Medical history, lifestyle, family history, and occupational risk factors for Diffuse Large B-cell Lymphoma: The interLymph non-Hodgkin lymphoma subtypes project

James R Cerhan, Anne Kricker, Ora Paltiel, Christopher R. Flowers, Sophia S. Wang, Alain Monnereau, Aaron Blair, Luigino Dal Maso, Eleanor V. Kane, Alexandra Nieters, James M Foran, Lucia Miligi, Jacqueline Clavel, Leslie Bernstein, Nathaniel Rothman, Susan L Slager, Joshua N. Sampson, Lindsay M. Morton, Christine F. Skibola

Research output: Contribution to journalArticle

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Abstract

Background: Although risk factors for diffuse large B-cell lymphoma (DLBCL) have been suggested, their independent effects, modification by sex, and association with anatomical sites are largely unknown. Methods: In a pooled analysis of 4667 cases and 22 639 controls from 19 studies, we used stepwise logistic regression to identify the most parsimonious multivariate models for DLBCL overall, by sex, and for selected anatomical sites. Results: DLBCL was associated with B-cell activating autoimmune diseases (odds ratio [OR] = 2.36, 95% confidence interval [CI] = 1.80 to 3.09), hepatitis C virus seropositivity (OR = 2.02, 95% CI = 1.47 to 2.76), family history of non-Hodgkin lymphoma (OR = 1.95, 95% CI = 1.54 to 2.47), higher young adult body mass index (OR = 1.58, 95% CI = 1.12 to 2.23, for 35+ vs 18.5 to 22.4 kg/m2), higher recreational sun exposure (OR = 0.78, 95% CI = 0.69 to 0.89), any atopic disorder (OR = 0.82, 95% CI = 0.76 to 0.89), and higher socioeconomic status (OR = 0.86, 95% CI = 0.79 to 0.94). Additional risk factors for women were occupation as field crop/vegetable farm worker (OR = 1.78, 95% CI = 1.22 to 2.60), hairdresser (OR = 1.65, 95% CI = 1.12 to 2.41), and seamstress/embroider (OR = 1.49, 95% CI = 1.13 to 1.97), low adult body mass index (OR = 0.46, 95% CI = 0.29 to 0.74, for <18.5 vs 18.5 to 22.4 kg/m2), hormone replacement therapy started age at least 50 years (OR = 0.68, 95% CI = 0.52 to 0.88), and oral contraceptive use before 1970 (OR = 0.78, 95% CI = 0.62 to 1.00); and for men were occupation as material handling equipment operator (OR = 1.58, 95% CI = 1.02 to 2.44), lifetime alcohol consumption (OR = 0.57, 95% CI = 0.44 to 0.75, for >400 kg vs nondrinker), and previous blood transfusion (OR = 0.69, 95% CI = 0.57 to 0.83). Autoimmune disease, atopy, and family history of non-Hodgkin lymphoma showed similar associations across selected anatomical sites, whereas smoking was associated with central nervous system, testicular and cutaneous DLBCLs; inflammatory bowel disease was associated with gastrointestinal DLBCL; and farming and hair dye use were associated with mediastinal DLBCL. Conclusion: Our results support a complex and multifactorial etiology for DLBCL with some variation in risk observed by sex and anatomical site.

Original languageEnglish (US)
Pages (from-to)15-25
Number of pages11
JournalJournal of the National Cancer Institute - Monographs
Issue number48
DOIs
StatePublished - 2014

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Medical History Taking
Lymphoma, Large B-Cell, Diffuse
Non-Hodgkin's Lymphoma
Life Style
Odds Ratio
Confidence Intervals
Autoimmune Diseases
Body Mass Index
Hair Dyes
Solar System
Agriculture
Inflammatory Bowel Diseases
Occupations

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Medical history, lifestyle, family history, and occupational risk factors for Diffuse Large B-cell Lymphoma : The interLymph non-Hodgkin lymphoma subtypes project. / Cerhan, James R; Kricker, Anne; Paltiel, Ora; Flowers, Christopher R.; Wang, Sophia S.; Monnereau, Alain; Blair, Aaron; Maso, Luigino Dal; Kane, Eleanor V.; Nieters, Alexandra; Foran, James M; Miligi, Lucia; Clavel, Jacqueline; Bernstein, Leslie; Rothman, Nathaniel; Slager, Susan L; Sampson, Joshua N.; Morton, Lindsay M.; Skibola, Christine F.

