Alcohol consumption and risk of non-Hodgkin lymphoma: a pooled analysis

Morton, Lindsay M.; Zheng, Tongzhang; Holford, Theodore R.; Holly, Elizabeth A.; Chiu, Brian C.‐H.; Costantini, Adele Seniori; Stagnaro, Emanuele; Willett, Eleanor V.; Maso, Luigino Dal; Serraino, Diego; Chang, Ellen T.; Cozen, Wendy; Davis, Scott; Severson, Richard K.; Bernstein, Leslie; Mayne, Susan T.; Dee, Fred R.; Cerhan, James R.; Hartge, Patricia

doi:10.1016/s1470-2045(05)70214-x

Cited by 127 publications

(106 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the current study, this hierarchical scheme was used. One of the main differences with many other studies using other classifications, is that in the current study PCN (including MM) is included in the group of lymphoid neoplasms, which most studies did not include 6,8,[10][11][12]42,43 The use of different classifications in previous studies, mostly among case-control studies, makes meaningful comparison of results between epidemiological studies very difficult and might explain the observed differences between case-control studies and between case-control and cohort studies. Subjects with baseline information on total ethanol consumption.…”

Section: Discussionmentioning

confidence: 87%

Alcohol consumption and risk of lymphoid and myeloid neoplasms: Results of the Netherlands cohort study

Heinen

Verhage

Schouten

et al. 2013

Intl Journal of Cancer

View full text Add to dashboard Cite

Results from epidemiological studies suggest that alcohol drinkers have a decreased risk of lymphoid neoplasms, whereas results for myeloid neoplasms are inconsistent. However, most of these studies have used retrospective data. We examined prospectively whether alcohol consumption decreases the risk of both lymphoid and myeloid neoplasms, including most common subtypes. Moreover, we investigated whether this decreased risk is due to ethanol or other contents of specific alcoholic beverages (i.e., beer, wine and liquor). The Netherlands cohort study consisted of 120,852 individuals who completed a baseline questionnaire in 1986. After 17.3 years of follow-up, 1,375 cases of lymphoid and 245 cases of myeloid neoplasms with complete exposure information were available for analysis. Compared with abstinence, we observed for plasma cell neoplasms hazard rate ratios (HR) of 1.66 (95% confidence interval (CI), 1.21-2.29), 1.63 (95% CI, 1.17-2.27), 1.11 (95% CI, 0.75-1.64) and 0.85 (95% CI, 0.51-1.42) with daily ethanol consumption of 0.1-<5, 5-<15, 15-<30 and 30 g, respectively. A similar pattern was observed for chronic lymphocytic leukemia=small lymphocytic lymphoma. No associations were observed for other subtypes and for myeloid neoplasms. When results were analyzed by beverage type, no clear associations were observed. In conclusion, our study did not show an inverse association between alcohol consumption and lymphoid neoplasms. Also, no inverse association was observed with myeloid neoplasms. If any association between alcohol consumption and lymphoid neoplasms exists, our study suggests an increased risk rather than a decreased risk.Hematologic malignancies, a heterogeneous group of neoplasms arising in lymphoid and myeloid cells throughout the body, account for 7.4% of cancers in males and 6.4% in females worldwide. 1 So far, little is known about the causes of hematologic malignancies. A few factors have been linked to lymphoid neoplasms, including age, gender, primary=inherited immune deficiencies, a number of viruses including the human immunodeficiency virus and several autoimmune diseases. 2 Also for myeloid neoplasms just few etiologic factors have been identified so far, including age, gender, genetic abnormalities, family history and exposures to radiation and benzene. 3 There is some evidence indicating that distinguishing between subtypes of lymphoid and myeloid neoplasms may reveal etiological heterogeneity 4 and, therefore, further research including individual subtypes with sufficient numbers of these neoplasms is needed.Most studies about alcohol consumption and risk of hematologic malignancies concern non-Hodgkin lymphoma (NHL). Recently, a meta-analysis including 20 case-control studies, one pooled analysis of nine case-control studies and eight cohort studies showed a reduction in NHL risk in association with higher alcohol intake. 5 Compared with nondrinkers, the pooled relative risks (RRs) were 0.88 (95% confidence interval (CI), 0.81-0.96) for light drinking ( 1 drink per day) and 0.87 (95...

show abstract

Section: Discussionmentioning

confidence: 87%

Alcohol consumption and risk of lymphoid and myeloid neoplasms: Results of the Netherlands cohort study

Heinen

Verhage

Schouten

et al. 2013

Intl Journal of Cancer

View full text Add to dashboard Cite

show abstract

“…14,16,19,30,38,40,42,43,55 Our results were also in accordance with the Interlymph findings in so far as in the pooled analysis no protective effect of alcohol was observed for European centers. 47 Similarly, the findings of the 2 other studies reporting an inverse association between alcohol intake and development of overall NHL were not based on European study populations, as one was a case-control study carried out in Japan 24 and the other one was a large American cohort study. 37 Our results reporting a protective effect of alcohol on development of NHL in countries like Ireland, Germany and Czech republic and the absence of such an effect in Mediterranean countries are consistent with findings from previous epidemiological studies revealing a protective effect of alcohol essentially in USA.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, risk estimates for alcohol consumption were adjusted by age (10-year intervals), sex, educational level (in 3 categories), smoking status (in 3 categories) and study center. 47,48 Never-smokers were the reference category for each of the analyses performed concerning tobacco smoking, and never regular drinkers were the reference category for each of the analyses performed concerning alcohol drinking. Linear trends were calculated by including categorical exposure variables as continuous variables in the regression models, and significance was tested by the Wald test (p < 0.05).…”

