Adulthood residential ultraviolet radiation, sun sensitivity, dietary vitamin D, and risk of lymphoid malignancies in the California Teachers Study

Chang, Ellen T.; Canchola, Alison J.; Cockburn, Myles; Lu, Yani; Wang, Sophia; Bernstein, Leslie; Clarke, Christina A.; Horn‐Ross, Pamela L.

doi:10.1182/blood-2011-02-336065

Cited by 67 publications

(66 citation statements)

References 43 publications

(45 reference statements)

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“…39 16 The Californian study reported a nonsignificant inverse association of HL risk with minimum average annual UVR near one's residence (relative risk, 0.86; 95% CI, 0.46 to 1.62), but not with median or maximum average annual UVR. 15 In the Greek study, a nonsignificant inverse association (OR, 0.83; 95% CI, 0.58 to 1.19) was detected with 15 days or more spent annually at seaside resorts. 12 These 3 studies were not included in the present pooled analysis because they were not part of InterLymph at the inception of this project.…”

Section: Discussionmentioning

confidence: 99%

“…Prior research in this area has been scant, and the 3 largest previously published studies were included in this pooled analysis. 11,13,14 Among other studies, neither a case-control study in Singapore involving 74 cases and 829 controls 16 nor a prospective cohort study in California female teachers that included 38 HL cases 15 observed a significant association between UVR exposure and HL. A Greek study of 71 childhood HL cases (mostly patients age 10 to 14 years) and 164 controls also found no association of UVR exposure with HL risk.…”

Section: Discussionmentioning

confidence: 99%

“…7,9 Ultraviolet radiation (UVR) exposure has been associated with HL risk, albeit inconsistently and based on only a few studies. [11][12][13][14][15][16] A large population-based case-control study in Sweden and Denmark detected an inverse association between risk of HL and sunbathing or There is an Inside Blood commentary on this article in this issue.…”

Section: Introductionmentioning

confidence: 99%

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Exposure to UV radiation and risk of Hodgkin lymphoma: a pooled analysis

Monnereau

Glaser

Schupp

et al. 2013

Blood

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• Our pooled analysis found an inverse association between several measures of UVR exposure and Hodgkin lymphoma. • Significant UVR-related inverse associations of EBV-positive HL with a doseresponse relationship support etiologic heterogeneity in HL.Ultraviolet radiation (UVR) exposure has been inversely associated with Hodgkin lymphoma (HL) risk, but only inconsistently, only in a few studies, and without attention to HL heterogeneity. We conducted a pooled analysis of HL risk focusing on type and timing of UVR exposure and on disease subtypes by age, histology, and tumor-cell Epstein-Barr virus (EBV) status. Four case-control studies contributed 1320 HL cases and 6381 controls. We estimated lifetime, adulthood, and childhood UVR exposure and history of sunburn and sunlamp use. We used 2-stage estimation with mixed-effects models and weighted pooled effect estimates by inverse marginal variances. We observed statistically significant inverse associations with HL risk for UVR exposures during childhood and adulthood, sunburn history, and sunlamp use, but we found no significant doseresponse relationships. Risks were significant only for EBV-positive HL (pooled odds ratio, 0.56; 95% confidence interval, 0.35 to 0.91 for the highest overall UVR exposure category), with a significant linear trend for overall exposure (P 5 .03). Pooled relative risk estimates were not heterogeneous across studies. Increased UVR exposure may protect against HL, particularly EBV-positive HL. Plausible mechanisms involving UVR induction of regulatory T cells or the cellular DNA damage response suggest opportunities for new prevention targets. (Blood. 2013;122(20):3492-3499)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exposure to UV radiation and risk of Hodgkin lymphoma: a pooled analysis

