Smoking and non‐Hodgkin lymphoma: Case‐control study in Italy

Abstract

Tobacco smoking is a well-documented risk factor for several cancers, but the role of cigarette smoking in the etiology of non-Hodgkin lymphoma (NHL) is inadequately understood. Hepatitis C virus (HCV) has been associated with NHL, but the interaction between HCV and smoking habits has not yet been studied. Between 1999 and 2002, we conducted a case-control study on the association of HCV, smoking habits and NHL in 2 areas of northern and southern Italy. Cases were 225 consecutive patients (median age, 59 years) with a new diagnosis of NHL that were admitted to reference and general hospitals. Controls were 504 patients (median age, 63 years) admitted to the same hospitals as cases, for a wide spectrum of acute, nonneoplastic, nonimmune-, nor tobacco-related conditions. Current, heavy smokers (!20 cigarettes/day) had an odds ratio (OR) of NHL of 2.10 (95% confidence interval, CI: 1.07-4.12) compared to never smokers. The association between smoking and NHL was consistent across strata of sex and age. Compared to never smokers, current smokers of !20 cigarettes/day had ORs of 1.14 (95% CI: 0.37-3.56) for B-cell-low-grade, 2.10 (95% CI: 0.94-4.67) for B-cell-intermediate and high-grade, and 25.84 (95% CI: 1.95-342.17) for T-cell NHL. The effect of tobacco smoking and HCV were independent on the relative risk, leading a 4-fold elevated risk in current smokers HCV positive subjects. Tobacco smoking and hepatitis C virus (HCV) have been associated to non-Hodgkin lymphoma (NHL), but the interaction between HCV and smoking habits has not yet been studied. Our study confirms that tobacco is related to NHL, and reports on the combined effect of tobacco smoking and HCV. Infection acted together according to a multiplicative model, leading to a 4-fold elevated risk in current smokers HCV positive subjects. ' 2005 Wiley-Liss, Inc.

Family History of Hemolymphopoietic and Other Cancers and Risk of Non-Hodgkin's Lymphoma

“…Although we collected data also on Hodgkin's lymphoma cases (15,16), we did not analyze them together because (a) there is evidence suggesting that risk factors for Hodgkin's lymphoma and NHL differ; (b) Hodgkin's lymphoma cases were much younger than NHL cases and controls and thus first-degree relatives of Hodgkin's lymphoma cases belonged to different generations than those of NHL cases or controls; and (c) this improves comparability with previous articles. Chronic lymphocytic leukemia is similar to small lymphocytic lymphoma and was included among NHL in our study, as done by most authors.…”

“…Between January 1999 and July 2002, we conducted a casecontrol study on NHL in the province of Pordenone, NorthEastern Italy, and in Naples, Southern Italy (15,16). Cases were patients between 18 and 84 years of age with incident, histologically confirmed NHL.…”

Cigarette Smoking and Risk of Non-Hodgkin's Lymphoma—A Population-Based Case-Control Study

“…Stratified analyses indicated that smoking might be associated with an increased risk of follicular lymphoma in women and of T-cell lymphomas in men. For T-cell lymphoma, the only other indication of an association with smoking stems from a small scaled Italian study encompassing only eight cases of T-cell lymphoma, and reporting an OR of 25.84 (95% CI, 1.95-342.17) in heavy smokers (42).…”

The Utility of t(14;18) in Understanding Risk Factors for Non-Hodgkin Lymphoma

“…These risk factors have been associated with a higher risk of NHL (3,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). In some studies, these risk factors were not associated, or only weakly associated with risk of NHL overall, but were specifically associated with risk of either follicular lymphoma, diffuse large B-cell lymphoma, or chronic lymphocytic leukemia/small lymphocytic lymphoma (21)(22)(23)25,(28)(29)(30)(31).…”