Abstract

To better understand the role of individual and lifestyle factors in human disease, an exposome‐wide association study was performed to investigate within a single‐study anthropometry measures and lifestyle factors previously associated with B‐cell lymphoma (BCL). Within the European Prospective Investigation into Cancer and nutrition study, 2402 incident BCL cases were diagnosed from 475 426 participants that were followed‐up on average 14 years. Standard and penalized Cox regression models as well as principal component analysis (PCA) were used to evaluate 84 exposures in relation to BCL risk. Standard and penalized Cox regression models showed a positive association between anthropometric measures and BCL and multiple myeloma/plasma cell neoplasm (MM). The penalized Cox models additionally showed the association between several exposures from categories of physical activity, smoking status, medical history, socioeconomic position, diet and BCL and/or the subtypes. PCAs confirmed the individual associations but also showed additional observations. The PC5 including anthropometry, was positively associated with BCL, diffuse large B‐cell lymphoma (DLBCL) and MM. There was a significant positive association between consumption of sugar and confectionary (PC11) and follicular lymphoma risk, and an inverse association between fish and shellfish and Vitamin D (PC15) and DLBCL risk. The PC1 including features of the Mediterranean diet and diet with lower inflammatory score showed an inverse association with BCL risk, while the PC7, including dairy, was positively associated with BCL and DLBCL risk. Physical activity (PC10) was positively associated with DLBCL risk among women. This study provided informative insights on the etiology of BCL.

Highlights

  • B-cell lymphomas (BCLs) are an etiologically, clinically, and histologically heterogeneous group of malignant diseases of B lymphocytes

  • In multivariable Cox models adjusted for age, sex and country, we found six principal component (PC) (PC5, PC7, PC10, PC11, PC12 and PC15) reached to significance of 0.05 in relation to BCL and/or subtypes, among which PC5 including anthropometry measures was significant after multiple testing correction (Table S9)

  • In this large prospective cohort study, several anthropometric measures and lifestyle factors were associated with BCL and/or subtypes, with strong evidence for a positive association of anthropometric measures

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Summary

Introduction

B-cell lymphomas (BCLs) are an etiologically, clinically, and histologically heterogeneous group of malignant diseases of B lymphocytes. Immunodeficiency and autoimmunity are strong B-cell lymphoma risk factors.[1] Epidemiological studies showed that the risk of BCL is associated with anthropometry measures, lifestyle, viral, environmental and occupational factors (collectively called the exposome).[2,3,4,5,6,7,8] in the last two decades, reports from epidemiological studies suggested differences in risks among BCL subtypes for a wide range of risk factors.[2]. To better understand the role of risk factors in the occurrence of BCL, it would be preferable to study a large set of lifestyle factors (exposome) in a single study. Few methods are available to comprehensively evaluate the role of specific risk factors with disease. EWAS techniques have recently been used to assess environmental factors in relation to chronic diseases (eg, Type 2 diabetes, high blood pressure and peripheral arterial disease) and mortality.[9,10,11]

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