title: Sunlight exposure, vitamin D, and risk of non-Hodgkin lymphoma in the Nurses' Health Study.
abstract: OBJECTIVE
  Case-control studies suggest increased sun exposure reduces non-Hodgkin lymphoma (NHL) risk. Evidence from prospective cohort studies, however, is limited and inconsistent. We evaluated the association between ambient ultraviolet radiation (UV) exposure and NHL in a nationwide cohort of women, the Nurses' Health Study (NHS).
  
  
  METHODS
  Between 1976 and 2006, we identified 1064 incident NHL cases among 115,482 women in the prospective NHS. Exposures assessed included average annual UV-B flux based on residence at various times during life, vitamin D intake, and predicted plasma 25-hydroxyvitamin D levels. We estimated incidence rate ratios (RRs) and 95% confidence intervals (CIs) for risk of all NHL and histologic subtypes using Cox proportional hazards models.
  
  
  RESULTS
  NHL risk was increased for women residing in areas of high ambient UV radiation (UV-B flux >113 R-B count × 10(-4)) compared to those with lower exposure (<113), with positive linear trends at all time points. The multivariable-adjusted RR for high UV area at age 15 was 1.21 (95% CI: 1.00, 1.47; p-trend < 0.01). There was no evidence of statistical heterogeneity by subtype, although power was limited for subtype analyses. We observed no association between vitamin D measures and risk of NHL overall or by subtype.
  
  
  CONCLUSIONS
  Our findings do not support the hypothesis of a protective effect of UV radiation exposure on NHL risk. We found no association between vitamin D and NHL risk.
authors: Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. kbertran@hsph.harvard.edu
authors: Kimberly A
authors: KA
authors: Bertrand
authors: Ellen T
authors: ET
authors: Chang
authors: Gregory A
authors: GA
authors: Abel
authors: Shumin M
authors: SM
authors: Zhang
authors: Donna
authors: D
authors: Spiegelman
authors: Abrar A
authors: AA
authors: Qureshi
authors: Francine
authors: F
authors: Laden
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004032:Diet; D019587:Dietary Supplements; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology*; D008875:Middle Aged; D009726:Nurses; D016016:Proportional Hazards Models; D012307:Risk Factors; D013472:Sunlight / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014466:Ultraviolet Rays / Q000009:adverse effects*; D014807:Vitamin D / Q000494:pharmacology*; D014815:Vitamins / Q000494:pharmacology*
chemical_list: D014815:Vitamins; D014807:Vitamin D