Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Diet and risk of multiple myeloma in EMMA: a case-control study (126483)

Simon Cheah 1 2 , Allison M Hodge 1 2 , Julie K Bassett 1 2 , Nina Afshar 1 2 , Fiona J Bruinsma 1 2 3 , Wendy Cozen 4 , Simon Harrison 5 6 , Harindra Jayasekara 1 2 , Miles Prince 5 7 , Nicole Wong Doo 8 , Graham G Giles 1 2 9 , Roger L Milne 1 2 9
  1. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
  2. Cancer Epidemiology Division, Cancer Council Victoria, East Melbourne, VIC, Australia
  3. Burnet Institute, Melbourne, Victoria, Australia
  4. University of California, Irvine, California, USA
  5. Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
  6. Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, VIC, Australia
  7. Epworth Healthcare, Melbourne, VIC, Australia
  8. Concord Clinical School, University of Sydney, Sydney, NSW, Australia
  9. Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Melbourne, VIC, Australia

Background/rationale

Multiple myeloma (MM) is one of the most common blood cancers. Despite lengthened survival with recent advances in therapies, it remains essentially incurable. Understanding the influence of common modifiable risk factors on MM risk is necessary to inform prevention of this disease. We aimed to assess the association of dietary pattern, fish consumption, and lifestyle index score, with MM risk.

Methods

Histologically confirmed, incident cases of MM (n=746) were recruited primarily via cancer registries in Victoria and NSW, Australia. Controls (n=706) were siblings or spouses of cases. Unconditional logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between dietary exposures and MM risk. Multiple imputation using chained equations was utilised to handle missing data.

Results

Higher scores on a modified version of the Alternative Healthy Eating Index-2010 (mAHEI: OR=0.88, 95%CI=0.78-0.98 and the healthful plant-based dietary index (hDPI: OR=0.91, 95%CI=0.81-1.02) were associated with reduced risk of MM. Higher scores on empirical dietary inflammatory pattern (EDIP: OR=1.20, 95%CI=1.07-1.35) and empirical dietary indices for hyperinsulinaemia (EDIH: OR=1.15, 95%CI=1.02-1.31) and insulin resistance (EDIR: OR=1.21, 95%CI=1.08-1.37) were associated with increased risk of MM. There was no clear evidence of association with MM risk for oily fish consumption (OR=0.96, 95%CI=0.85-1.08), total fish consumption (OR=0.95, 95%CI=0.85-1.07) or a healthy lifestyle index (OR=0.94, 95%CI=0.84-1.05).

Conclusion

Adherence to a higher quality diet, or healthy plant-based diet, might reduce MM risk. Adherence to dietary patterns with the potential to increase insulin levels, insulin resistance, or promote inflammation, could increase risk of MM. Future research to confirm findings and investigate underlying mechanisms is warranted.