title: Common infection-related conditions and risk of lymphoid malignancies in older individuals.
abstract: BACKGROUND
  Chronic antigenic stimulation may initiate non-Hodgkin (NHL) and Hodgkin lymphoma (HL) development. Antecedent, infection-related conditions have been associated, but evidence by lymphoproliferative subtype is limited.
  
  
  METHODS
  From the US SEER-Medicare database, 44,191 NHL, 1832 HL and 200,000 population-based controls, frequency-matched to all SEER cancer cases, were selected. Logistic regression models, adjusted for potential confounders, compared infection-related conditions in controls with HL and NHL patients and by the NHL subtypes diffuse large B-cell, T-cell, follicular and marginal zone lymphoma (MZL). Stratification by race was undertaken.
  
  
  RESULTS
  Respiratory tract infections were broadly associated with NHL, particularly MZL. Skin infections were associated with a 15-28% increased risk of NHL and with most NHL subtypes, particularly cellulitis with T-cell lymphoma (OR 1.36, 95%CI 1.24-1.49). Only herpes zoster remained associated with HL following Bonferroni correction (OR 1.55, 95% CI 1.28-1.87). Gastrointestinal and urinary tract infections were not strongly associated with NHL or HL. In stratified analyses by race, sinusitis, pharyngitis, bronchitis and cellulitis showed stronger associations with total NHL in blacks than whites (P<0.001).
  
  
  CONCLUSIONS
  Infections may contribute to the aetiologic pathway and/or be markers of underlying immune modulation. Precise elucidation of these mechanisms may provide important clues for understanding how immune disturbance contributes to lymphoma.
authors.affiliation: Centre for Public Health, Queen's University Belfast, Northern Ireland BT12 6BJ, UK.
authors.forename: L A
authors.initials: LA
authors.lastname: Anderson
authors.affiliation: Centre for Public Health, Queen's University Belfast, Northern Ireland BT12 6BJ, UK.
authors.forename: A A
authors.initials: AA
authors.lastname: Atman
authors.affiliation: Centre for Public Health, Queen's University Belfast, Northern Ireland BT12 6BJ, UK.
authors.forename: C M
authors.initials: CM
authors.lastname: McShane
authors.affiliation: Centre for Public Health, Queen's University Belfast, Northern Ireland BT12 6BJ, UK.
authors.forename: G J
authors.initials: GJ
authors.lastname: Titmarsh
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, MSC 9776, Bethesda, Maryland 20892, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Engels
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, MSC 9776, Bethesda, Maryland 20892, USA.
authors.forename: J
authors.initials: J
authors.lastname: Koshiol
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002481:Cellulitis / Q000150:complications; D005260:Female; D006562:Herpes Zoster / Q000150:complications; D006689:Hodgkin Disease / Q000821:virology; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000209:etiology*; D016399:Lymphoma, T-Cell / Q000209:etiology*; D008297:Male; D012141:Respiratory Tract Infections / Q000150:complications*; D012307:Risk Factors; D018426:SEER Program