Common community-acquired infections and subsequent risk of multiple myeloma: a population-based study

Charlene M. McShane, Liam J Murray, Eric A Engels, Ola Landgren, Lesley A Anderson

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18 Citations (Scopus)


The role of bacteria and viruses as aetiological agents in the pathogenesis of cancer has been well established for several sites, including a number of haematological malignancies. Less clear is the impact of such exposures on the subsequent development of multiple myeloma (MM). Using the population-based U.S. Surveillance Epidemiology and End Results-Medicare dataset, 15,318 elderly MM and 200,000 controls were identified to investigate the impact of 14 common community-acquired infections and risk of MM. Odds ratios (ORs) and associated 95% confidence intervals (CIs) were adjusted for sex, age and calendar year of selection. The 13-month period prior to diagnosis/selection was excluded. Risk of MM was increased by 5-39% following Medicare claims for eight of the investigated infections. Positive associations were observed for several infections including bronchitis (adjusted OR 1.14, 95% CI 1.09-1.18), sinusitis (OR 1.15, 95% CI 1.10-1.20) pneumonia (OR 1.27, 95% CI 1.21-1.33), herpes zoster (OR 1.39, 95% CI 1.29-1.49) and cystitis (OR 1.09, 95% CI 1.05-1.14). Each of these infections remained significantly elevated following the exclusion of more than 6 years of claims data. Exposure to infectious antigens may therefore play a role in the development of MM. Alternatively, the observed associations may be a manifestation of an underlying immune disturbance present several years prior to MM diagnosis and thereby part of the natural history of disease progression.
Original languageEnglish
Pages (from-to)1734-1740
Number of pages7
JournalInternational Journal of Cancer
Issue number7
Publication statusPublished - 01 Apr 2014


  • Aged
  • Aged, 80 and over
  • Community-Acquired Infections
  • Confidence Intervals
  • Female
  • Humans
  • Male
  • Multiple Myeloma
  • Odds Ratio
  • Risk
  • SEER Program
  • United States


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