Non-Hodgkin's lymphomas (NHL) risk factors
Citations
Bernstein L, Ross RK. Prior medication use and health history
as risk factors for non-Hodgkin's lymphoma: preliminary results from a case-control study
in Los Angeles County.Cancer Res. 1992 Oct 1;52(19
Suppl):5510s-5515s.PMID: 1394165 [PubMed - indexed for MEDLINE]
To determine whether non-Hodgkin's lymphoma (NHL) is related to prior medication use or
health history, a population-based case-control study was conducted. A total of 619 male
and female residents of Los Angeles County who were diagnosed with NHL between January 1,
1979, and June 30, 1982, were compared to individually age-, race-, and sex-matched
neighborhood controls with regard to history of use of 49 different medications, 47
chronic and infectious diseases or other conditions, 15 types of immunizations, and 15
specific allergic reactions. Based on preliminary analyses, long-term regular use of aspirin
and other pain relievers and greater than or equal to 2 mo of treatment
with penicillin and other antibiotics were associated
with significantly increased risk of NHL. Other drugs associated with greater risk of NHL
were use of digitalis and estrogen replacement therapy
by women, use of corticosteroids, and greater than or equal to 2 mo of use of tranquilizers.
NHL was strongly associated with a prior history of cancer. Cases more frequently reported
histories of kidney infections and anemia than did controls; a history of eczema appeared
to be protective against NHL. Women who had been immunized against polio by injectable
vaccine were at significantly lower risk of NHL than women who had not received this
immunization. Among men, cholera immunization and allergy to nuts and berries were
significantly protective. Subjects who had received a yellow fever immunization also had
lower NHL risk. Further analyses of these data will attempt to establish the relative
importance of these potential risk factors and to determine whether any are markers of
early symptoms of NHL.
Zahm
SH, Weisenburger DD, Babbitt PA, Saal RC, Vaught JB, Cantor KP, Blair A.
A case-control study of non-Hodgkin's lymphoma and the herbicide 2,4-dichlorophenoxyacetic
acid (2,4-D) in eastern Nebraska.Epidemiology. 1990
Sep;1(5):349-56.PMID: 2078610 [PubMed - indexed for MEDLINE]
To evaluate the role of the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) in the
development of non-Hodgkin's lymphoma (NHL), we conducted a population-based, case-control
study in 66 counties in eastern Nebraska. Telephone interviews were conducted with 201
white men diagnosed with NHL between July 1, 1983, and June 30, 1986, and with 725
controls. There was a 50% excess of NHL among men who mixed or applied 2,4-D (odds ratio
[OR] = 1.5; 95% confidence interval = 0.9, 2.5). The risk of NHL increased with the
average frequency of use to over threefold for those exposed 20 or more days per year (p
for trend = 0.051). Adjusting for use of organophosphate insecticides lowered the risk
estimate for frequent users (OR = 1.8), but adjustment for fungicide use increased the
risk estimate (OR = 4.5). Simultaneous adjustment for organophosphates and fungicides
yielded an OR of 3.1 for farmers who mixed or applied 2,4-D more than 20 days per year.
Risk also increased with degree of exposure, as indicated by application method and time
spent in contaminated clothing, but not with the number of years of 2,4-D use or failure
to use protective equipment. Although other pesticides, especially organophosphate
insecticides, may be related to NHL, the risk associated with 2,4-D does not appear to be
explained completely by these other exposures.