Section: Lifetime Alcohol Consumption ðKgþ ¼mentioning

confidence: 99%

“…46 In this analysis based on 6,492 cases of NHL and 8,683 controls, a slight inverse association was found between alcohol intake and the development of NHL. 47 The analysis of the effect of tobacco smoking, based on 6,594 cases of NHL and 8,892 controls, reported a slightly increased risk of NHL overall and of B-cell follicular lymphoma in particular. 48 Thus, we have attempted to confirm the results of the pooled analysis using data from an independent European multicenter case-control study (Epilymph).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Tobacco smoking, alcohol drinking and non‐Hodgkin's lymphoma: A European multicenter case‐control study (Epilymph)

Besson

Brennan

Becker

et al. 2006

Intl Journal of Cancer

View full text Add to dashboard Cite

To study the role of tobacco smoking and alcohol drinking in the etiology of non-Hodgkin's lymphoma (NHL), we conducted a multicenter case-control study in Spain, France, Germany, Italy, Ireland and Czech Republic between 1998 and 2004, which included 1,742 cases of NHL and 2,465 controls matched on age, sex and recruitment area. Tobacco smoking was not associated with the risk of NHL overall or with risk of specific histological subtypes. Similarly, there was no association between alcohol drinking and the risk of NHL overall or across histological subtypes. However, a protective effect of alcohol drinking was observed among men (OR 5 0.76, 95% CI 5 0.62-0.93) and in non-Mediterranean countries (OR 5 0.73, 95% CI 5 0.61-0.86). There was no evidence of interaction between alcohol drinking and tobacco smoking in NHL etiology. The results of this large-scale European study did not support an association between tobacco and NHL and suggested a protective effect of alcohol on development of NHL for men and in non-Mediterranean countries. ' 2006 Wiley-Liss, Inc.Key words: lymphoma; non-Hodgkin's; tobacco; alcohol; EuropeThe incidence of non-Hodgkin's lymphoma (NHL) has increased considerably in the last few decades in all countries with reliable information. 1 In Europe, between the early and the late 1990s, the rise in mortality was 5% for men and 8% for women. 2 There is no clear explanation of this phenomenon. To date, the established risk factors for NHL are autoimmune diseases, 3 infection with human immunodeficiency virus and human T-cell leukemia/lymphoma virus, 4 but these factors explain only a small proportion of the etiology of NHL. The role of tobacco smoking and alcohol drinking in the development of NHL remains uncertain partly due to the small sample sizes of previous epidemiologic studies. Recently, the International Lymphoma Epidemiology Consortium (Interlymph) has reported results based on pooled data of studies from Europe, 32-34 USA 22,28,39,45 and Australia. 46 In this analysis based on 6,492 cases of NHL and 8,683 controls, a slight inverse association was found between alcohol intake and the development of NHL. 47 The analysis of the effect of tobacco smoking, based on 6,594 cases of NHL and 8,892 controls, reported a slightly increased risk of NHL overall and of B-cell follicular lymphoma in particular. 48 Thus, we have attempted to confirm the results of the pooled analysis using data from an independent European multicenter case-control study (Epilymph). Material and methodsOur investigation was conducted in 7 European countries (Czech Republic, Finland, France, Germany, Ireland, Italy, and Spain), but data from Finland were not included in this analysis because of methodological issues, in particular, controls were not matched to cases on age, sex and residence area, as done in other study centers, and the present study is based on data from 6 countries.Histologically or cytologically confirmed incident cases of lymphoma were recruited from 1998 to 2004 (Table I). Cases were classified ac...

show abstract

“…368,369,373,374,376,382,388,[394][395][396][397][398][399] In a recent pooled analysis of 9 case-control studies, Morton et al 398 reported a significant inverse association with alcohol (pooled OR 5 0.83, 95% CI: 0.76-0.89), which did not vary with frequency or duration of intake, or by type of alcoholic beverage (OR for beer only, compared to nondrinkers 5 0.85, 95% CI: 0.76-0.95; OR for wine only 5 0.85, 95% CI: 0.74-0.99; OR for liquor only 5 0.90, 95% CI: 0.74-1.09). In a subgroup analysis of 4 of the studies with sufficient data, relative risk estimates were lower for current drinkers (pooled OR 5 0.73, 95% CI: 0.64-0.84) than for former drinkers (pooled OR 5 0.95, 95% CI: 0.80-1.14), compared to nondrinkers.…”

Section: Lifestyle and Personal Factors Tobacco And Alcohol Usementioning

confidence: 99%