Martha S Linet1, Claire M Vajdic2, Lindsay M Morton2, Anneclaire J de Roos2, Christine F Skibola2, Paolo Boffetta2, James R Cerhan2, Christopher R Flowers2, Silvia de Sanjosé2, Alain Monnereau2, Pierluigi Cocco2, Jennifer L Kelly2, Alexandra G Smith2, Dennis D Weisenburger2, Christina A Clarke2, Aaron Blair2, Leslie Bernstein2, Tongzhang Zheng2, Lucia Miligi2, Jacqueline Clavel2, Yolanda Benavente2, Brian C H Chiu2. 1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (MSL, LMM, AB); Prince of Wales Clinical School, University of New South Wales, Sydney, Australia (CMV); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (AJdR); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain (SdS, YB); INSERM, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Cagliari, Italy (PC); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JLK); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (AGS); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW); Cancer Prevention Institute of California, Fremont, CA (CAC); Department of Cancer Etiology, City of Hope Beckman Research Institute, Duarte, CA (LB); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (TZ); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO, Florence, Italy (LM); Department of Health Studies, University of Chicago, Chicago, IL (BCHC). linetm@mail.nih.gov. 2. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (MSL, LMM, AB); Prince of Wales Clinical School, University of New South Wales, Sydney, Australia (CMV); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (AJdR); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL (CFS); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (JRC); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain (SdS, YB); INSERM, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Cagliari, Italy (PC); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JLK); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (AGS); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW); Cancer Prevention Institute of California, Fremont, CA (CAC); Department of Cancer Etiology, City of Hope Beckman Research Institute, Duarte, CA (LB); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (TZ); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO, Florence, Italy (LM); Department of Health Studies, University of Chicago, Chicago, IL (BCHC).
Abstract
BACKGROUND: Follicular lymphoma (FL) has been linked with cigarette smoking and, inconsistently, with other risk factors. METHODS: We assessed associations of medical, hormonal, family history, lifestyle, and occupational factors with FL risk in 3530 cases and 22639 controls from 19 case-control studies in the InterLymph consortium. Age-, race/ethnicity-, sex- and study-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. RESULTS: Most risk factors that were evaluated showed no association, except for a few modest or sex-specific relationships. FL risk was increased in persons: with a first-degree relative with non-Hodgkin lymphoma (OR = 1.99; 95% CI = 1.55 to 2.54); with greater body mass index as a young adult (OR = 1.15; 95% CI = 1.04 to 1.27 per 5 kg/m(2) increase); who worked as spray painters (OR = 2.66; 95% CI = 1.36 to 5.24); and among women with Sjögren syndrome (OR = 3.37; 95% CI = 1.23 to 9.19). Lower FL risks were observed in persons: with asthma, hay fever, and food allergy (ORs = 0.79-0.85); blood transfusions (OR = 0.78; 95% CI = 0.68 to 0.89); high recreational sun exposure (OR = 0.74; 95% CI = 0.65 to 0.86, fourth vs first quartile); who worked as bakers or millers (OR = 0.51; 95% CI = 0.28 to 0.93) or university/higher education teachers (OR = 0.58; 95% CI = 0.41 to 0.83). Elevated risks specific to women included current and longer duration of cigarette use, whereas reduced risks included current alcohol use, hay fever, and food allergies. Other factors, including other autoimmune diseases, eczema, hepatitis C virus seropositivity, hormonal drugs, hair dye use, sun exposure, and farming, were not associated with FL risk. CONCLUSIONS: The few relationships observed provide clues suggesting a multifactorial etiology of FL but are limited in the extent to which they explain FL occurrence. Published by Oxford University Press 2014.
BACKGROUND:Follicular lymphoma (FL) has been linked with cigarette smoking and, inconsistently, with other risk factors. METHODS: We assessed associations of medical, hormonal, family history, lifestyle, and occupational factors with FL risk in 3530 cases and 22639 controls from 19 case-control studies in the InterLymph consortium. Age-, race/ethnicity-, sex- and study-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. RESULTS: Most risk factors that were evaluated showed no association, except for a few modest or sex-specific relationships. FL risk was increased in persons: with a first-degree relative with non-Hodgkin lymphoma (OR = 1.99; 95% CI = 1.55 to 2.54); with greater body mass index as a young adult (OR = 1.15; 95% CI = 1.04 to 1.27 per 5 kg/m(2) increase); who worked as spray painters (OR = 2.66; 95% CI = 1.36 to 5.24); and among women with Sjögren syndrome (OR = 3.37; 95% CI = 1.23 to 9.19). Lower FL risks were observed in persons: with asthma, hay fever, and food allergy (ORs = 0.79-0.85); blood transfusions (OR = 0.78; 95% CI = 0.68 to 0.89); high recreational sun exposure (OR = 0.74; 95% CI = 0.65 to 0.86, fourth vs first quartile); who worked as bakers or millers (OR = 0.51; 95% CI = 0.28 to 0.93) or university/higher education teachers (OR = 0.58; 95% CI = 0.41 to 0.83). Elevated risks specific to women included current and longer duration of cigarette use, whereas reduced risks included current alcohol use, hay fever, and food allergies. Other factors, including other autoimmune diseases, eczema, hepatitis C virus seropositivity, hormonal drugs, hair dye use, sun exposure, and farming, were not associated with FL risk. CONCLUSIONS: The few relationships observed provide clues suggesting a multifactorial etiology of FL but are limited in the extent to which they explain FL occurrence. Published by Oxford University Press 2014.
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