Smoking, alcohol use, obesity, and overall survival from non-Hodgkin lymphoma: A population-based study

Susan M. Geyer, Lindsay M. Morton, Thomas Matthew Habermann, Cristine Allmer, Scott Davis, Wendy Cozen, Richard K. Severson, Charles F. Lynch, Sophia S. Wang, Matthew J. Maurer, Patricia Hartge, James R Cerhan

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

BACKGROUND: Smoking, alcohol use, and obesity appear to increase the risk of developing non-Hodgkin lymphoma (NHL), but to the authors' knowledge, few studies to date have assessed their impact on NHL prognosis. METHODS: The association between prediagnosis cigarette smoking, alcohol use, and body mass index (BMI) and overall survival was evaluated in 1286 patients enrolled through population-based registries in the United States from 1998 through 2000. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox regression, adjusting for clinical and demographic factors. RESULTS: Through 2007, 442 patients had died (34%), and the median follow-up for surviving patients was 7.7 years. Compared with never smokers, former (HR, 1.59; 95% CI, 1.12-2.26) and current (HR, 1.50; 95% CI, 0.97-2.29) smokers had poorer survival, and poorer survival was found to be positively associated with smoking duration, number of cigarettes smoked per day, pack-years of smoking, and shorter time since quitting (all P <0.01). Alcohol use was associated with poorer survival (P = 0.03); compared with nonusers. Those drinking >43.1 g/week (median intake among drinkers) had poorer survival (HR, 1.55; 95% CI, 1.06-2.27), whereas those drinkers consuming less than this amount demonstrated no survival disadvantage (HR, 1.13; 95% CI, 0.75-1.71). Greater BMI was associated with poorer survival (P = 0.046), but the survival disadvantage was only noted among obese individuals (HR, 1.32 for BMI ≥30 vs BMI 20-24.9; 95% CI, 1.02-1.70). These results held for lymphoma-specific survival and were broadly similar for diffuse large B-cell lymphoma and follicular lymphoma. CONCLUSIONS: NHL patients who smoked, consumed alcohol, or were obese before diagnosis were found to have a poorer overall and lymphoma-specific survival.

Original languageEnglish (US)
Pages (from-to)2993-3000
Number of pages8
JournalCancer
Volume116
Issue number12
DOIs
StatePublished - Jun 15 2010

Fingerprint

Non-Hodgkin's Lymphoma
Obesity
Smoking
Alcohols
Survival
Confidence Intervals
Population
Body Mass Index
Lymphoma
Follicular Lymphoma
Lymphoma, Large B-Cell, Diffuse
Tobacco Products
Registries
Demography

Keywords

  • Alcohol
  • Non-Hodgkin lymphoma
  • Obesity
  • Smoking
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Smoking, alcohol use, obesity, and overall survival from non-Hodgkin lymphoma : A population-based study. / Geyer, Susan M.; Morton, Lindsay M.; Habermann, Thomas Matthew; Allmer, Cristine; Davis, Scott; Cozen, Wendy; Severson, Richard K.; Lynch, Charles F.; Wang, Sophia S.; Maurer, Matthew J.; Hartge, Patricia; Cerhan, James R.

In: Cancer, Vol. 116, No. 12, 15.06.2010, p. 2993-3000.

Research output: Contribution to journalArticle

Geyer, SM, Morton, LM, Habermann, TM, Allmer, C, Davis, S, Cozen, W, Severson, RK, Lynch, CF, Wang, SS, Maurer, MJ, Hartge, P & Cerhan, JR 2010, 'Smoking, alcohol use, obesity, and overall survival from non-Hodgkin lymphoma: A population-based study', Cancer, vol. 116, no. 12, pp. 2993-3000. https://doi.org/10.1002/cncr.25114
Geyer, Susan M. ; Morton, Lindsay M. ; Habermann, Thomas Matthew ; Allmer, Cristine ; Davis, Scott ; Cozen, Wendy ; Severson, Richard K. ; Lynch, Charles F. ; Wang, Sophia S. ; Maurer, Matthew J. ; Hartge, Patricia ; Cerhan, James R. / Smoking, alcohol use, obesity, and overall survival from non-Hodgkin lymphoma : A population-based study. In: Cancer. 2010 ; Vol. 116, No. 12. pp. 2993-3000.
@article{2b756fb195214098ad1a82c37b101f39,
title = "Smoking, alcohol use, obesity, and overall survival from non-Hodgkin lymphoma: A population-based study",
abstract = "BACKGROUND: Smoking, alcohol use, and obesity appear to increase the risk of developing non-Hodgkin lymphoma (NHL), but to the authors' knowledge, few studies to date have assessed their impact on NHL prognosis. METHODS: The association between prediagnosis cigarette smoking, alcohol use, and body mass index (BMI) and overall survival was evaluated in 1286 patients enrolled through population-based registries in the United States from 1998 through 2000. Hazard ratios (HRs) and 95{\%} confidence intervals (95{\%} CIs) were estimated using Cox regression, adjusting for clinical and demographic factors. RESULTS: Through 2007, 442 patients had died (34{\%}), and the median follow-up for surviving patients was 7.7 years. Compared with never smokers, former (HR, 1.59; 95{\%} CI, 1.12-2.26) and current (HR, 1.50; 95{\%} CI, 0.97-2.29) smokers had poorer survival, and poorer survival was found to be positively associated with smoking duration, number of cigarettes smoked per day, pack-years of smoking, and shorter time since quitting (all P <0.01). Alcohol use was associated with poorer survival (P = 0.03); compared with nonusers. Those drinking >43.1 g/week (median intake among drinkers) had poorer survival (HR, 1.55; 95{\%} CI, 1.06-2.27), whereas those drinkers consuming less than this amount demonstrated no survival disadvantage (HR, 1.13; 95{\%} CI, 0.75-1.71). Greater BMI was associated with poorer survival (P = 0.046), but the survival disadvantage was only noted among obese individuals (HR, 1.32 for BMI ≥30 vs BMI 20-24.9; 95{\%} CI, 1.02-1.70). These results held for lymphoma-specific survival and were broadly similar for diffuse large B-cell lymphoma and follicular lymphoma. CONCLUSIONS: NHL patients who smoked, consumed alcohol, or were obese before diagnosis were found to have a poorer overall and lymphoma-specific survival.",
keywords = "Alcohol, Non-Hodgkin lymphoma, Obesity, Smoking, Survival",
author = "Geyer, {Susan M.} and Morton, {Lindsay M.} and Habermann, {Thomas Matthew} and Cristine Allmer and Scott Davis and Wendy Cozen and Severson, {Richard K.} and Lynch, {Charles F.} and Wang, {Sophia S.} and Maurer, {Matthew J.} and Patricia Hartge and Cerhan, {James R}",
year = "2010",
month = "6",
day = "15",
doi = "10.1002/cncr.25114",
language = "English (US)",
volume = "116",
pages = "2993--3000",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "12",

