Type 2 diabetes and risk of non-Hodgkin lymphoma and multiple myeloma: A pooled analysis

Authors: ARDISSON KORAT, ANDRES - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; DEUBLER, EMILY - American Cancer Society; BERTRAND, KIMBERLY - Boston University; TERAS, LAUREN - American Cancer Society; LACEY JR., JAMES - Beckman Research Institute; PATEL, ALPHA - American Cancer Society; ROSNER, BERNARD - Brigham & Women'S Hospital; SHU, YU-HSIANG - Kaiser Permanente; ZHONG, CHARLIE - American Cancer Society; WANG, SOPHIA - Beckman Research Institute; BIRMANN, BRENDA - Brigham & Women'S Hospital; CHAO, CHUN - Kaiser Permanente

Submitted to: Journal of the National Cancer Institute
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/30/2026
Publication Date: 2/17/2026
Citation: Ardisson Korat, A., Deubler, E., Bertrand, K., Teras, L.R., Lacey Jr., J.V., Patel, A.V., Rosner, B.A., Shu, Y., Zhong, C., Wang, S.S., Birmann, B.M., Chao, C.R. 2026. Type 2 diabetes and risk of non-Hodgkin lymphoma and multiple myeloma: A pooled analysis. Journal of the National Cancer Institute. 10(2). https://doi.org/10.1093/jncics/pkag017.
DOI: https://doi.org/10.1093/jncics/pkag017

Interpretive Summary: Type 2 diabetes is associated with elevated risks of several cancers. Findings from previous studies have suggested that type 2 diabetes may influence the risk of non-Hodgkin lymphoma and multiple myeloma. However, few studies have included enough participants to confirm these observations and evaluate this relationship for non-Hodgkin lymphoma subtypes. To address this gap, we combined data from six studies, including the Cancer Prevention Study-II Nutrition Cohort, California Teachers' Study, Health Professionals Follow-up Study, Nurses' Health Study I and II cohorts, and a sample of Kaiser Permanente Southern California members, for a total of 585,114 participants. We found that type 2 diabetes was not associated with the risk of total non-Hodgkin lymphoma. However, we found that type 2 diabetes was linked to elevated risk of diffuse large B-cell lymphoma, a common and aggressive lymphoma subtype, and also with an increased risk of multiple myeloma. On the other hand, we observed that type 2 diabetes was related to lower risks of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia, mycosis fungoides/Sezary syndrome, and T-cell non-Hodgkin lymphoma, which are less common non-Hodgkin lymphoma subtypes. Longer duration of type 2 diabetes was associated with elevated risks of diffuse large B-cell lymphoma and multiple myeloma.

Technical Abstract: Background: Prior studies suggest positive associations of type 2 diabetes (T2D) with risk of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM), but few studies had sufficient statistical power to evaluate associations for specific histologic subtypes. Methods: We pooled data from the Cancer Prevention Study-II Nutrition Cohort, California Teachers' Study, Health Professionals Follow-up Study, Nurses' Health Study (NHS), and NHSII cohorts and a sample of Kaiser Permanente Southern California members (585,114 total study participants). We confirmed incident NHL and MM diagnoses through medical records or cancer registries. T2D history was assessed by self-report or clinical diagnosis. We estimated the associations of T2D history (yes/no) and T2D duration with risk of overall NHL, NHL subtypes, or MM using multivariable Cox regression models adjusted for age, sex, cohort, follow-up year, race, education, smoking, and body mass index. Results: We confirmed 11,478 NHL and 2,783 MM diagnoses over a median follow-up of 20 years. T2D history was not associated with overall NHL risk but was positively associated with risk of diffuse large B-cell lymphoma (DLBCL; hazard ratio [HR]: 1.15, 95% confidence interval [CI]: 1.04-1.28) and MM (1.20, 1.07-1.35) and inversely associated with risk of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia (0.45, 0.27-0.75), mycosis fungoides/Sezary syndrome (0.67, 0.46-0.98), and T-cell NHL (0.78, 0.62-0.97). T2D duration was positively associated with risk of DLBCL and MM. Conclusions: Our findings suggest a role for T2D in DLBCL and MM; thus, T2D prevention may be important in reducing their incidence. Some unexpected inverse associations require further investigation.