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A prospective analysis of body size during childhood, adolescence, and adulthood and risk of non-Hodgkin lymphoma.

Abstract

The etiology of non-Hodgkin lymphoma (NHL) is poorly understood. Obesity is associated with inflammation, a cytokine milieu conducive to lymphocyte proliferation, and has been associated with NHL risk in some epidemiologic studies. To prospectively examine NHL risk in relation to adult and earlier life obesity, we documented 635 incident NHL diagnoses among 46,390 men in the Health Professionals Follow-up Study and 1,254 diagnoses among 116,794 women in the Nurses' Health Study over 22 to 32 years of follow-up. Using multivariable Cox proportional hazards models, we estimated cohort-specific incidence rate ratios (RR) and 95% confidence intervals (CI) for risk of NHL and major histologic subtypes associated with cumulative average middle and young adult (ages, 18-21 years) body mass index (BMI) and adolescent and childhood somatotype. NHL risk was modestly increased in men (but not women) with a cumulative average middle adult BMI ≥ 30 kg/m(2) (vs. 15-22.9 kg/m(2); RR, 1.28; 95% CI, 0.92-1.77; Ptrend = 0.05). In meta-analyses across cohorts, higher young adult BMI was associated with increased risk of all NHL (pooled RR per 5 kg/m(2), 1.19; 95% CI, 1.05-1.37), diffuse large B-cell lymphoma (DLBCL), and follicular lymphoma (all Ptrend ≤ 0.02). Adolescent somatotype was also positively associated with all NHL, DLBCL, and follicular lymphoma in pooled analyses (all Ptrend ≤ 0.03), whereas childhood somatotype was positively associated with NHL overall among women only (Ptrend < 0.01). These findings in two large prospective cohorts provide novel evidence that larger body size in childhood, adolescence, and young adulthood predicts increased risk of NHL, and particularly of DLBCL and follicular lymphoma.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. kbertran@hsph.harvard.edu

    , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Body Mass Index
    Body Size
    Female
    Follow-Up Studies
    Humans
    Lymphoma, Non-Hodgkin
    Male
    Middle Aged
    Obesity
    Prognosis
    Prospective Studies
    Risk Factors
    Young Adult

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    23803416

    Citation

    Bertrand, Kimberly A., et al. "A Prospective Analysis of Body Size During Childhood, Adolescence, and Adulthood and Risk of non-Hodgkin Lymphoma." Cancer Prevention Research (Philadelphia, Pa.), vol. 6, no. 8, 2013, pp. 864-73.
    Bertrand KA, Giovannucci E, Zhang SM, et al. A prospective analysis of body size during childhood, adolescence, and adulthood and risk of non-Hodgkin lymphoma. Cancer Prev Res (Phila). 2013;6(8):864-73.
    Bertrand, K. A., Giovannucci, E., Zhang, S. M., Laden, F., Rosner, B., & Birmann, B. M. (2013). A prospective analysis of body size during childhood, adolescence, and adulthood and risk of non-Hodgkin lymphoma. Cancer Prevention Research (Philadelphia, Pa.), 6(8), pp. 864-73. doi:10.1158/1940-6207.CAPR-13-0132.
    Bertrand KA, et al. A Prospective Analysis of Body Size During Childhood, Adolescence, and Adulthood and Risk of non-Hodgkin Lymphoma. Cancer Prev Res (Phila). 2013;6(8):864-73. PubMed PMID: 23803416.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A prospective analysis of body size during childhood, adolescence, and adulthood and risk of non-Hodgkin lymphoma. AU - Bertrand,Kimberly A, AU - Giovannucci,Edward, AU - Zhang,Shumin M, AU - Laden,Francine, AU - Rosner,Bernard, AU - Birmann,Brenda M, Y1 - 2013/06/26/ PY - 2013/6/28/entrez PY - 2013/6/28/pubmed PY - 2014/3/5/medline SP - 864 EP - 73 JF - Cancer prevention research (Philadelphia, Pa.) JO - Cancer Prev Res (Phila) VL - 6 IS - 8 N2 - The etiology of non-Hodgkin lymphoma (NHL) is poorly understood. Obesity is associated with inflammation, a cytokine milieu conducive to lymphocyte proliferation, and has been associated with NHL risk in some epidemiologic studies. To prospectively examine NHL risk in relation to adult and earlier life obesity, we documented 635 incident NHL diagnoses among 46,390 men in the Health Professionals Follow-up Study and 1,254 diagnoses among 116,794 women in the Nurses' Health Study over 22 to 32 years of follow-up. Using multivariable Cox proportional hazards models, we estimated cohort-specific incidence rate ratios (RR) and 95% confidence intervals (CI) for risk of NHL and major histologic subtypes associated with cumulative average middle and young adult (ages, 18-21 years) body mass index (BMI) and adolescent and childhood somatotype. NHL risk was modestly increased in men (but not women) with a cumulative average middle adult BMI ≥ 30 kg/m(2) (vs. 15-22.9 kg/m(2); RR, 1.28; 95% CI, 0.92-1.77; Ptrend = 0.05). In meta-analyses across cohorts, higher young adult BMI was associated with increased risk of all NHL (pooled RR per 5 kg/m(2), 1.19; 95% CI, 1.05-1.37), diffuse large B-cell lymphoma (DLBCL), and follicular lymphoma (all Ptrend ≤ 0.02). Adolescent somatotype was also positively associated with all NHL, DLBCL, and follicular lymphoma in pooled analyses (all Ptrend ≤ 0.03), whereas childhood somatotype was positively associated with NHL overall among women only (Ptrend < 0.01). These findings in two large prospective cohorts provide novel evidence that larger body size in childhood, adolescence, and young adulthood predicts increased risk of NHL, and particularly of DLBCL and follicular lymphoma. SN - 1940-6215 UR - https://www.unboundmedicine.com/medline/citation/23803416/A_prospective_analysis_of_body_size_during_childhood_adolescence_and_adulthood_and_risk_of_non_Hodgkin_lymphoma_ L2 - http://cancerpreventionresearch.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=23803416 DB - PRIME DP - Unbound Medicine ER -