In: Journal of the National Cancer Institute - Monographs, No. 48, 2014, p. 15-25.

Research output: Contribution to journalArticle

Cerhan, JR, Kricker, A, Paltiel, O, Flowers, CR, Wang, SS, Monnereau, A, Blair, A, Maso, LD, Kane, EV, Nieters, A, Foran, JM, Miligi, L, Clavel, J, Bernstein, L, Rothman, N, Slager, SL, Sampson, JN, Morton, LM & Skibola, CF 2014, 'Medical history, lifestyle, family history, and occupational risk factors for Diffuse Large B-cell Lymphoma: The interLymph non-Hodgkin lymphoma subtypes project', Journal of the National Cancer Institute - Monographs, no. 48, pp. 15-25. https://doi.org/10.1093/jncimonographs/lgu010
Cerhan, James R ; Kricker, Anne ; Paltiel, Ora ; Flowers, Christopher R. ; Wang, Sophia S. ; Monnereau, Alain ; Blair, Aaron ; Maso, Luigino Dal ; Kane, Eleanor V. ; Nieters, Alexandra ; Foran, James M ; Miligi, Lucia ; Clavel, Jacqueline ; Bernstein, Leslie ; Rothman, Nathaniel ; Slager, Susan L ; Sampson, Joshua N. ; Morton, Lindsay M. ; Skibola, Christine F. / Medical history, lifestyle, family history, and occupational risk factors for Diffuse Large B-cell Lymphoma : The interLymph non-Hodgkin lymphoma subtypes project. In: Journal of the National Cancer Institute - Monographs. 2014 ; No. 48. pp. 15-25.
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title = "Medical history, lifestyle, family history, and occupational risk factors for Diffuse Large B-cell Lymphoma: The interLymph non-Hodgkin lymphoma subtypes project",
abstract = "Background: Although risk factors for diffuse large B-cell lymphoma (DLBCL) have been suggested, their independent effects, modification by sex, and association with anatomical sites are largely unknown. Methods: In a pooled analysis of 4667 cases and 22 639 controls from 19 studies, we used stepwise logistic regression to identify the most parsimonious multivariate models for DLBCL overall, by sex, and for selected anatomical sites. Results: DLBCL was associated with B-cell activating autoimmune diseases (odds ratio [OR] = 2.36, 95{\%} confidence interval [CI] = 1.80 to 3.09), hepatitis C virus seropositivity (OR = 2.02, 95{\%} CI = 1.47 to 2.76), family history of non-Hodgkin lymphoma (OR = 1.95, 95{\%} CI = 1.54 to 2.47), higher young adult body mass index (OR = 1.58, 95{\%} CI = 1.12 to 2.23, for 35+ vs 18.5 to 22.4 kg/m2), higher recreational sun exposure (OR = 0.78, 95{\%} CI = 0.69 to 0.89), any atopic disorder (OR = 0.82, 95{\%} CI = 0.76 to 0.89), and higher socioeconomic status (OR = 0.86, 95{\%} CI = 0.79 to 0.94). Additional risk factors for women were occupation as field crop/vegetable farm worker (OR = 1.78, 95{\%} CI = 1.22 to 2.60), hairdresser (OR = 1.65, 95{\%} CI = 1.12 to 2.41), and seamstress/embroider (OR = 1.49, 95{\%} CI = 1.13 to 1.97), low adult body mass index (OR = 0.46, 95{\%} CI = 0.29 to 0.74, for <18.5 vs 18.5 to 22.4 kg/m2), hormone replacement therapy started age at least 50 years (OR = 0.68, 95{\%} CI = 0.52 to 0.88), and oral contraceptive use before 1970 (OR = 0.78, 95{\%} CI = 0.62 to 1.00); and for men were occupation as material handling equipment operator (OR = 1.58, 95{\%} CI = 1.02 to 2.44), lifetime alcohol consumption (OR = 0.57, 95{\%} CI = 0.44 to 0.75, for >400 kg vs nondrinker), and previous blood transfusion (OR = 0.69, 95{\%} CI = 0.57 to 0.83). Autoimmune disease, atopy, and family history of non-Hodgkin lymphoma showed similar associations across selected anatomical sites, whereas smoking was associated with central nervous system, testicular and cutaneous DLBCLs; inflammatory bowel disease was associated with gastrointestinal DLBCL; and farming and hair dye use were associated with mediastinal DLBCL. Conclusion: Our results support a complex and multifactorial etiology for DLBCL with some variation in risk observed by sex and anatomical site.",
author = "Cerhan, {James R} and Anne Kricker and Ora Paltiel and Flowers, {Christopher R.} and Wang, {Sophia S.} and Alain Monnereau and Aaron Blair and Maso, {Luigino Dal} and Kane, {Eleanor V.} and Alexandra Nieters and Foran, {James M} and Lucia Miligi and Jacqueline Clavel and Leslie Bernstein and Nathaniel Rothman and Slager, {Susan L} and Sampson, {Joshua N.} and Morton, {Lindsay M.} and Skibola, {Christine F.}",
year = "2014",
doi = "10.1093/jncimonographs/lgu010",
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TY - JOUR

