Smoking and Risk of Non-Hodgkin Lymphoma Subtypes in a Cohort of Older Women

Abstract

Although non-Hodgkin lymphoma (NHL) has not been considered to be a smoking-related malignancy, recent investigations suggest otherwise. We evaluated this association in a cohort of 37,336 women, aged 55-69 years, who reported in a mailed questionnaire in 1986 information regarding smoking history as well as demographic, medical history and dietary factors. Cancer and mortality experience through 1996 was determined by linkage to the Iowa Cancer Registry and other databases; there were 200 incident cases of NHL during the 380,231 total person-years of follow-up. Compared to never smokers, former (age-adjusted RR = 1.0; 95% CI 0.8-1.5) and current smokers (age-adjusted RR = 1.0; 95% CI 0.7-1.5) were not at elevated risk of NHL, and there was no trend with pack-years smoked (Ptrend = 0.3). Multivariate adjustment for other NHL risk factors did not alter these findings. Age-adjusted analysis by NHL subtype revealed a suggestive positive association of smoking with follicular NHL [(RRformer = 1.3; 95% CI 0.6-2.8), (RRcurrent = 1.8; 95% CI 0.8-3.8)], which strengthened after multivariate adjustment [(RRformer = 1.6; 95% CI 0.7-3.4), (RRcurrent = 2.3; 95% CI 1.0-5.0)]; there was no association for diffuse or small cleaved-cell NHL. Our study findings, which are consistent with other recent investigations, suggest that smoking may be associated with an increased risk of follicular NHL.

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

“…19 In line with our results, a study of a cohort of Iowa women did not show any excess risk of NHL for neither current nor former smokers. 18 In contrast, one population-based case-control study 10 presented a significantly higher risk of NHL associated with pipe and cigar smoking, but not for cigarette smoking, nor any dose-response relationship for number of cigarettes smoked. A large multicenter study provided support for a slightly increased risk of NHL.…”

“…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.…”

“…7 Whereas several studies have suggested smoking to be associated with NHL [8][9][10][11] and HD, 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 morbidity and mortality around the world.…”

“…[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 morbidity and mortality around the world.…”

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

“…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).…”