Association between anthropometry and lifestyle factors and risk of B‐cell lymphoma: An exposome‐wide analysis

Abstract

B‐cell lymphomas (BCLs) are an etiologically, clinically, and histologically heterogeneous group of malignant diseases of B lymphocytes. Immunodeficiency and autoimmunity are strong B‐cell lymphoma risk factors.1 Epidemiological studies showed that the risk of BCL is associated with anthropometry measures, lifestyle, viral, environmental and occupational factors (collectively called the exposome).2-8 Moreover, in the last two decades, reports from epidemiological studies suggested differences in risks among BCL subtypes for a wide range of risk factors.2

To better understand the role of risk factors in the occurrence of BCL, it would be preferable to study a large set of lifestyle factors (exposome) in a single study. Few methods are available to comprehensively evaluate the role of specific risk factors with disease. Recently, a study design analogous to genome‐wide association studies, the exposome‐wide association study, or equivalently, environment‐wide association study (EWAS), has been proposed to search for and validate exposures associated with complex diseases. Instead of testing one or only a few associations at a time, EWAS evaluates multiple exposures for association, with proper adjustment for multiplicity and collinearity of comparisons. EWAS techniques have recently been used to assess environmental factors in relation to chronic diseases (eg, Type 2 diabetes, high blood pressure and peripheral arterial disease) and mortality.9-11

In this study, we aimed to use an exposome‐wide approach to evaluate multiple lifestyle exposures and determine both their independent and combined roles (using a multivariable penalized regression algorithm and principal component [PC] approaches) with respect to the risk of BCL and major subtypes using data from the European Prospective Investigation into Nutrition and Cancer cohort (EPIC)