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- Chang, Ellen T., et al.
(författare)
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Alcohol intake and risk of non-Hodgkin lymphoma in men and women
- 2004
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 0957-5243 .- 1573-7225. ; 15:10, s. 1067-1076
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVE: The effect of alcohol intake on risk of NHL is unclear. We therefore conducted a population-based case-control study to examine the association between alcohol and NHL risk. METHODS: 613 NHL cases and 480 population controls in Sweden reported their average consumption of beer, wine, and liquor 2 years before the study. Unconditional logistic regression was used to estimate the odds ratios (OR) and corresponding 95% confidence intervals (CI) for associations between alcohol intake and NHL risk. RESULTS: Intake of total alcohol, beer, wine, or liquor was not associated with risk of overall NHL. There was no difference in risk of NHL among those who habitually consumed above 19.1 g of ethanol per day, compared to those who consumed on average 0-2.2 g of ethanol per day (OR = 1.2 (95% CI: 0.8, 1.7); Ptrend = 0.29). However, the association was significantly positive among males (OR = 1.8 (95% CI: 1.1, 2.9); Ptrend = 0.06). Total alcohol, beer, wine, or liquor intake was not associated with any major histopathologic subtype of NHL examined, apart from an association between high wine consumption and increased risk of chronic lymphocytic leukemia. CONCLUSIONS: Alcohol does not appear to be a major etiologic factor for overall NHL, nor its common subtypes.
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- Chang, Ellen T., et al.
(författare)
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Family history of hematopoietic malignancy and risk of lymphoma
- 2005
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Ingår i: Journal of the National Cancer Institute. - : Oxford University Press (OUP). - 0027-8874 .- 1460-2105. ; 97:19, s. 1466-1474
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: A family history of hematopoietic malignancy is associated with an increased risk of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL), although the magnitude of the relative risk is unclear. We estimated the association between familial hematopoietic cancer and risk of lymphoma using validated, registry-based family data, and we also investigated whether associations between some environmental exposures and risk of lymphoma vary between individuals with and without such a family history. METHODS: In a population-based case-control study of malignant lymphoma, 1506 case patients and 1229 control subjects were linked to the Swedish Multi-Generation Register and then to the Swedish Cancer Register to ascertain history of cancer in first-degree relatives of patients with malignant lymphoma. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with the risk of lymphoma. RESULTS: A history of hematopoietic malignancy in any first-degree relative was associated with an increased risk of all NHL (OR = 1.8, 95% CI = 1.2 to 2.5), common B-cell NHL subtypes, and HL. Relative risks were generally stronger in association with sibling hematopoietic cancer (OR for all NHL = 3.2, 95% CI = 1.3 to 7.6) than with parental hematopoietic cancer (OR = 1.6, 95% CI = 1.1 to 2.3). A family history of NHL or chronic lymphocytic leukemia (CLL) was associated with an increased risk of several NHL subtypes and HL, whereas familial multiple myeloma was associated with a higher risk of follicular lymphoma. There was no statistically significant heterogeneity in NHL risk associations with environmental factors between individuals with and without familial hematopoietic malignancy. CONCLUSIONS: The increased risk of NHL and HL among individuals with a family history of hematopoietic malignancy was approximately twofold for both lymphoma types. There was no evidence that etiologic associations varied between familial NHL and nonfamilial NHL.
