Obesity and non-Hodgkin lymphoma survival in an ethnically diverse population: the Multiethnic Cohort study
Evidence is emerging that obesiy and weight gain may affect the prognosis of several types of cancer. We investigated the impact of body mass index (BMI) as well as pre-and postdiagnosis weight changes on non-Hodgkin lymphoma (NHL) prognosis. A cohort of 573 female incident NHL cases diagnosed during 1996-2000 in Connecticut was followed for a median of 7.8 yr. Self-reported height and weight at 3 time points before and after diagnosis were collected. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using proportional hazard models adjusting for factors believed to be associated with overall survival of NHL. Underweight (BMI < 18.5; HR = 2.84; 95% CI = 1.12-7.15) before diagnosis was associated with poorer survival compared to being normal weight (18.5 ≤ BMI < 25). Prediagnosis weight loss (HR = 1.42; 95% CI = 1.02-1.97) and posttreatment weight loss (HR = 1.98; 95% CI = 1.14-3.45) and weight gain (HR = 1.85; 95% CI = 1.04-3.32) were associated with poorer survival. NHL patients who were underweight, lost weight prediagnosis, or change weight after treatment were found to have a poorer survival.