}

TY - JOUR

T1 - Smoking, alcohol use, obesity, and overall survival from non-Hodgkin lymphoma

T2 - A population-based study

AU - Geyer, Susan M.

AU - Morton, Lindsay M.

AU - Habermann, Thomas Matthew

AU - Allmer, Cristine

AU - Davis, Scott

AU - Cozen, Wendy

AU - Severson, Richard K.

AU - Lynch, Charles F.

AU - Wang, Sophia S.

AU - Maurer, Matthew J.

AU - Hartge, Patricia

AU - Cerhan, James R

PY - 2010/6/15

Y1 - 2010/6/15

N2 - BACKGROUND: Smoking, alcohol use, and obesity appear to increase the risk of developing non-Hodgkin lymphoma (NHL), but to the authors' knowledge, few studies to date have assessed their impact on NHL prognosis. METHODS: The association between prediagnosis cigarette smoking, alcohol use, and body mass index (BMI) and overall survival was evaluated in 1286 patients enrolled through population-based registries in the United States from 1998 through 2000. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox regression, adjusting for clinical and demographic factors. RESULTS: Through 2007, 442 patients had died (34%), and the median follow-up for surviving patients was 7.7 years. Compared with never smokers, former (HR, 1.59; 95% CI, 1.12-2.26) and current (HR, 1.50; 95% CI, 0.97-2.29) smokers had poorer survival, and poorer survival was found to be positively associated with smoking duration, number of cigarettes smoked per day, pack-years of smoking, and shorter time since quitting (all P <0.01). Alcohol use was associated with poorer survival (P = 0.03); compared with nonusers. Those drinking >43.1 g/week (median intake among drinkers) had poorer survival (HR, 1.55; 95% CI, 1.06-2.27), whereas those drinkers consuming less than this amount demonstrated no survival disadvantage (HR, 1.13; 95% CI, 0.75-1.71). Greater BMI was associated with poorer survival (P = 0.046), but the survival disadvantage was only noted among obese individuals (HR, 1.32 for BMI ≥30 vs BMI 20-24.9; 95% CI, 1.02-1.70). These results held for lymphoma-specific survival and were broadly similar for diffuse large B-cell lymphoma and follicular lymphoma. CONCLUSIONS: NHL patients who smoked, consumed alcohol, or were obese before diagnosis were found to have a poorer overall and lymphoma-specific survival.

AB - BACKGROUND: Smoking, alcohol use, and obesity appear to increase the risk of developing non-Hodgkin lymphoma (NHL), but to the authors' knowledge, few studies to date have assessed their impact on NHL prognosis. METHODS: The association between prediagnosis cigarette smoking, alcohol use, and body mass index (BMI) and overall survival was evaluated in 1286 patients enrolled through population-based registries in the United States from 1998 through 2000. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox regression, adjusting for clinical and demographic factors. RESULTS: Through 2007, 442 patients had died (34%), and the median follow-up for surviving patients was 7.7 years. Compared with never smokers, former (HR, 1.59; 95% CI, 1.12-2.26) and current (HR, 1.50; 95% CI, 0.97-2.29) smokers had poorer survival, and poorer survival was found to be positively associated with smoking duration, number of cigarettes smoked per day, pack-years of smoking, and shorter time since quitting (all P <0.01). Alcohol use was associated with poorer survival (P = 0.03); compared with nonusers. Those drinking >43.1 g/week (median intake among drinkers) had poorer survival (HR, 1.55; 95% CI, 1.06-2.27), whereas those drinkers consuming less than this amount demonstrated no survival disadvantage (HR, 1.13; 95% CI, 0.75-1.71). Greater BMI was associated with poorer survival (P = 0.046), but the survival disadvantage was only noted among obese individuals (HR, 1.32 for BMI ≥30 vs BMI 20-24.9; 95% CI, 1.02-1.70). These results held for lymphoma-specific survival and were broadly similar for diffuse large B-cell lymphoma and follicular lymphoma. CONCLUSIONS: NHL patients who smoked, consumed alcohol, or were obese before diagnosis were found to have a poorer overall and lymphoma-specific survival.

KW - Alcohol

KW - Non-Hodgkin lymphoma

KW - Obesity

KW - Smoking

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=77954020406&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77954020406&partnerID=8YFLogxK

U2 - 10.1002/cncr.25114

DO - 10.1002/cncr.25114

M3 - Article

C2 - 20564404

AN - SCOPUS:77954020406

VL - 116

SP - 2993

EP - 3000

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 12

ER -