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- Ekström Smedby, Karin
(författare)
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Ultraviolet light, autoimmune disorders and the etiology of malignant lymphomas
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Malignant lymphomas constitute a clinically and morphologically diverse group of malignancies that may also differ etiologically. The incidence of the most common non-Hodgkin lymphomas (NHL) has increased dramatically worldwide during the past decades. Established risk factors together only explain a minority of the cases, let alone the NHL increase. Observations of a positive link between skin cancer and NHL have fostered the hypothesis that frequent sun exposure could be a risk factor for both malignancies and a contributing factor to the rise in NHL incidence. The aim of this thesis was to test the hypothesis of a positive association between sun exposure and malignant lymphomas, and to evaluate the role of autoimmune and chronic inflammatory disorders, especially rheumatoid arthritis (RA) and celiac disease, in the development of malignant lymphoma subtypes, and lymphomagenic mechanisms in this context. We performed a population-based case-control study in all of Denmark and Sweden (the Scandinavian Lymphoma Etiology, or SCALE, study) between 1999 and 2002, including 3,740 patients with malignant lymphomas and 3,187 control subjects aged 18 to 74 years. Based on structured telephone interviews, information was collected on history of ultraviolet (UV) light exposure, sun sensitivity, skin cancer history and other potential risk factors. In contrast with the a priori hypothesis, frequent sun exposure in Denmark/Sweden and abroad and sun burns at different ages were associated with a statistically significant 30-40% reduction in risk of overall NHL, with clear indications of inverse doseresponse trends (all Ptrends, < .003). There was similar but weaker evidence of inverse associations for Hodgkin lymphoma (HL). Self-reported skin cancer history was associated with a doubling in risks of NHL and HL. To test the hypothesis that the established excess risk of lymphomas in RA is due to risk factors shared by both disorders, we undertook a retrospective registry-based cohort study of Swedish patients hospitalized with RA (n=76,527) and the first-degree relatives (n=70,290) of a subset of these patients. Relative risks of malignant lymphomas were assessed by matching the respective cohorts with the population-based cancer register. The RA patients had a doubled risk of malignant lymphomas overall, although the excess risk did not persist beyond 20 years of follow-up. Firstdegree relatives were generally not at increased risk of malignant lymphomas, and thus a prominent role of shared risk factors in RA-related lymphomagenesis was not supported. To evaluate the spectrum of lymphoma subtypes associated with celiac disease, we re-classified 56 malignant lymphoma cases occurring in a large cohort of patients previously hospitalized for celiac disease (n=11,650). Our results indicated that celiac disease patients are at increased risk, not only of the well-described enteropathy-type T-cell lymphoma, but also of non-intestinal T-cell lymphomas and the common B-cell lymphomas compared to the general population. Finally, we estimated relative risks of NHL overall and by subtype in association with several autoimmune and chronic inflammatory disorders, disease phenotype and treatment, using selfreported data in SCALE. We confirmed an increased risk of NHL in RA, systemic lupus erythematosus, primary Sjögren's syndrome and celiac disease, but not in type I diabetes, inflammatory bowel disorders, sarcoidosis or psoriasis. The first four disorders were all specifically associated with diffuse large B-cell lymphoma and with a few more uncommon NHL subtypes. Data suggested a tendency towards higher risks in severe and long-standing inflammation, but there was little to support previous notions of risk associated with medical treatments in these conditions.
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- Elfström, Peter, 1974-, et al.
(författare)
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Hematopoietic cancer including lymphoma in celiac disease according to Marsh criteria 0-3
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Celiac disease (CD) is associated with an increased risk of lymphoma, but it is unknown if borderline mucosal damage and latent CD are risk factors for lymphoma.Methods: We examined the risk of hematopoietic cancer in a nationwide population–based cohort of 28,800 individuals with biopsy-verified CD (villous atrophy, Marsh 3), 12,663 individuals with small intestinal inflammation (Marsh 1+2), and 3,551 with latent CD (positive antiendomysial, tissue transglutaminase or antigliadin test but normal mucosa on biopsy). The study participants were identified through all pathology departments (n=28) in Sweden and were biopsied in 1969-2006 (median: 1998). Cox regression estimated the hazard ratio (HR) for hematopoietic malignancies.Results: While biopsy-verified CD and intestinal inflammation were both statistically significantly associated with lymphoma (CD: HR = 3.18; 95% CI = 2.63-3.83; inflammation: 1.66; 1.28-2.17), latent CD was not (1.04; 0.44-2.43). CD was associated with both non-Hodgkin’s (NHL) and Hodgkin’s lymphoma (HL) (4.81; 3.81-6.07 and 4.39; 2.59-7.45 respectively). Risk estimates for NHL and HL were lower in inflammation (1.65; 1.15-2.38 and 1.48; 0.60-3.62 respectively) and latent CD (1.79; 0.74-4.34 and 1.08; 0.13-9.00 respectively). No increased risk of lymphoma was seen in children with a small intestinal biopsy. This study found no association between leukemia and small intestinal pathology.Conclusion: CD is associated with an increased risk of lymphoma. This risk increase was also seen in individuals with small intestinal inflammation. Latent CD is not associated with lymphoma of any kind, and positive CD serology alone cannot be used to predict future risk of lymphoma.
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