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American Journal of Epidemiology 2004 160(8):766-773; doi:10.1093/aje/kwh278
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Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

Menstrual and Reproductive Factors and Risk of Non-Hodgkin’s Lymphoma among Connecticut Women

Yawei Zhang1, Theodore R. Holford1, Brian Leaderer1, Peter Boyle2, Shelia Hoar Zahm3, Bing Zhang4, Kaiyong Zou5, Lindsay M. Morton1, Patricia H. Owens1, Stuart Flynn6, Giovanni Tallini6 and Tongzhang Zheng1 

1 Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT.
2 Department of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
3 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD.
4 Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada.
5 Department of Molecular, Cellular, and Developmental Biology, Yale University, New Haven, CT.
6 Department of Pathology, Yale University School of Medicine, New Haven, CT.

Several recent studies have suggested a potential role of menstrual and reproductive factors in the risk of non-Hodgkin’s lymphoma. To further examine the relation, the authors analyzed data from a population-based case-control study of non-Hodgkin’s lymphoma in Connecticut women between 1996 and 2000. A total of 601 histologically confirmed cases and 717 randomly selected population-based controls were included in this study. An in-person interview was conducted using a standardized and structured questionnaire to collect information on menstrual and reproductive factors and potential confounding factors. Compared with nulliparous women, women who had four or more pregnancies during their lifetime were found to have a significantly reduced risk of non-Hodgkin’s lymphoma (odds ratio (OR) = 0.6, 95% confidence interval (CI): 0.4, 0.9). Risk appeared to decrease with increasing number of pregnancies (ptrend = 0.03). The authors also observed an increased risk of non-Hodgkin’s lymphoma overall (OR = 1.5, 95% CI: 1.0, 2.2) and of diffuse non-Hodgkin’s lymphoma (OR = 1.7, 95% CI: 1.1, 2.7) for women who started their first menstrual period at age 15 or more years compared with those who started their first menstrual period before age 12 years. These findings support a reduced risk of non-Hodgkin’s lymphoma associated with multiple pregnancies and an increased risk of non-Hodgkin’s lymphoma associated with later age at menarche.

case-control studies; Connecticut; lymphoma, non-Hodgkin; menstruation; reproduction; risk factors; women

Abbreviations: Abbreviations: CI, confidence interval; OR, odds ratio.


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