Abstract
The role of tobacco in the etiology of non-Hodgkin's lymphoma (NHL)was evaluated in a combined analysis of data from three population-basedcase-control studies conducted in four midwestern states of the UnitedStates: Nebraska, Iowa, Minnesota, and Kansas. Interviews were obtained from1,177 cases (993 men, 184 women) and 3,625 controls (2,918 men, 707 women )or, if deceased, from their next-of-kin. Overall, there was no associationbetween NHL and tobacco use (odds ratio [OR] = 1.0, 95 percent confidenceinterval [CI] = 0.8-1.1) or cigarette smoking (OR = 1.0, CI = 0.8-1.1). Aslight negative association evident in analyses by intensity and duration ofsmoking was not present when interviews from proxy respondents wereeliminated. There was a suggestion of a positive association between smokingand NHL among women (OR = 1.3, CI = 0.9-1.9), although there was no clearexposure-response relationship. This large case-control analysis provides noevidence that smoking is linked to the development of NHL among men. Thepossible role of smoking in the etiology of NHL among women needs furtherevaluation.
Similar content being viewed by others
References
Doll R. Mortality in relation to smoking: 20 years' observation on male British doctors. Br Med J 1976; 2: 1525–36.
Williams RR, Horm JW. Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. JNCI 1977; 58: 525–47.
Paffenbarger RS, Wing AL, Hyde RT. Characteristics in youth predictive of adult-onset malignant lymphomas, melanomas, and leukemias: brief communication. JNCI 1978; 60: 89–92.
Rogot EL, Murray JL. Smoking and causes of death among US veterans: 16 years of observation. Public Health Rep 1980; 95: 213–22.
Hoar SK, Blair A, Holmes FF, et al. Agricultural herbicide use and risk of lymphoma and soft-tissue sarcoma. JAMA 1986; 256: 1141–7.
Cartwright RA, McKinney PA, O'Brien C, et al. Non-Hodgkin's lymphoma: case control epidemiologic study in Yorkshire. Leukemia Res 1988; 12: 81–8.
Franceschi S, Serraino D, Bidoli E, et al. The epidemiology of non-Hodgkin's lymphoma in the north-east of Italy: a hospital-based case-control study. Leukemia Res 1989; 13: 465–72.
Tavani A, Negri E, Franceschi S, Serraino D, La Vecchia C. Smoking habits and non-Hodgkin's lymphoma: a casecontrol study in northern Italy. Prev Med 1994; 23: 447–52.
Siemiatycki J, Krewski D, Franco E, Kaiserman M. Associations between cigarette smoking and each of 21 types of cancer: a multi-site case-control study. Int J Epidemiol 1995; 24: 504–14.
Brown LM, Everett GD, Gibson R, Burmeister LF, Schuman LM, Blair A. Smoking and risk of non-Hodgkin's lymphoma and multiple myeloma. Cancer Causes Control 1992; 3: 49–55.
Linet MS, McLaughlin JK, Hsing AW, et al. Is cigarette smoking a risk factor for non-Hodgkin's lymphoma or multiple myeloma? Results from the Lutheran Brotherhood Cohort Study. Leukemia Res 1992; 16: 621–4.
Kinlen LJ, Rogot E. Leukaemia and smoking habits among United States veterans. Br Med J 1988; 297: 657–9.
Sandler DP, Shore DL, Anderson JR, et al. Cigarette smoking and risk of acute leukemia: associations with morphology and cytogenetic abnormalities in bone marrow. JNCI 1993; 85: 1994–2003.
Doll R, Peto R, Wheatley K, Gray R, Sutherland I. Mortality in relation to smoking: 40 years' observations on male British doctors. Br Med J 1994; 309: 901–11.
McLaughlin JK, Hrubec Z, Blot WJ, Fraumeni JF Jr. Smoking and cancer mortality among US veterans: a 26 year followup. Int J Cancer 1995; 60: 190–3.
Bain BJ. Does cigarette smoking cause leukemia? J Smoking Related Dis 1995; 5: 115–22.
Zahm SH, Weisenburger DD, Babbitt PA, et al. A casecontrol study of non-Hodgkin's lymphoma and the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) in eastern Nebraska. Epidemiology 1990; 1: 349–56.
Cantor KP, Blair A, Everett G, et al. Pesticides and other agricultural risk factors for non-Hodgkin's lymphoma among men in Iowa and Minnesota. Cancer Res 1992; 52: 2447–55.
Brown LM, Blair A, Gibson R, et al. Pesticide exposures and other agricultural risk factors for leukemia among men in Iowa and Minnesota. Cancer Res 1990; 50: 6585–91.
Pottern LM, Linet M, Blair A, et al. Familial cancers associated with subtypes of leukemia and non-Hodgkin's lymphoma. Leukemia Res 1991; 15: 305–14.
Zahm SH, Blair A, Holmes FF, Boysen CD, Robel RJ. A case-referent study of soft-tissue sarcoma and Hodgkin's disease. Scand J Work Environ Health 1988; 14: 224–30.
Zahm SH, Blair A, Holmes FF, Boysen CD, Robel RJ, Fraumeni JF Jr. A case-control study of soft-tissue sarcoma. Am J Epidemiol 1989; 130: 665–74.
