Multiple myeloma among blacks and Whites in the United States: the role of chronic antigenic stimulation |
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Authors: | Dr Denise Riedel Lewis Dr Linda M Pottern Ms Linda Morris Brown Drs Debra T Silverman Richard B Haves Ms Janet B Schoenberg Drs Raymond S Greenberg Dr G Marie Swanson Dr Ann Grossbart Schwartz Jonathan M Liff Robert N Hoover |
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Institution: | (1) Epidemiology Branch, Health Effects Research Laboratory, US Environmental Protection Agency, Chapel Hill, NC, USA;(2) Epidemiology and Biostatistics Program at the US National Cancer Institute, EPN Room 418, 6130 Executive Blvd., MSC-7364 Bethesda, MD 20892-7264, USA;(3) Special Epidemiology Program at the New Jersey Department of Health, Trenton, NJ, USA;(4) Division of Epidemiology, School of Public Health at Emory University, Atlanta, GA, USA;(5) College of Human Medicine at Michigan State University, East Lansing, MI, USA;(6) Department of Clinical Epidemiology and Family Medicine at the University of Pittsburgh, Pittsburgh, PA, USA |
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Abstract: | Multiple myeloma (MM) is twice as common among Blacks than Whites in the United States. The reasons for this racial disparity are unknown, and the etiology of this cancer in general, is poorly understood. Repeated or chronic antigenic stimulation (CAS) of the immune system has been suggested as a risk factor. Previous case-control studies have reported inconsistent CAS associations based on evaluations of individual and biologic categories of medical conditions. Interview data from 573 cases and 2,131 population-based controls were used to investigate further the CAS hypothesis using an immunologically based approach, and to determine whether CAS accounts for the excess of myeloma among Blacks. Over 50 medical conditions were grouped into biologically and immunologically related categories, and B-cell-and T-cell-mediated response groups. Except for urinary tract infections among Black men (odds ratio OR]=2.0), no significantly increased risks of MM were observed. However, there was a suggestion of increased risk among Blacks with an increased exposure to anaphylatic conditions. Analysis by immunoglobulin type revealed significantly elevated risks of IgG myeloma with eczema (OR=2.1), the biologic category allergic conditions (OR=1.6), and the immunologic category anaphylaxis response (OR=1.6) among Whites, with Blacks having slightly lower risks. Our findings do not support a causal relationship between CAS and MM, nor do they explain the higher incidence among Blacks.This research was funded under comtracts NO1-CP-51090, NO1-CN-0522, NO1-CP-51089, NO1-CN-31022, NO1-CP-51092, NO1-CN-05227 from the US National Cancer Institute. |
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Keywords: | Antigenic stimulation case-control study etiology multiple myeloma race United States |
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