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American Journal of Epidemiology Advance Access originally published online on June 27, 2007
American Journal of Epidemiology 2007 166(6):697-708; doi:10.1093/aje/kwm122
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2007.

ORIGINAL CONTRIBUTIONS

Alcohol, Smoking, and Body Size in Relation to Incident Hodgkin's and Non-Hodgkin's Lymphoma Risk

Unhee Lim1, Lindsay M. Morton1, Amy F. Subar2, Dalsu Baris1, Rachael Stolzenberg-Solomon1, Michael Leitzmann1, Victor Kipnis2, Traci Mouw1, Leslie Carroll3, Arthur Schatzkin1 and Patricia Hartge1

1 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD
2 Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD
3 Information Management Services, Inc., Silver Spring, MD

Correspondence to Unhee Lim, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, EPS 320, Rockville, MD 20852 (e-mail: limu{at}mail.nih.gov).

Received for publication October 17, 2006. Accepted for publication March 14, 2007.

Studies associate alcohol consumption, cigarette smoking, and body size with the risk of overall or subtype lymphoma. Current data come mostly from case-control studies or prospective studies with few cases. In the prospective National Institutes of Health-former American Association of Retired Persons (NIH-AARP) Diet and Health Study, the authors assessed the above lifestyle factors via baseline questionnaire among 285,079 men and 188,905 women aged 50–71 years and ascertained histologically confirmed Hodgkin's lymphoma (n = 58) and non-Hodgkin's lymphoma (n = 1,381) cases through linkage with cancer registries from 1995 to 2000. Compared with nondrinkers, alcohol consumers had a lower risk for non-Hodgkin's lymphoma overall (for >28 drinks/week: adjusted relative risk (RR) = 0.77, 95% confidence interval (CI): 0.59, 1.00; ptrend among drinkers = 0.02) and for its main subtypes. Compared with never smokers, current smokers and recent quitters (≤4 years ago) had higher risk of Hodgkin's lymphoma (RR = 2.25, 95% CI: 1.04, 4.89; RR = 4.20, 95% CI: 1.94, 9.09, respectively), whereas current or former smokers had lower risk of follicular non-Hodgkin's lymphoma (RR = 0.67, 95% CI: 0.52, 0.86). Severe obesity (body mass index of ≥35: RR = 1.29, 95% CI: 1.02, 1.64) and taller height (RR = 1.19, 95% CI: 1.03, 1.38) were associated moderately with non-Hodgkin's lymphoma. These findings add to the evidence that lifestyle factors and relevant anthropometric characteristics play a role in lymphoma etiology.

alcohol drinking; body height; Hodgkin disease; lymphoma, non-Hodgkin; motor activity; obesity; prospective studies; smoking

Abbreviations: AARP, former American Association of Retired Persons; CI, confidence interval; ICD-O-2, International Classification of Diseases for Oncology, Second Edition; NIH-AARP, National Institutes of Health-former American Association of Retired Persons; RR, relative risk; SEER, Surveillance, Epidemiology, and End Results


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