Fast track — ArticlesAlcohol consumption and risk of non-Hodgkin lymphoma: a pooled analysis
Introduction
Non-Hodgkin lymphoma (NHL) is a group of heterogeneous diseases characterised by the malignant transformation of healthy lymphoid cells.1 Incidence of NHL has risen worldwide in past decades,2, 3 and in developed countries, NHL is the sixth most common cancer in men and eighth most common in women.4
Several epidemiological studies have associated alcohol consumption with NHL, although results have been inconsistent. Six population-based case-control studies5, 6, 7, 8, 9, 10 and a cohort study11 have suggested that alcohol consumption reduces the risk of NHL, whereas four population-based12, 13, 14, 15 and five hospital-based16, 17, 18, 19, 20, 21, 22 case-control studies found no association between alcohol consumption and NHL. Furthermore, positive associations between alcohol consumption and NHL have been reported in men12 and in men with a family history of haemolymphoproliferative cancer5 in two population-based case-control studies, and in cigarette smokers in a cohort study.23 Epidemiological studies that have assessed alcohol consumption and NHL by type of alcoholic beverage5, 6, 7, 8, 9, 10, 11, 12, 14, 16, 17, 20, 21, 23, 24 or by subtype of NHL5, 6, 7, 9, 11, 12, 14, 15, 24 have reported conflicting results. If the association between NHL and alcohol consumption varies by disease subtype or by beverage type, individual epidemiological studies might have limited statistical power to analyse the relation.
The International Lymphoma Epidemiology Consortium (InterLymph) is a voluntary case-control consortium established in 2000 to facilitate collaboration among major epidemiological studies of lymphoma worldwide.25 We aimed to assess the role of alcohol consumption in NHL with sufficient sample size to analyse by type of alcoholic beverage and by disease subtype.
Section snippets
Study population
We did a pooled analysis of original data from nine case-control studies identified through InterLymph. Studies were eligible if they had been completed between Jan 1, 1990, and Jan 1, 2004; had available electronic data at May 1, 2004; and had data for alcohol consumption. Data were pooled from nine case-control studies six of which had been reported previously.8, 9, 10, 12, 14, 20, 21
Data gathering and exposure definitions
Data for the nine participating studies were obtained mainly by use of interviews with standardised,
Results
Table 1 shows selected characteristics for every study. The pooled study population of 8683 controls and 6492 cases consisted of 7864 men and 7311 women, 95% of whom were of white ethnic origin. The median age was 58 years (range 17–86). 2605 (30%) controls were in the highest category for socioeconomic status compared with 1690 (26%) cases (p<0·0001). By contrast, more cases than controls had a body-mass index of 27·5 kg/m2 or more (1206 of 4433 [27%] vs 1418 of 6505 [22%]; p<0·0001), history
Discussion
Our pooled analysis of 15 175 study participants from nine case-control studies suggests that people who drink alcoholic beverages have a lower risk of NHL than those who do not. In participants from the Connecticut, UCSF, Italy (Verona), and Sweden studies, current drinkers were 0·73 times as likely as non-drinkers to develop NHL. We found no dose-response relation for increasing frequency and duration of consumption, or total lifetime consumption. The type of alcoholic beverage consumed did
References (54)
- et al.
Alcohol consumption, family history of hematolymphoproliferative cancer, and the risk of non-Hodgkin's lymphoma in men
Ann Epidemiol
(2002) - et al.
Alcohol consumption and risk of leukemia, non-Hodgkin's lymphoma, and multiple myeloma
Leuk Res
(1992) - et al.
Non-Hodgkin's lymphoma: case-control epidemiological study in Yorkshire
Leuk Res
(1988) - et al.
Tobacco, alcohol, diet and risk of non-Hodgkin's lymphoma: a case-control study in Uruguay
Leuk Res
(1998) - et al.
The epidemiology of non-Hodgkin's lymphoma in the north-east of Italy: a hospital-based case-control study
Leuk Res
(1989) - et al.
Are alcohol intake and smoking associated with mycosis fungoides? A European multicentre case-control study
Eur J Cancer
(2001) - et al.
A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group
Blood
(1994) - et al.
Insulin-mediated effects of alcohol intake on serum lipid levels in a general population: the Hisayama Study
J Clin Epidemiol
(2003) - et al.
Ethanol feeding induces insulin resistance with enhanced PI 3-kinase activation
Biochem Biophys Res Commun
(2003) - et al.
Light-to-moderate alcohol consumption and mortality in the physicians' health study enrollment cohort
J Am Coll Cardiol
(2000)