T1 - Medical history, lifestyle, family history, and occupational risk factors for Diffuse Large B-cell Lymphoma

T2 - The interLymph non-Hodgkin lymphoma subtypes project

AU - Cerhan, James R

AU - Kricker, Anne

AU - Paltiel, Ora

AU - Flowers, Christopher R.

AU - Wang, Sophia S.

AU - Monnereau, Alain

AU - Blair, Aaron

AU - Maso, Luigino Dal

AU - Kane, Eleanor V.

AU - Nieters, Alexandra

AU - Foran, James M

AU - Miligi, Lucia

AU - Clavel, Jacqueline

AU - Bernstein, Leslie

AU - Rothman, Nathaniel

AU - Slager, Susan L

AU - Sampson, Joshua N.

AU - Morton, Lindsay M.

AU - Skibola, Christine F.

PY - 2014

Y1 - 2014

N2 - Background: Although risk factors for diffuse large B-cell lymphoma (DLBCL) have been suggested, their independent effects, modification by sex, and association with anatomical sites are largely unknown. Methods: In a pooled analysis of 4667 cases and 22 639 controls from 19 studies, we used stepwise logistic regression to identify the most parsimonious multivariate models for DLBCL overall, by sex, and for selected anatomical sites. Results: DLBCL was associated with B-cell activating autoimmune diseases (odds ratio [OR] = 2.36, 95% confidence interval [CI] = 1.80 to 3.09), hepatitis C virus seropositivity (OR = 2.02, 95% CI = 1.47 to 2.76), family history of non-Hodgkin lymphoma (OR = 1.95, 95% CI = 1.54 to 2.47), higher young adult body mass index (OR = 1.58, 95% CI = 1.12 to 2.23, for 35+ vs 18.5 to 22.4 kg/m2), higher recreational sun exposure (OR = 0.78, 95% CI = 0.69 to 0.89), any atopic disorder (OR = 0.82, 95% CI = 0.76 to 0.89), and higher socioeconomic status (OR = 0.86, 95% CI = 0.79 to 0.94). Additional risk factors for women were occupation as field crop/vegetable farm worker (OR = 1.78, 95% CI = 1.22 to 2.60), hairdresser (OR = 1.65, 95% CI = 1.12 to 2.41), and seamstress/embroider (OR = 1.49, 95% CI = 1.13 to 1.97), low adult body mass index (OR = 0.46, 95% CI = 0.29 to 0.74, for <18.5 vs 18.5 to 22.4 kg/m2), hormone replacement therapy started age at least 50 years (OR = 0.68, 95% CI = 0.52 to 0.88), and oral contraceptive use before 1970 (OR = 0.78, 95% CI = 0.62 to 1.00); and for men were occupation as material handling equipment operator (OR = 1.58, 95% CI = 1.02 to 2.44), lifetime alcohol consumption (OR = 0.57, 95% CI = 0.44 to 0.75, for >400 kg vs nondrinker), and previous blood transfusion (OR = 0.69, 95% CI = 0.57 to 0.83). Autoimmune disease, atopy, and family history of non-Hodgkin lymphoma showed similar associations across selected anatomical sites, whereas smoking was associated with central nervous system, testicular and cutaneous DLBCLs; inflammatory bowel disease was associated with gastrointestinal DLBCL; and farming and hair dye use were associated with mediastinal DLBCL. Conclusion: Our results support a complex and multifactorial etiology for DLBCL with some variation in risk observed by sex and anatomical site.

