title: Relationship between ambient ultraviolet radiation and non-Hodgkin lymphoma subtypes: a U.S. population-based study of racial and ethnic groups.
abstract: Associations between ultraviolet radiation (UVR) exposure and non-Hodgkin lymphoma (NHL) have been inconsistent, but few studies have examined these associations for specific subtypes or across race/ethnicities. We evaluated the relationship between ambient UVR exposure and subtype-specific NHL incidence for whites, Hispanics and blacks in the United States for years 2001-2010 (n = 187,778 cases). Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated for UVR quintiles using Poisson regression. Incidence was lower for the highest UVR quintile for chronic/small lymphocytic/leukemia (CLL/SLL) (IRR = 0.87, 95% CI: 0.77-0.97), mantle cell (IRR = 0.82, 95% CI: 0.69-0.97), lymphoplasmacytic (IRR = 0.58, 95% CI: 0.42-0.80), mucosa-associated lymphoid tissue (MZLMALT) (IRR = 0.74, 95% CI: 0.60-0.90), follicular (FL) (IRR = 0.76, 95% CI: 0.68-0.86), diffuse large B-cell (IRR = 0.84, 95% CI: 0.76-0.94;), peripheral T-cell other (PTCL) (IRR = 0.76, 95% CI: 0.61-0.95) and PTCL not otherwise specified (PNOS) (IRR = 0.77, 95% CI: 0.61-0.98). Trends were significant for MZLMALT, FL, DLBCL, BNOS and PTCL, with FL and DLBCL still significant after Bonferroni correction. We found interaction by race/ethnicity for CLL/SLL, FL, Burkitt, PNOS and MF/SS, with CLL/SLL and FL still significant after Bonferroni correction. Some B-cell lymphomas (CLL/SLL, FL and Burkitt) suggested significant inverse relationships in whites and Hispanics, but not in blacks. Some T-cell lymphomas suggested the most reduced risk for the highest quintile of UVR among blacks (PNOS and MF/SS), though trends were not significant. These findings strengthen the case for an inverse association of UVR exposure, support modest heterogeneity between NHL subtypes and suggest some differences by race/ethnicity.
authors.affiliation: Radiation Epidemiology Branch, National Cancer Institute, Division of Cancer Epidemiology and Genetics, U.S. Department of Health and Human Services, National Institutes of Health, Bethesda, MD.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Cahoon
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Pfeiffer
authors.forename: David C
authors.initials: DC
authors.lastname: Wheeler
authors.forename: Juan
authors.initials: J
authors.lastname: Arhancet
authors.forename: Shih-Wen
authors.initials: SW
authors.lastname: Lin
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Alexander
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.forename: D Michal
authors.initials: DM
authors.lastname: Freedman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D044469:Racial Groups / Q000706:statistics & numerical data*; D018426:SEER Program; D014466:Ultraviolet Rays; D014481:United States; D055815:Young Adult
keywords: non-Hodgkin lymphoma; race; ultraviolet radiation