Cigarette smoking and risk of non-Hodgkin lymphoma subtypes among women

Morton, Lindsay M.; Holford, Theodore R.; Leaderer, Brian P.; Boyle, Peter; Zahm, Shelia Hoar; Zhang, Y; Flynn, Stuart D.; Tallini, Giovanni; Zhang, B; Owens, Pamela L; Zheng, Tongzhang

doi:10.1038/sj.bjc.6601388

Cited by 45 publications

(43 citation statements)

References 31 publications

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“…However a positive link in ever smoking women was perceived for follicular lymphoma. 17 Other publications 18,20,[29][30] have contributed results of close resemblance. In a pooled analysis of nine case-control studies 31 smoking was associated with a slightly increased risk of NHL overall.…”

Section: Discussionmentioning

confidence: 80%

Tobacco use, body mass index and the risk of malignantlymphomas—A nationwide cohort study in Sweden

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Bellocco

et al. 2005

Intl Journal of Cancer

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In the search for risk factors involved in the etiology of lymphoproliferative malignancies there is still inconsistent evidence regarding effects of smoking tobacco, and the role of smokeless tobacco is poorly investigated. New evidence indicates that excess body weight increases the risk of NHL and HD. To determine if tobacco use of various forms and high Body Mass Index (BMI) affect the occurrence of these neoplasms, we conducted a prospective cohort study on over 330,000 Swedish construction workers included in the Construction Industry Working Environment and Health program. Information on smoking, snuff dipping, height and weight was gathered by self administered questionnaires together with personal interviews. Cancer incidence was ascertained through the year 2000 by record linkage to the nationwide Swedish Cancer Registry, Migration Registry and Cause of Death Registry. At the end of follow up, 1,309 subjects had been diagnosed with NHL (including chronic lymphocytic leukemia) and 205 with HD respectively. Age adjusted incidence rate ratios were computed using Cox proportional Hazard regression modeling. Smoking cigarette, pipe or cigar was not associated with NHL or HD. There was no evidence indicating a relation between quantity and duration of smoking and NHL or HD risk. No link was found between NHL and usage of smokeless tobacco. Having a BMI of 30 or higher did not convey excess risk of developing NHL or HD compared to normal weight ). We conclude that tobacco smoking and high BMI do not entail an increased risk of NHL and HD. Our findings of a relation between the duration of snuff dipping and HD need further investigation. ' 2005 Wiley-Liss, Inc.Key words: non-Hodgkin's lymphoma; Hodgkins disease; smokingtobacco; moist snuff; body mass index Over the past decades, there has been controversy regarding the impact of tobacco use on the development of lymphatic malignancies. Although studies conducted within this area are not sparse, results have been largely inconsistent. In part, the conflicting results might reflect the various designs and sizes of the studies, study type and subjects, interview compliance and if information was obtained from study subjects or their next of kin.Tobacco smoke is known to comprise a number of components, including benzene, lead and polonium 1-3 affecting the immune system by means such as increasing mean leukocyte counts, [4][5] most strongly correlated to neutrophils and CD41 cells, 5 and altered T-cell function. 6 Moreover smoking has been correlated to lowered levels of immunoglobulins, lysozyme as well as a decrease in the total number of NK-cells in long time smokers. 7Whereas several studies have suggested smoking to be associated with NHL [8][9][10][11]8,12 others have failed to confirm these results. [13][14][15][16][17][18][19] More recent studies have indicated this relation to be particularly strong for follicular lymphoma and high grade lymphomas. 9,17,20 Overweight and obesity has become a globally accelerating health issue related to increased morbidi...

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Section: Discussionmentioning

confidence: 80%

Tobacco use, body mass index and the risk of malignantlymphomas—A nationwide cohort study in Sweden

Fernberg

Odenbro

Bellocco

et al. 2005

Intl Journal of Cancer

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“…Of interest was a small but significant increase in risk of NHL after bladder cancer, which could also indicate some joint exposures for the two cancers. Although smoking is an attractive putative common risk factor between NHL, bladder and lung cancer, the evidence for a role of smoking in NHL has been very limited until now, with only few studies suggesting that smoking may be associated with follicular NHL (Herrinton and Friedman, 1998;Parker et al, 2000;Morton et al, 2003;Stagnaro et al, 2004).…”

Section: Treatment Effectsmentioning

confidence: 99%

Second primary cancers among 109 000 cases of non-Hodgkin's lymphoma

et al. 2005

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An analysis of other primary cancers in individuals with non-Hodgkin's lymphoma (NHL) can help to elucidate this cancer aetiology. In all, 109 451 first primary NHL were included in a pooled analysis of 13 cancer registries. The observed numbers of second cancers were compared to the expected numbers derived from the age-, sex-, calendar period-and registry-specific incidence rates. We also calculated the standardised incidence ratios for NHL as a second primary after other cancers. There was a 47% (95% confidence interval 43 -51%) overall increase in the risk of a primary cancer after NHL. A strongly significant (Po0.001) increase was observed for cancers of the lip, tongue, oropharynx*, stomach, small intestine, colon*, liver, nasal cavity*, lung, soft tissues*, skin melanoma*, nonmelanoma skin*, bladder*, kidney*, thyroid*, Hodgkin's lymphoma*, lymphoid leukaemia* and myeloid leukaemia. NonHodgkin's lymphoma as a second primary was increased after cancers marked with an asterisk. Patterns of risk indicate a treatment effect for lung, bladder, stomach, Hodgkin's lymphoma and myeloid leukaemia. Common risk factors may be involved for cancers of the lung, bladder, nasal cavity and for soft tissues, such as pesticides. Bidirectional effects for several cancer sites of potential viral origin argue strongly for a role for immune suppression in NHL. 1992, 2002) indicates that this increase is occurring at an average annual rate of 4 -5% each year, implying a doubling of NHL incidence every 20 years. This upward trend has been observed in all geographical regions covered by cancer registration, and is not restricted to any particular age group or sex, or to predominantly rural or urban areas. The reason for the increase has attracted much speculation although there is no clear explanation for it.It has long been recognised that clusters of second primary cancers provide a unique clue to the understanding of cancer aetiology and mechanisms (Hanlon, 1931). If detection and other biases can be excluded, then the increased risk of an individual developing more than one primary cancer may be attributed to either (i) common risk factors between the cancers including environmental exposures and genetic factors, or (ii) effects of treatment, particularly chemo-and radiotherapy for the first primaries . It is often possible to distinguish between these two explanations. Cancers that share a common aetiology are likely to be increased after each other, whereas an increased incidence of treatment-related second primary cancers is often unidirectional. Furthermore, an increase in treatment-related cancers usually only becomes apparent years after the first primary cancer. To help elucidate the potential causes of NHL and the recent increasing incidence, we have therefore studied the occurrence of second primary cancers in over 109 000 patients with NHL from 13 cancer registries.

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“…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%