Zahm SH, Weisenburger DD, Babbitt PA, Saal RC, Vaught JB, Blair A. Use of hair coloring products and the risk of lymphoma, multiple myeloma, and chronic lymphocytic leukemia. Am J Public Health 1992; 82: 990–7.
Zahm SH, Weisenburger DD, Cantor KP, Holmes FF, Blair A. Role of the herbicide atrazine in the development of non-Hodgkin's lymphoma. Scand J Work Environ Health 1993; 19: 108–14.
Non-Hodgkin's Lymphoma Pathologic Classification Project. National Cancer Institute sponsored study of classification of non-Hodgkin's lymphomas: Summary and description of a Working Formulation for clinical usage. Cancer 1982; 49: 2112–35.
Dick F, Van Lier S, Banks P, et al. Use of the Working Formulation for non-Hodgkin's lymphoma in epidemiologic studies: Agreement between reported diagnoses and a panel of experienced pathologists. JNCI 1987; 78: 1137–44.
Dick FR, Van Lier SF, McKeen K, Everett GD, Blair A. Nonconcurrence in abstracted diagnoses of non-Hodgkin's lymphoma. JNCI 1987; 78: 675–8.
Waksberg J. Sampling methods for random digit dialing. J Am Stat Assoc 1978; 73: 40–6.
Gart JJ. Point and interval estimation of the common odds ratio in the combination of 2 x 2 tables with fixed marginals. Biometrika 1970; 57: 471–5.
Mantel N. Chi square test with 1 degree of freedom, extension of the Mantel-Haenszel procedure. Am Stat Assoc J 1963; 58: 690–700.
McLaughlin JK, Blot WJ, Mehl ES, Mandel JS. Problems in the use of dead controls in case-control studies. II. Effect of excluding certain causes of death. Am J Epidemiol 1985; 122: 485–94.
Risch HA, Howe GR, Jain M, Burch JD, Holowaty EJ, Miller AB. Are female smokers at higher risk for lung cancer than male smokers? A case-control analysis by histologic type. Am J Epidemiol 1993; 138: 281–93.
Ossan KE, Anton-Culver H, Kurosaki T, Taylor T. Sex differences in lung cancer risk associated with cigarette smoking. Int J Cancer 1993; 54: 44–8.
Zang EA, Wynder EL. Differences in lung cancer risk between men and women: examination of the evidence. JNCI 1996; 88: 183–92.
Brown LM, Gibson R, Blair A, et al. Smoking and risk of leukemia. Am J Epidemiol 1992; 135: 763–8.
Correa F, Lellouch J, Schwartz D. Smoking and leukocyte counts. Results of an epidemiologic survey. Lancet 1971; ii: 632–3.
Friedman GD, Siegelaub AB, Seltzer CC, Feldman R, Collen MF. Smoking habits and the leukocyte count. Arch Environ Health 1973; 26: 137–43.
Hersey P, Prendergast D, Edwards A. Effects of cigarette smoking on the immune system. Follow-up studies in normal subjects after cessation of smoking. Med J Aust 1983; ii: 425–9.
Tollerud DJ, Clark JW, Brown LM, et al.The effects of cigarette smoking on T cell subsets: a population-based survey of healthy Caucasians. Am Rev Respir Dis 1989; 139: 1446–51.
Tollerud DJ, Clark JW, Brown LM, et al.Association of cigarette smoking with decreased numbers of circulating natural killer cells. Am Rev Respir Dis 1989; 139: 194–8.
Filipovich AH, Mathur A, Kamat D, Shapiro RS. Primary immunodeficiencies: genetic risk factors for lymphoma. Cancer Res 1992; 52(Suppl): 5465s–7s.
Kinlen L. Immunosuppressive therapy and acquired immunological disorders. Cancer Res 1992; 52(Suppl): 5474s–6s.
Burns DM, Lee L, Shen Z, et al. Cigarette smoking behavior in the United States. In: Changes in Cigarette-Related Disease Risks and Their Implication for Prevention and Control. Smoking and Tobacco Control Monograph 8. Bethesda, MD (USA): National Cancer Institute; NIH Pub. No. 97-4213 (in press).
Ries LAG, Miller BA, Hankey BF, Kosary CL, Harras A, Edwards BK, eds. SEER Cancer Statistics Review, 1973-1991: Tables and Graphs. Bethesda, MD (USA): National Cancer Institute, 1994; NIH Pub. No. 94-2789.
Hartge P, Devesa SS. Quantification of the impact of known risk factors on time trends in non-Hodgkin's lymphoma incidence. Cancer Res 1992; 52(Suppl): 5566s–9s.
Zahm SH, Blair A. Pesticides and non-Hodgkin's lymphoma. Cancer Res 1992; 52(Suppl): 5485s–8s.
Pearce N. Increasing incidence of non-Hodgkin's lymphoma: occupational and environmental factors. Cancer Res 1992; 52(Suppl): 5496s–500s.
Zahm SH, Blair A, Fraumeni JF Jr. Hair coloring product use: safe or still suspect? JNCI 1994; 86: 941–3.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Zahm, S.H., Weisenburger, D.D., Holmes, F.F. et al. Tobacco and non-Hodgkin's lymphoma: combined analysis of three case-control studies (United States). Cancer Causes Control 8, 159–166 (1997). https://doi.org/10.1023/A:1018412027985
Issue Date:
DOI: https://doi.org/10.1023/A:1018412027985