AB - Background: Although risk factors for diffuse large B-cell lymphoma (DLBCL) have been suggested, their independent effects, modification by sex, and association with anatomical sites are largely unknown. Methods: In a pooled analysis of 4667 cases and 22 639 controls from 19 studies, we used stepwise logistic regression to identify the most parsimonious multivariate models for DLBCL overall, by sex, and for selected anatomical sites. Results: DLBCL was associated with B-cell activating autoimmune diseases (odds ratio [OR] = 2.36, 95% confidence interval [CI] = 1.80 to 3.09), hepatitis C virus seropositivity (OR = 2.02, 95% CI = 1.47 to 2.76), family history of non-Hodgkin lymphoma (OR = 1.95, 95% CI = 1.54 to 2.47), higher young adult body mass index (OR = 1.58, 95% CI = 1.12 to 2.23, for 35+ vs 18.5 to 22.4 kg/m2), higher recreational sun exposure (OR = 0.78, 95% CI = 0.69 to 0.89), any atopic disorder (OR = 0.82, 95% CI = 0.76 to 0.89), and higher socioeconomic status (OR = 0.86, 95% CI = 0.79 to 0.94). Additional risk factors for women were occupation as field crop/vegetable farm worker (OR = 1.78, 95% CI = 1.22 to 2.60), hairdresser (OR = 1.65, 95% CI = 1.12 to 2.41), and seamstress/embroider (OR = 1.49, 95% CI = 1.13 to 1.97), low adult body mass index (OR = 0.46, 95% CI = 0.29 to 0.74, for <18.5 vs 18.5 to 22.4 kg/m2), hormone replacement therapy started age at least 50 years (OR = 0.68, 95% CI = 0.52 to 0.88), and oral contraceptive use before 1970 (OR = 0.78, 95% CI = 0.62 to 1.00); and for men were occupation as material handling equipment operator (OR = 1.58, 95% CI = 1.02 to 2.44), lifetime alcohol consumption (OR = 0.57, 95% CI = 0.44 to 0.75, for >400 kg vs nondrinker), and previous blood transfusion (OR = 0.69, 95% CI = 0.57 to 0.83). Autoimmune disease, atopy, and family history of non-Hodgkin lymphoma showed similar associations across selected anatomical sites, whereas smoking was associated with central nervous system, testicular and cutaneous DLBCLs; inflammatory bowel disease was associated with gastrointestinal DLBCL; and farming and hair dye use were associated with mediastinal DLBCL. Conclusion: Our results support a complex and multifactorial etiology for DLBCL with some variation in risk observed by sex and anatomical site.

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