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Cigarette smoking and risk of Hodgkin lymphoma: a population-based case-control study.

Abstract

BACKGROUND

Studies have inconsistently reported an association between tobacco smoking and Hodgkin lymphoma (HL) risk. The conflicting finding may reflect etiologic heterogeneity between HL subtypes, warranting further characterization of the relationship.

METHODS

We collected information on tobacco-smoking habits in 586 classic HL cases and 3,187 population controls in a Danish-Swedish case-control study. HL EBV status was established for 499 cases by standard techniques. Odds ratios (OR) for an association with cigarette smoking were calculated by logistic regression for HL overall and stratified by age, sex, major histology subtypes, and tumor EBV status, adjusting for known confounders.

RESULTS

Compared with never smokers, current cigarette smokers were at an increased overall HL risk [adjusted OR, 1.57; 95% confidence interval (95% CI), 1.22-2.03]. The association was strongest for EBV-positive HL (adjusted OR, 2.36; 95% CI, 1.51-3.71), but also applied to EBV-negative HL (adjusted OR, 1.43; 95% CI, 1.05-1.97; P(homogeneity EBV-pos) versus P(homogeneity EBV-neg) = 0.04). The association did not vary appreciably by age, sex, or histologic subtype, the apparent EBV-related difference present in all strata. There was no evidence of a dose-response pattern, whether by age at smoking initiation, daily cigarette consumption, number of years smoking, or cumulative number of cigarettes smoked. Similar results were obtained in analyses using non-HL patients (n = 3,055) participating in the founding study as comparison group.

CONCLUSION

The observed association between cigarette smoking and HL risk is consistent with previous findings and biologically credible. Although not easily dismissed as an artifact, the limited evidence of a dose-response pattern renders the overall evidence of causality weak.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology Research, Statens Serum Institut, University of Copenhagen, Artillerivej 5, DK-2300 Copenhagen S, Denmark. hhj@ssi.dk

    , , , , , , , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Age Factors
    Aged
    Case-Control Studies
    Confounding Factors (Epidemiology)
    Epstein-Barr Virus Infections
    Female
    Herpesvirus 4, Human
    Hodgkin Disease
    Humans
    Lymphoma, Non-Hodgkin
    Male
    Middle Aged
    Population Surveillance
    Risk Factors
    Sex Factors
    Smoking
    Time Factors

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17684129

    Citation

    Hjalgrim, Henrik, et al. "Cigarette Smoking and Risk of Hodgkin Lymphoma: a Population-based Case-control Study." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 16, no. 8, 2007, pp. 1561-6.
    Hjalgrim H, Ekström-Smedby K, Rostgaard K, et al. Cigarette smoking and risk of Hodgkin lymphoma: a population-based case-control study. Cancer Epidemiol Biomarkers Prev. 2007;16(8):1561-6.
    Hjalgrim, H., Ekström-Smedby, K., Rostgaard, K., Amini, R. M., Molin, D., Hamilton-Dutoit, S., ... Melbye, M. (2007). Cigarette smoking and risk of Hodgkin lymphoma: a population-based case-control study. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 16(8), pp. 1561-6.
    Hjalgrim H, et al. Cigarette Smoking and Risk of Hodgkin Lymphoma: a Population-based Case-control Study. Cancer Epidemiol Biomarkers Prev. 2007;16(8):1561-6. PubMed PMID: 17684129.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cigarette smoking and risk of Hodgkin lymphoma: a population-based case-control study. AU - Hjalgrim,Henrik, AU - Ekström-Smedby,Karin, AU - Rostgaard,Klaus, AU - Amini,Rose-Marie, AU - Molin,Daniel, AU - Hamilton-Dutoit,Stephen, AU - Schöllkopf,Claudia, AU - Chang,Ellen T, AU - Ralfkiaer,Elisabeth, AU - Adami,Hans-Olov, AU - Glimelius,Bengt, AU - Melbye,Mads, PY - 2007/8/9/pubmed PY - 2007/10/12/medline PY - 2007/8/9/entrez SP - 1561 EP - 6 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 16 IS - 8 N2 - BACKGROUND: Studies have inconsistently reported an association between tobacco smoking and Hodgkin lymphoma (HL) risk. The conflicting finding may reflect etiologic heterogeneity between HL subtypes, warranting further characterization of the relationship. METHODS: We collected information on tobacco-smoking habits in 586 classic HL cases and 3,187 population controls in a Danish-Swedish case-control study. HL EBV status was established for 499 cases by standard techniques. Odds ratios (OR) for an association with cigarette smoking were calculated by logistic regression for HL overall and stratified by age, sex, major histology subtypes, and tumor EBV status, adjusting for known confounders. RESULTS: Compared with never smokers, current cigarette smokers were at an increased overall HL risk [adjusted OR, 1.57; 95% confidence interval (95% CI), 1.22-2.03]. The association was strongest for EBV-positive HL (adjusted OR, 2.36; 95% CI, 1.51-3.71), but also applied to EBV-negative HL (adjusted OR, 1.43; 95% CI, 1.05-1.97; P(homogeneity EBV-pos) versus P(homogeneity EBV-neg) = 0.04). The association did not vary appreciably by age, sex, or histologic subtype, the apparent EBV-related difference present in all strata. There was no evidence of a dose-response pattern, whether by age at smoking initiation, daily cigarette consumption, number of years smoking, or cumulative number of cigarettes smoked. Similar results were obtained in analyses using non-HL patients (n = 3,055) participating in the founding study as comparison group. CONCLUSION: The observed association between cigarette smoking and HL risk is consistent with previous findings and biologically credible. Although not easily dismissed as an artifact, the limited evidence of a dose-response pattern renders the overall evidence of causality weak. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/17684129/Cigarette_smoking_and_risk_of_Hodgkin_lymphoma:_a_population_based_case_control_study_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=17684129 DB - PRIME DP - Unbound Medicine ER -