Monnereau

Glaser

Schupp

et al. 2013

Blood

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“…[6][7][8][9][10] More recently, observational studies have also indicated a protective effect of UVR exposure on NHL risk based on a variety of measures. An inverse association between NHL risk and level of residential ambient UVR has been reported by case-control 11,12 and some, 13 although not all, 14,15 cohort studies and an inverse association between NHL risk and recalled recreational sun exposure was reported by a pooled analysis of case-control studies from Australia, Europe and the United States. 16 The inconsistent evidence for a causative or protective effect of UVR exposure on NHL risk might be related to etiological heterogeneity by NHL subtype, although subtypespecific data are few.…”

mentioning

confidence: 98%

“…In addition, there has been limited ecological assessment of the relationship between Hodgkin lymphoma (HL) and ambient UVR, 8,17 and cohort evidence is inconclusive. 13 To better elucidate the association between UVR exposure and risk of both NHL and HL, we used population-based registry data from Australia between 2002 and 2006 to examine subtype-specific incidence of lymphoid neoplasms by residential latitude at diagnosis.…”

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confidence: 99%

Latitude gradients for lymphoid neoplasm subtypes in Australia support an association with ultraviolet radiation exposure

Leeuwen

Turner²,

Falster

et al. 2013

Intl Journal of Cancer

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Given the uncertainty surrounding solar ultraviolet radiation (UVR) exposure and risk of lymphoid neoplasms, we performed an ecological analysis of national Australian data for incident cases diagnosed between 2002 and 2006. Subtype-specific incidence was examined by latitude band (<29 S, 29-36 S, 37 S), a proxy for ambient UVR exposure, using multiple Poisson regression, adjusted for sex, age-group and calendar year. Incidence increased with distance from the equator for several mature B-cell non-Hodgkin lymphomas, including diffuse large B-cell [incidence rate ratio (IRR) 5 1.

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Pigmentary traits, sun exposure, and risk of non‐Hodgkin’s lymphoma/chronic lymphocytic leukemia: A study within the French E3N prospective cohort

et al. 2020

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To investigate whether risk factors for keratinocyte carcinomas (KCs), namely pigmentary traits and sun exposure, are associated with risk of non‐Hodgkin's lymphomas (NHL) and chronic lymphocytic leukemia (CLL). E3N is a prospective cohort of French women aged 40–65 years at inclusion in 1990. Cancer data were collected at baseline and updated every 2–3 years. Hazard Ratios (HRs) and 95% confidence intervals (CIs) for associations between pigmentary traits and sun exposure, and risk of CLL/NHL were estimated using Cox models. With a median follow‐up of 24 years, 622 incident cases of CLL/NHL were ascertained among the 92,097 included women. The presence of nevi was associated with CLL/NHL risk: HR for “many or very many nevi” relative to “no nevi”: 1.56 [1.15; 2.11]. Such association with number of nevi appears to be mostly limited to risk of CLL: HR for “many or very many nevi”: 3.00 [1.38; 6.52]; versus 1.32 [0.94; 1.84] for NHL. Women whose skin was highly sensitive to sunburn also had a higher risk of CLL: HR = 1.96 [1.21; 3.18], while no increase in risk of NHL was observed. Skin or hair color, number of freckles, and average daily ultraviolet (UV) dose during spring and summer in location of residence at birth or at inclusion (kJ/m2) were not associated with CLL/NHL risk. Some pigmentary traits (presence of nevi and skin sensitivity), but not sun exposure, were associated with CLL/NHL. These observations suggest that CLL may share some constitutional risk factors with keratinocyte cancers.

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Adulthood residential ultraviolet radiation, sun sensitivity, dietary vitamin D, and risk of lymphoid malignancies in the California Teachers Study

Cited by 67 publications

References 43 publications

Exposure to UV radiation and risk of Hodgkin lymphoma: a pooled analysis

Exposure to UV radiation and risk of Hodgkin lymphoma: a pooled analysis

Latitude gradients for lymphoid neoplasm subtypes in Australia support an association with ultraviolet radiation exposure

Pigmentary traits, sun exposure, and risk of non‐Hodgkin’s lymphoma/chronic lymphocytic leukemia: A study within the French E3N prospective cohort

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