A Population-Based Family Case-Control Study of Sun Exposure and Follicular Lymphoma Risk

Michael K Odutola¹, Marina T van Leeuwen¹, Fiona Bruinsma^{2

3}, Jennifer Turner^{4

5}, Mark Hertzberg⁶, John F Seymour⁷, H Miles Prince⁷, Judith Trotman⁸, Emma Verner⁸, Fernando Roncolato⁹, Stephen Opat¹⁰, Robert Lindeman¹¹, Campbell Tiley¹², Samuel T Milliken¹³, Craig R Underhill¹⁴, Geza Benke¹⁵, Graham G Giles^{2

16}, Claire M Vajdic^{1

17}

Affiliations

¹ Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
² Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.
³ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.
⁴ Anatomical Pathology, Douglass Hanly Moir Pathology, Macquarie Park, Sydney, Australia.
⁵ Department of Clinical Medicine, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, Australia.
⁶ Department of Haematology, Prince of Wales Hospital and University of New South Wales, Sydney, New South Wales, Australia.
⁷ Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.
⁸ Concord Repatriation General Hospital, Concord, New South Wales, Australia.
⁹ St. George Hospital, Kogarah, New South Wales, Australia.
¹⁰ Clinical Haematology, Monash Health, Clayton, Victoria, Australia.
¹¹ New South Wales Health Pathology, Sydney, New South Wales, Australia.
¹² Gosford Hospital, Gosford, New South Wales, Australia.
¹³ St. Vincent's Hospital, Sydney, New South Wales, Australia.
¹⁴ Border Medical Oncology Research Unit, Albury, New South Wales, Australia.
¹⁵ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
¹⁶ Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia.
¹⁷ The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.

PMID: 37831120
PMCID: PMC10774741
DOI: 10.1158/1055-9965.EPI-23-0578

A Population-Based Family Case-Control Study of Sun Exposure and Follicular Lymphoma Risk

Michael K Odutola et al. Cancer Epidemiol Biomarkers Prev. 2024.

. 2024 Jan 9;33(1):106-116.

doi: 10.1158/1055-9965.EPI-23-0578.

Authors

Affiliations

¹ Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
² Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.
³ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.
⁴ Anatomical Pathology, Douglass Hanly Moir Pathology, Macquarie Park, Sydney, Australia.
⁵ Department of Clinical Medicine, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, Australia.
⁶ Department of Haematology, Prince of Wales Hospital and University of New South Wales, Sydney, New South Wales, Australia.
⁷ Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.
⁸ Concord Repatriation General Hospital, Concord, New South Wales, Australia.
⁹ St. George Hospital, Kogarah, New South Wales, Australia.
¹⁰ Clinical Haematology, Monash Health, Clayton, Victoria, Australia.
¹¹ New South Wales Health Pathology, Sydney, New South Wales, Australia.
¹² Gosford Hospital, Gosford, New South Wales, Australia.
¹³ St. Vincent's Hospital, Sydney, New South Wales, Australia.
¹⁴ Border Medical Oncology Research Unit, Albury, New South Wales, Australia.
¹⁵ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
¹⁶ Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia.
¹⁷ The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.

PMID: 37831120
PMCID: PMC10774741
DOI: 10.1158/1055-9965.EPI-23-0578

Abstract

Background: Epidemiologic evidence suggests an inverse association between sun exposure and follicular lymphoma risk.

Methods: We conducted an Australian population-based family case-control study based on 666 cases and 459 controls (288 related, 171 unrelated). Participants completed a lifetime residence and work calendar and recalled outdoor hours on weekdays, weekends, and holidays in the warmer and cooler months at ages 10, 20, 30, and 40 years, and clothing types worn in the warmer months. We used a group-based trajectory modeling approach to identify outdoor hour trajectories over time and examined associations with follicular lymphoma risk using logistic regression.

Results: We observed an inverse association between follicular lymphoma risk and several measures of high lifetime sun exposure, particularly intermittent exposure (weekends, holidays). Associations included reduced risk with increasing time outdoors on holidays in the warmer months [highest category OR = 0.56; 95% confidence interval (CI), 0.42-0.76; Ptrend < 0.01], high outdoor hours on weekends in the warmer months (highest category OR = 0.71; 95% CI, 0.52-0.96), and increasing time outdoors in the warmer and cooler months combined (highest category OR = 0.66; 95% CI, 0.50-0.91; Ptrend 0.01). Risk was reduced for high outdoor hour maintainers in the warmer months across the decade years (OR = 0.71; 95% CI, 0.53-0.96).

Conclusions: High total and intermittent sun exposure, particularly in the warmer months, may be protective against the development of follicular lymphoma.

Impact: Although sun exposure is not recommended as a cancer control policy, confirming this association may provide insights regarding the future control of this intractable malignancy.

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Figures

Figure 1. Estimated lifetime trajectories of outdoor hours in solid lines and group percentages with 95% pointwise CIs: outdoor hours on weekdays only (A), weekends only (B), holidays only (C), outdoor hours in warmer months (D), outdoor hours in cooler months (E), total outdoor hours in warmer and cooler months (F). — **Figure 1.**
Estimated lifetime trajectories of outdoor hours in solid lines and group percentages with 95% pointwise CIs: outdoor hours on weekdays only (A), weekends only (B), holidays only (C), outdoor hours in warmer months (D), outdoor hours in cooler months (E), total outdoor hours in warmer and cooler months (F).

See this image and copyright information in PMC

References

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A Population-Based Family Case-Control Study of Sun Exposure and Follicular Lymphoma Risk

Affiliations

A Population-Based Family Case-Control Study of Sun Exposure and Follicular Lymphoma Risk

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical