random-digit dialing for controls less than 65 years of age and Centers for Medicare and Medicaid Services (CMS) for controls 65 years of age and older. Data were collected through in-person interviews. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression. Results Educational attainment was inversely associated with risk, adjusted for age and race (P = 0.004). Risk was significantly elevated for subjects with less than a high school education compared with individuals with a graduate or professional degree (OR = 2.1, 95% CI = 1.1–4.3). Similarly, an increased risk was observed for those in the lowest annual income category (<$10,000) compared with those in the highest (>$75,000) (OR = 1.93, 95% CI = 0.9–4.4). There was a suggestion of increasing risk with increasing BMI; however, the dose–response relationship was not statistically significant. We found no evidence of increased risk of myeloma risk for smoking and alcohol use. Conclusion Our findings support a previously observed association, that the risk of multiple myeloma increases with decreasing SES. The SES-related exposures that may contribute to multiple myeloma risk remain to be determined.