title: Case-control study of non-Hodgkin's lymphoma among women and heterosexual men in the San Francisco Bay Area, California.
abstract: A population-based case-control study was conducted between 1988 and 1995 in the San Francisco Bay Area of California to determine risk factors for non-Hodgkin's lymphoma. Participants completed in-person interviews, and blood was drawn to test for viruses and lymphocyte subsets. This report includes data for 1,281 cases and 2,095 controls. In multivariate analyses, the factors associated with a decreased risk for non-Hodgkin's lymphoma were allergy to plants, bee and wasp stings, five or more vaccinations, drugs to lower blood cholesterol, nonsteroidal anti-inflammatory drugs, total number of sexual partners, and lifetime marijuana use, whereas an increased risk was associated with cimetidine and other histamine H2-receptor antagonists, splenectomy, gonorrhea, and body mass index. Unique to sex-specific models was an increased risk for endocrine gland disorders among women and for polio among men. Median CD3, CD4, CD8, CD20, and lymphocyte counts for non-Hodgkin's lymphoma patients were significantly lower than those for controls. These results implicate environmental factors that may influence the early stages of lymphomagenesis by stimulating the immune system. Antigen-driven B cells that accumulate to form lymphoma may be suppressed by immunologic stresses such as exposure to an increased number of sexual partners and to certain medications. A history of allergies provides evidence for a persistent capacity for B-cell differentiation and therefore a decreased accumulation of B cells. The decreased risk for non-Hodgkin's lymphoma with use of nonsteroidal anti-inflammatory drugs and cholesterol-lowering drugs is consistent with a macrophage inflammatory role in B-cell proliferation.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Holly
authors.forename: C
authors.initials: C
authors.lastname: Lele
authors.forename: P M
authors.initials: PM
authors.lastname: Bracci
authors.forename: M S
authors.initials: MS
authors.lastname: McGrath
mesh_terms: D000328:Adult; D000368:Aged; D015982:Bias; D002140:California; D016022:Case-Control Studies; D005260:Female; D020010:Heterosexuality; D006801:Humans; D007958:Leukocyte Count; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology* / Q000276:immunology / Q000821:virology; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012495:San Francisco; D014780:Viruses / Q000302:isolation & purification