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. 2017 Jun 16;17(1):421.
doi: 10.1186/s12885-017-3414-2.

The dose-response relationship between tobacco smoking and the risk of lymphomas: a case-control study

Martina Taborelli  1 , Maurizio Montella  2 , Massimo Libra  3 , Rosamaria Tedeschi  4 , Anna Crispo  2 , Maria Grimaldi  2 , Luigino Dal Maso  1 , Diego Serraino  1 , Jerry Polesel  5
Affiliations

The dose-response relationship between tobacco smoking and the risk of lymphomas: a case-control study

Martina Taborelli et al. BMC Cancer. .

Abstract

Background: Previous studies have provided limited support to the association between tobacco smoking and lymphomas with weak evidence of a dose-response relationship.

Methods: We investigated the relationship between tobacco smoking and risk of non-Hodgkin lymphomas (NHL) and Hodgkin lymphomas (HL) through logistic regression spline models. Data were derived from an Italian hospital-based case-control study (1999-2014), which enrolled 571 NHLs, 188 HLs, and 1004 cancer-free controls. Smoking habits and other lifestyle factors were assessed through a validated questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression, adjusting for potential confounders.

Results: Compared to never smokers, people smoking ≥15 cigarettes/day showed increased risks of both NHL (OR = 1.42, 95% CI: 1.02, 1.97) and HL (OR = 2.47, 95% CI: 1.25, 4.87); the risk was particularly elevated for follicular NHL (OR = 2.43; 95% CI:1.31-4.51) and mixed cellularity HL (OR = 5.60, 95% CI: 1.31, 23.97). No excess risk emerged for former smokers or people smoking <15 cigarettes/day. Spline analyses showed a positive dose-response relationship with significant increases in NHL and HL risks starting from 15 and 21 cigarettes/day, respectively, with the most evident effects for follicular NHL and mixed cellularity HL. Smoking duration was significantly associated with the HL risk only (OR = 2.15, 95% CI: 1.16, 3.99).

Conclusions: These findings support a role of tobacco smoking in the etiology of both NHL and HL, providing evidence of a direct association of risk with smoking intensity.

Keywords: Case-control study; Dose-response relationship; Hodgkin lymphoma; Non-Hodgkin lymphoma; Spline models; Tobacco smoking.

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Figures

Fig. 1
Fig. 1
Dose-response relationship between tobacco smoking and the risk of non-Hodgkin lymphoma a and its major subtypes: DLBCL b and follicular c. Odds ratios and 95% confidence intervals were estimated through logistic regression spline models adjusted for gender, age, study center, years of education, and place of birth. Curves are shown for best-fitting splines according to Akaike Information Criterion. The reference category was defined as never smokers. Filled circles show knot location
Fig. 2
Fig. 2
Dose-response relationship between tobacco smoking and the risk of Hodgkin lymphoma a and its major subtypes: nodular sclerosis b and mixed cellularity c. Odds ratios and 95% confidence intervals were estimated through logistic regression spline models adjusted for gender, age, study center, years of education, and place of birth. Curves are shown for best-fitting splines according to Akaike Information Criterion. The reference category was defined as never smokers. Filled circles show knot location
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References

    1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC CancerBase no. 11. International Agency for Research on Cancer: Lyon, France; 2013. http://globocan.iarc.fr. Accessed 14 June 2017.
    1. International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Vol. 100. A review of human carcinogens, Part B: Biological agents. Lyon, France: International Agency for Research on Cancer; 2012.
    1. Morton LM, Slager SL, Cerhan JR, Wang SS, Vajidic CM, Skibola CF, et al. Etiologic heterogeneity among non-Hodgkin lymphoma subtypes: the InterLymph non-Hodgkin lymphoma subtypes project. J Natl Cancer Inst Monographs. 2014;2014:130–144. doi: 10.1093/jncimonographs/lgu013. - DOI - PMC - PubMed
    1. Cartwright RA, Watkins G. Epidemiology of Hodgkin’s disease: a review. Hematol Oncol. 2004;22:11–26. doi: 10.1002/hon.723. - DOI - PubMed
    1. Alexander DD, Mink PJ, Adami H-O, Chang ET, Cole P, Mandel JS, et al. The non-Hodgkin lymphomas: a review of the epidemiologic literature. Int J Cancer. 2007;120(Suppl 12):1–39. doi: 10.1002/ijc.22719. - DOI - PubMed

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