Tobacco smoking and risk of multiple myeloma: A meta‐analysis of 40 observational studies

This meta‐analysis aims to quantitatively synthesize all available data on the association between tobacco smoking and multiple myeloma (MM) risk. Eligible studies were identified and pooled effect estimates (odds ratios and relative risks) were calculated regarding ever, current and former smoking....

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Bibliographic Details
Published in:International journal of cancer 2013-05, Vol.132 (10), p.2413-2431
Main Authors: Psaltopoulou, Theodora, Sergentanis, Theodoros N., Kanellias, Nick, Kanavidis, Prodromos, Terpos, Evangelos, Dimopoulos, Meletios A.
Format: Article
Language:English
Subjects:
Adult
Age
Age Factors
Age of Onset
Aged
Aged, 80 and over
Biological and medical sciences
B‐cells
Cancer
Female
Humans
Male
Medical research
Medical sciences
Meta-analysis
Middle Aged
Multiple myeloma
Multiple Myeloma - epidemiology
Multiple Myeloma - etiology
Odds Ratio
Regression Analysis
Research Design
Risk
Risk Factors
Sex Factors
Smoking
Smoking - adverse effects
Smoking - epidemiology
Time Factors
Tobacco
Tobacco, tobacco smoking
Toxicology
Tumors
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Summary:This meta‐analysis aims to quantitatively synthesize all available data on the association between tobacco smoking and multiple myeloma (MM) risk. Eligible studies were identified and pooled effect estimates (odds ratios and relative risks) were calculated regarding ever, current and former smoking. Separate analyses were performed on case–control and cohort studies, as well as on males and females. Meta‐regression analysis with percentage of males, mean age, years of smoking, pack‐years, cigarettes per day, years since quit and age at onset was performed. Forty articles were deemed eligible; of them 27 used a case–control design (4,625 cases and 21,591 controls) and 13 used a cohort design (2,228 incident cases among a total cohort size equal to 1,852,763 subjects). Ever smoking was not associated with MM risk (pooled effect estimate = 0.92, 95% confidence interval (CI): 0.85–1.00); similar results were obtained for current (pooled effect estimate = 0.87, 95% CI: 0.74–1.03) and former smoking (pooled effect estimate = 1.04, 95% CI: 0.96–1.13). Regarding ever smoking, the null association was reproducible upon cohort studies (pooled effect estimate = 1.01, 95%CI: 0.89–1.15), whereas the inverse association in case–control studies (pooled effect estimate = 0.87, 95% CI: 0.78–0.96) was particularly due to the bias‐prone hospital‐based ones. Meta‐regression analysis did not yield statistically significant results. In conclusion, MM does not seem to be associated with tobacco smoking. There is a need to further explore how molecular mechanisms are involved in the resistance of MM progenitor cells toward smoking. What's new? Tobacco smoking has been linked with many cancers but some cancers seem unaffected. To assess the effect of tobacco smoking on multiple myeloma, the authors performed a meta‐analysis of 40 existing studies. They found no significant association with ever, current or former smoking. They suggest that a specific resistance mechanism protects multiple myeloma progenitor cells from the negative influence of tobacco smoking.
ISSN:0020-7136
1097-0215
DOI:10.1002/ijc.27898