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Meta-Analysis
. 2012 Sep;23(9):2362-2374.
doi: 10.1093/annonc/mds171. Epub 2012 Jul 10.

Menstrual and reproductive factors, and hormonal contraception use: associations with non-Hodgkin lymphoma in a pooled analysis of InterLymph case-control studies

E V Kane  1 , E Roman  2 , N Becker  3 , L Bernstein  4 , P Boffetta  5 , P M Bracci  6 , J R Cerhan  7 , B C-H Chiu  8 , P Cocco  9 , L Costas  10 , L Foretova  11 , E A Holly  6 , C La Vecchia  12 , K Matsuo  13 , M Maynadie  14 , S Sanjose  15 , J J Spinelli  16 , A Staines  17 , R Talamini  18 , S S Wang  4 , Y Zhang  19 , T Zheng  19 , A Kricker  20
Affiliations
Meta-Analysis

Menstrual and reproductive factors, and hormonal contraception use: associations with non-Hodgkin lymphoma in a pooled analysis of InterLymph case-control studies

E V Kane et al. Ann Oncol. 2012 Sep.

Abstract

Background: The two most common forms of non-Hodgkin lymphoma (NHL) exhibit different sex ratios: diffuse large B-cell lymphoma (DLBCL) occurs more frequently in men and follicular lymphoma (FL) more frequently in women. Looking among women alone, this pooled analysis explores the relationship between reproductive histories and these cancers.

Materials and methods: Self-reported reproductive histories from 4263 women with NHL and 5971 women without NHL were pooled across 18 case-control studies (1983-2005) from North America, Europe and Japan. Study-specific odd ratios (ORs) and confidence intervals (CIs) were estimated using logistic regression and pooled using random-effects meta-analyses.

Results: Associations with reproductive factors were found for FL rather than NHL overall and DLBCL. In particular, the risk of FL decreased with increasing number of pregnancies (pooled OR(trend) = 0.88, 95% CI 0.81-0.96). FL was associated with hormonal contraception (pooled OR = 1.30, 95% CI 1.04-1.63), and risks were increased when use started after the age of 21, was used for <5 years or stopped for >20 years before diagnosis. DLBCL, on the other hand, was not associated with hormonal contraception (pooled OR = 0.87, 95% CI 0.65-1.16).

Conclusions: Hormonal contraception is associated with an increased risk of FL but not of DLBCL or NHL overall.

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Figures

Figure 1
Figure 1
Study-specific associations between non-Hodgkin lymphoma, diffuse large B-cell lymphoma, follicular lymphoma and hormonal contraception use among women born 1925 or later. Studies are ordered by the percentage of control women who had ever used hormonal contraceptives. NHL, non-Hodgkin lymphoma; DLBCL, diffuse large B-cell lymphoma; FL, follicular lymphoma.
Figure 2
Figure 2
Percent of control women who had ever used hormonal contraception by study and birth cohort. Shading of the bars reflects the birth cohort distribution, where >40% of women were born before 1940, >25% in the 1940s and ∼15% in each of the other two time periods.
See this image and copyright information in PMC

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