American Journal of Epidemiology Vol. 148, No. 9: 833-841
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Relation of Cigarette Smoking to Non-Hodgkin's Lymphoma among Middle-aged Men
1National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta, GA
2Departments of Environmental and Occupational Health and of Epidemiology, Rollins School of Public Health, Emory University Atlanta, GA
3National Center for Environmental Health, Centers for Disease Control and Prevention Atlanta, GA
4Department of Pathology, University of Utah Medical Center Salt Lake City, UT
Reprint requests to Dr. David S. Freedman, Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Mailstop K-26, 4770 Buford Highway NE, Atlanta, GA 30341.
Because of previous inconsistencies in the observed relation of cigarette smoking to non-Hodgkin's lymphoma, this association was investigated in the Selected Cancers Study, a population-based case-control study of 1, 193 non-Hodgkin's lymphoma cases and 1, 903 controls, conducted between 1984 and 1988. Study subjects were men, and the median age of non-Hodgkin's lymphoma cases was 50 years (range, 32–60 years). As compared with the risk among men who had never smoked cigarettes, the risk among ever smokers was not increased (odds ratio (OR) = 1.05, p {small tilde} 0.50), but the risk was significantly elevated among men who reported smoking 
21/2 packs per day and among men who had smoked for 30–39 years (OR = 1.45 in each group, p < 0.05). The estimated odds ratio among the 350 heavy smokers (>50 pack-years) was 1.41 (95% confidence interval 1.08–1.85) after controlling for educational achievement, various occupational and medical exposures, and other potential confounders. The observed associations, however, tended to vary by age, with the odds ratio among heavy smokers decreasing from 2.8 among 32- to 44-year-olds to 1.1 among men over 55 years of age. These age-related differences, which may account for some of the inconsistencies seen in previous studies of cigarette smoking and non-Hodgkin's lymphoma, should be considered in future investigations. Am J Epidemiol 1998; 148:833–41.
case-control studies; lymphoma; non-Hodkin's; men; smoking
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