Non-Hodgkin lymphoma in women: reproductive factors and exogenous hormone use.
Few studies of reproductive hormone exposures and non-Hodgkin lymphoma (NHL) have examined NHL subtypes. Associations between reproductive hormonal factors and risk of all NHL and of two predominant subtypes, diffuse large-cell lymphoma (DLCL) (n = 233) and follicular lymphoma (n = 173), were investigated among women (n = 581) in a large, population-based, case-control study (1,591 cases, 2,515 controls). Controls (n = 836) identified by random digit dialing were frequency matched by age and county to incident NHL cases ascertained in the San Francisco Bay Area of California in 1988-1993. Adjusted unconditional logistic regression was used to obtain odds ratios. More than four pregnancies indicated a possible lower risk of all NHL (odds ratio (OR) = 0.81, 95% confidence interval (CI): 0.55, 1.2; p-trend = 0.06) and of DLCL (OR = 0.53, 95% CI: 0.31, 0.90; p-trend = 0.01). Exclusive use of menopausal hormone therapy for > or =5 years was associated with a reduced risk of all NHL (OR = 0.68, 95% CI: 0.48, 0.98) and of DLCL (OR = 0.50, 95% CI: 0.30, 0.85). Oral contraceptive use indicated a lower risk of all NHL (OR = 0.68, 95% CI: 0.49, 0.94), and perhaps DLCL (OR = 0.79, 95% CI: 0.51, 1.2), and of follicular lymphoma (OR = 0.75, 95% CI: 0.46, 1.2). Results suggest that endogenous and exogenous reproductive hormones confer different risks by NHL subtype and are associated with a reduced risk of DLCL in women.
Division of Endocrinology, Clinical Nutrition, and Vascular Medicine, Department of Internal Medicine, University of California Davis, Sacramento, CA, USA.
Jennifer S
JS
Lee
Paige M
PM
Bracci
Elizabeth A
EA
Holly
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016001:Confidence Intervals; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D016015:Logistic Models; D008224:Lymphoma, Follicular / Q000453:epidemiology / Q000517:prevention & control; D016403:Lymphoma, Large B-Cell, Diffuse / Q000453:epidemiology / Q000517:prevention & control; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D017584:Reproductive History; D012307:Risk Factors; D018426:SEER Program; D012495:San Francisco / Q000453:epidemiology; D011795:Surveys and Questionnaires
D003276:Contraceptives, Oral