Approved Research

Prospective study of risk factors for multiple myeloma and its precursors in the context of the UK Biobank Cohort study

Lay summary

Multiple myeloma is a cancer of a type of white blood cells that help fighting against infections by making antibodies.  In 2015, 5500 new cases of multiple myeloma were diagnosed in the UK with a 10-year survival of approximately 30%. Multiple myeloma is preceded by a condition called monoclonal gammopathy of undetermined significance (MGUS), with a 3% prevalence in the white population at 50 years of age.  Around 1% of patients with MGUS progress to multiple myeloma but it is not known why some people progress and other do not. Factors that have been associated with a higher risk of developing multiple myeloma are: increasing age, immunodepressive states, black ethnicity, higher body mass index, being male and a family history of multiple myeloma. Obesity is the only modifiable risk factor that has been associated with multiple myeloma but it is not clear how other factors such as sex or ethnicity influence the association between MM and obesity. Obesity is a public health issue in the UK with around 65% of the adult population being overweight or obese. The UK biobank with detailed information on adiposity will provide useful insight into the role of obesity in multiple myeloma and may contribute to the development of future public health policy and research to reduce the burden of the disease. In the second part of the investigation, the project aims to identify potential multiple myeloma and MGUS risk factors and blood biomarkers for which previous findings to date have been inconclusive or that have never been examined before.

For this three-year project, our main research question is: Could the UK Biobank Cohort study give further insights into established risk factors and identify new risk factors associated with multiple myeloma and its precursors?

Specific aims:

1) To examine the association between established risk factors (ethnicity, sex, age, family history of multiple myeloma and obesity) and the risk of multiple myeloma and its precursors in the UKBiobank cohort study.

2) To examine the risk of MGUS, multiple myeloma and potential and new risk factors (episode of infections, physical activity, comorbidities, detailed physical measurement, lung function, vegetarian diet, chronotype/sleep, sexual life, domestic heating, occupational history, night/shift works) as well as biomarkers associated with the disease or some main exposure variables (obesity).

CURRENT SCOPE

Main research questions:

Could the UK Biobank Cohort study give further insights into established risk factors and identify new risk factors associated with multiple myeloma (MM) and its precursors, monoclonal gammopathy of undetermined significance (MGUS)?

Specific aims:

1) To examine prospectively the association between established risk factors (such ethnicity, sex, age, family history of MM or MGUS and obesity) and the risk of MM and its precursors in the UKBiobank cohort study

2) To examine the risk of MGUS, MM and potential and new risk factors (episode of infections, physical activity, comorbidities, detailed physical measurement and pulmonary function, vegetarian diet, chronotype/sleep, sexual life, domestic heating, occupational history, night/shift works) as well as biomarkers associated with the disease (bones, liver or renal biomarkers) or some main exposure variables (obesity and infections)

EXTENDED/NEW SCOPE:

EXTEND the analysis of circulating insulin-like growth factor (IGF) to all other hematological neoplams in the UK Biobank.