Reproductive Factors, Exogenous Hormone Use, and Risk of B-Cell Non-Hodgkin Lymphoma in a Cohort of Women From the European Prospective Investigation Into Cancer and Nutrition

Abstract

The role of hormonal factors in the etiology of lymphoid neoplasms remains unclear. Previous studies have yielded conflicting results, have lacked sufficient statistical power to assess many lymphoma subtypes, or have lacked detailed information on relevant exposures. Within the European Prospective Investigation Into Cancer and Nutrition cohort, we analyzed comprehensive data on reproductive factors and exogenous hormone use collected at baseline (1992-2000) among 343,458 women, including data on 1,427 incident cases of B-cell non-Hodgkin lymphoma (NHL) and its major subtypes identified after a mean follow-up period of 14 years (through 2015). We estimated hazard ratios and 95% confidence intervals using multivariable proportional hazards modeling. Overall, we observed no statistically significant associations between parity, age at first birth, breastfeeding, oral contraceptive use, or ever use of postmenopausal hormone therapy and risk of B-cell NHL or its subtypes. Women who had undergone surgical menopause had a 51% higher risk of B-cell NHL (based on 67 cases) than women with natural menopause (hazard ratio = 1.51, 95% confidence interval: 1.17, 1.94). Given that this result may have been due to chance, our results provide little support for the hypothesis that sex hormones play a role in lymphomagenesis.

Secular trends in the incidence and survival of all leukemia types in the United States from 1975 to 2017

“…However, females had comparatively higher APC than males for age-adjusted leukemia incidence during the entire monitoring period. The potential reasons for the sex difference in leukemia incidence maybe originate from female reproductive factors, exogenous hormones, and lifestyles, affecting potentially immune function and the carcinogenesis process 24 - 26 . However, we observed that the 5-year survival rate of all leukemia patients did not differ in sex throughout the monitoring period.…”

Increased Risk of Lymphoma in Men Infected With Tuberculosis

“…Costas et al observed a significantly higher risk of B-cell NHL in women who underwent hysterectomy and bilateral oophorectomy than in women who did not, supporting the role of oestrogens. 33 In addition, more TB-infected men present clinical symptoms than women. 34 However, a large sample prospective cohort study is warranted.…”

The role of pregnancy in maternal cancer risk: Epidemiologic evidence from the Nordic Countries Linked Birth and Cancer Registries Cohort Project

“…While malignant melanoma is the most common cancer arising during pregnancy, accounting for about a third of malignancies among expectant mothers, parous women are not at higher risk of subsequently developing melanoma than nulliparous women (51), or of developing non-melanoma skin cancer (52). Women have a lower incidence of leukemias and lymphomas overall than men, but there is little evidence that pregnancy factors are associated with non-Hodgkin's lymphoma (53). One study, however, showed that parous women had about a two-and-a-half-fold increased risk of lymphoid neoplasm compared with nulliparous women, but no associations were observed between lymphoid neoplasms and other reproductive factors, including age at first birth and breastfeeding (54).…”