title: Cigarette smoking and risk of Hodgkin lymphoma and its subtypes: a pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph).
abstract: BACKGROUND
  The etiology of Hodgkin lymphoma (HL) remains incompletely characterized. Studies of the association between smoking and HL have yielded ambiguous results, possibly due to differences between HL subtypes.
  
  
  METHODS
  Through the InterLymph Consortium, 12 case-control studies regarding cigarette smoking and HL were identified. Pooled analyses on the association between smoking and HL stratified by tumor histology and Epstein-Barr virus (EBV) status were conducted using random effects models adjusted for confounders. Analyses included 3335 HL cases and 14 278 controls.
  
  
  RESULTS
  Overall, 54.5% of cases and 57.4% of controls were ever cigarette smokers. Compared with never smokers, ever smokers had an odds ratio (OR) of HL of 1.10 [95% confidence interval (CI) 1.01-1.21]. This increased risk reflected associations with mixed cellularity cHL (OR = 1.60, 95% CI 1.29-1.99) and EBV-positive cHL (OR = 1.81, 95% CI 1.27-2.56) among current smokers, whereas risk of nodular sclerosis (OR = 1.09, 95% CI 0.90-1.32) and EBV-negative HL (OR = 1.02, 95% CI 0.72-1.44) was not increased.
  
  
  CONCLUSIONS
  These results support the notion of etiologic heterogeneity between HL subtypes, highlighting the need for HL stratification in future studies. Even if not relevant to all subtypes, our study emphasizes that cigarette smoking should be added to the few modifiable HL risk factors identified.
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, K, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Kamper-Jørgensen
authors.forename: K
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authors.lastname: Rostgaard
authors.forename: S L
authors.initials: SL
authors.lastname: Glaser
authors.forename: S H
authors.initials: SH
authors.lastname: Zahm
authors.forename: W
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authors.lastname: Cozen
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authors.initials: KE
authors.lastname: Smedby
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authors.lastname: Sanjosé
authors.forename: E T
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authors.lastname: Chang
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authors.lastname: Zheng
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
authors.forename: D
authors.initials: D
authors.lastname: Serraino
authors.forename: A
authors.initials: A
authors.lastname: Monnereau
authors.forename: E V
authors.initials: EV
authors.lastname: Kane
authors.forename: L
authors.initials: L
authors.lastname: Miligi
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authors.lastname: Vineis
authors.forename: J J
authors.initials: JJ
authors.lastname: Spinelli
authors.forename: J R
authors.initials: JR
authors.lastname: McLaughlin
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authors.initials: P
authors.lastname: Pahwa
authors.forename: J A
authors.initials: JA
authors.lastname: Dosman
authors.forename: M
authors.initials: M
authors.lastname: Vornanen
authors.forename: L
authors.initials: L
authors.lastname: Foretova
authors.forename: M
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authors.lastname: Maynadie
authors.forename: A
authors.initials: A
authors.lastname: Staines
authors.forename: N
authors.initials: N
authors.lastname: Becker
authors.forename: A
authors.initials: A
authors.lastname: Nieters
authors.forename: P
authors.initials: P
authors.lastname: Brennan
authors.forename: P
authors.initials: P
authors.lastname: Boffetta
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authors.lastname: Cocco
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mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000453:epidemiology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006689:Hodgkin Disease / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D012923:Social Class; D014029:Tobacco Use Disorder / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
keywords: Epstein–Barr virus; Hodgkin lymphoma; case–control; cigarette smoking; epidemiology; individual patient data meta-analysis