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Am J Epidemiol. 2018 Nov 27. doi: 10.1093/aje/kwy259. [Epub ahead of print]

Reproductive factors, exogenous hormone use and risk of B-cell non-Hodgkin lymphoma in a cohort of women from the European Prospective Investigation into Cancer and Nutrition.

Author information

1
Unit of Molecular Epidemiology and Genetics in Infections and Cancer. Cancer Epidemiology Research Programme. Bellvitge Biomedical Research Institute (IDIBELL). Catalan Institute of Oncology.
2
Unit of Nutrition and Cancer. Cancer Epidemiology Research Programme. IDIBELL. Catalan Institute of Oncology.
3
Department of Nursing of Public Health, Mental Health and Maternity and Child Health School of Nursing Universitat de Barcelona.
4
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP).
5
Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford.
6
Public Health Division of Gipuzkoa, BioDonostia Research Institute, Health Department of Basque Country, Spain.
7
Navarra Public Health Institute, Pamplona, Spain.
8
Unit of Hematology-Oncology, Centre Hospitalier de Versailles, Le Chesnay.
9
CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.
10
Gustave Roussy, F-94805, Villejuif, France.
11
German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114 - 116, 14558 Nuthetal, Germany.
12
Dept. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.
13
Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.
14
Dept. of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG London, United Kingdom.
15
Dept. of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, 50603, Kuala Lumpur, Malaysia.
16
Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
17
International Agency for Research on Cancer.World Health Organization. Lyon, France.
18
Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
19
Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
20
Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, SE22185 Lund, Sweden.
21
Hellenic Health Foundation, Athens, Greece.
22
Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece.
23
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
24
Department of Critical Care Medicine & Pulmonary Services, University of Athens Medical School, Evangelismos Hospital, Athens, Greece.
25
Department of Community Medicine, UiT The Arctic University of Norway, Pb 6070 Langnes, NO-9037 Tromsø, Norway.
26
Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO) Florence, Italy.
27
Dipartimento di Medicina Clinica e Chirugia Federico II University, Naples Italy.
28
Public Health Directorate, Asturias, Spain.
29
Medical Center - University of Freiburg, Center for Chronic Immunodeficiency, at Center for Translational Cell Research.
30
Aarhus University, Department of Public Health, Bartholins Alle 2, DK-8000 Aarhus C, Denmark.
31
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K.
32
Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy.
33
Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs. Granada. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
34
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
35
Epidemiology and Prevention Unit. Fondazione IRCCS Istituto Nazionale dei Tumori. Milano, Italy.
36
Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen.
37
Cancer Registry and Histopathology Department, "Civic M.P.Arezzo" Hospital, ASP Ragusa, Italy.
38
Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
39
Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
40
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
41
Genetic Epidemiology Group, Folkhälsan Research Center, and Faculty of Medicine, Helsinki University, Helsinki, Finland.
42
PATH, Seattle, US.

Abstract

The role of hormonal factors in lymphoid neoplasms etiology remains unclear. Previous studies have yielded conflicting results, been underpowered to assess many lymphoma subtypes, or lacked detailed information on relevant exposures. Within the European Prospective Investigation into Cancer and Nutrition cohort, we analyzed comprehensive data collected at baseline (1992-2000) on reproductive factors and exogenous hormone use among 343,458 women, including 1,427 incident B-cell non-Hodgkin lymphomas (NHL) and its major subtypes identified after a mean follow-up of 14 years (through 2015). We estimated hazard ratios and 95% confidence intervals using multivariable proportional hazards modeling. Overall, we observed no statistically significant associations between parity, age at first birth, breastfeeding, oral contraceptive use or ever use of postmenopausal hormone therapy and risk of B-cell NHL or its subtypes. Women who had a surgical menopause had a 51% higher risk of B-cell NHL (based on 67 cases) compared with natural menopause (hazard ratio=1.51, 95% confidence interval=1.17, 1.94). Given that this result may be due to chance, our results provide little support for the hypothesis that sex hormones play a role in lymphomagenesis.

PMID:
30481275
DOI:
10.1093/aje/kwy259

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