Cigarette Smoking and Risk of Non-Hodgkin's Lymphoma—A Population-Based Case-Control Study

Schöllkopf, Claudia; Smedby, Karin E.; Hjalgrim, Henrik; Rostgaard, Klaus; Gadeberg, Ole; Roos, Göran; Porwit‐MacDonald, Anna; Glimelius, Bengt; Adami, Hans‐Olov; Melbye, Mads

doi:10.1158/1055-9965.epi-05-0077

Cited by 41 publications

(27 citation statements)

References 54 publications

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“…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.…”

Section: Discussionsupporting

confidence: 92%

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

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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...

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Section: Discussionsupporting

confidence: 92%

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

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“…Although several studies have reported no association between smoking and the risk of lymphoma (3,10,11), the pooled analysis of the International Lymphoma Epidemiology Consortium study revealed a positive association between smoking and the risk of non-Hodgkin's lymphoma [OR (95% CI), reference for never smokers and 1.07 (1.00-1.15) for ever smokers], suggesting that smoking has carcinogenic effects (9). Consistent with this, our present study also showed a positive association between smoking exposure and lymphoma [OR (95% CI), reference for never smokers and 1.24 (1.02-1.51) for ever smokers] along with heterogeneity of this risk between each of the major histologic subtypes: follicular lymphoma, Hodgkin's lymphoma, marginal zone lymphoma, and diffuse large B-cell lymphoma.…”

Section: Discussionmentioning

confidence: 99%

“…Several case-control and cohort studies have investigated the association of alcohol intake and smoking with the risk of Hodgkin's and non-Hodgkin's lymphoma in nonAsian populations, with most suggesting an inverse association for alcohol consumption with the risk of malignant lymphoma (1-6) versus inconsistent results for smoking (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). However, little research has been conducted in Asian populations, particularly with regard to the effects of smoking and alcohol consumption on the risk of malignant lymphoma subtypes.…”

Section: Introductionmentioning

confidence: 99%

Association of Alcohol Intake and Smoking with Malignant Lymphoma Risk in Japanese: A Hospital-Based Case-Control Study at Aichi Cancer Center

Kanda

Matsuo

Kawase

et al. 2009

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Given the lower incidence and differences in distribution of malignant lymphoma in Asian than western populations, the association of alcohol intake and smoking with malignant lymphoma risk in Asian populations merits investigation. Here, we conducted a sex-and agematched case-control study of a Japanese population using two data sets, the first and second versions of the Hospital-based Epidemiological Research Program at Aichi Cancer Center Hospital (HERPACC-I and HERPACC-II, respectively), in 452 and 330 cases of histologically diagnosed malignant lymphoma and 2,260 and 1,650 noncancer controls, respectively. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using a conditional logistic regression model that incorporated smoking exposure and alcohol intake. Compared with nondrinking, consumption of ≥50 g/d by frequent drinkers was associated with significantly decreased risk in both data sets [OR (95% CI), 0.70 (0.53-0.93) for HERPACC-I and 0.40 (0.23-0.68) for HERPACC-II]. Given similar findings among groups, we used pooled data sets in subsequent analyses. For any alcohol intake versus nondrinking, point estimates of OR were less than unity for all four malignant lymphoma subtypes. In contrast, pack-years of smoking were associated with increased malignant lymphoma risk: relative to the reference (0-4 pack-years), OR (95% CI) were 1.32 (1.02-1.71), 1.39 (1.07-1.80), and 1.48 (1.12-1.95) for 5 to 19, 20 to 39, and ≥40 pack-years, respectively. This association with smoking was less apparent for all subtypes, except Hodgkin's lymphoma. In conclusion, we found that alcohol had an inverse association with malignant lymphoma risk across all malignant lymphoma subtypes in our Japanese subjects. Smoking appeared to be positively associated with malignant lymphoma risk, but this finding may vary by subtype.

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“…Most reports have shown no excess risk of NHL overall in tobacco or cigarette smokers [134 Á/137], but there are several exceptions [138Á/140]. Some studies have suggested a specific association with risk of the common follicular NHL subtype [139,141,142]. Tobacco smoking appears to induce the bcl-2 oncogene translocation (14;18) in peripheral lymphocytes of healthy individuals [143].…”

Section: Tobacco Smokingmentioning

confidence: 99%

Epidemiology and etiology of non-Hodgkin lymphoma – a review

2006

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The etiology of non-Hodgkin lymphoma, as well as its global dramatic rise in incidence during the past decades, remains largely unexplained. However, there is increasing awareness that this group of malignancies may entail not only clinical, morphological and molecular heterogeneity, but also considerable variations in terms of etiologic factors. In this review, epidemiologic patterns are summarized as well as current evidence of associations between various known or suspected risk factors for non-Hodgkin lymphoma overall or for any of its subtypes. Central pathogenetic mechanisms include immunosuppression, especially in relation to T-cell function and loss of control of latent EBV infection, and chronic antigen stimulation. Some degree of familiar aggregation also implies a role for genetic susceptibility. A number of recent investigations of non-Hodgkin lymphoma etiology will hopefully lead to a better understanding of the causes of these malignancies.

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Cigarette Smoking and Risk of Non-Hodgkin's Lymphoma—A Population-Based Case-Control Study

Cited by 41 publications

References 54 publications

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

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

Association of Alcohol Intake and Smoking with Malignant Lymphoma Risk in Japanese: A Hospital-Based Case-Control Study at Aichi Cancer Center

Epidemiology and etiology of non-Hodgkin lymphoma – a review

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