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To investigate the association between sun exposure and risk of non-Hodgkin lymphoma (NHL) by histologic subtypes and to explore whether or not vitamin D intake modify sun-NHL association, we analysed data from a population-based, case-control study conducted in Nebraska between 1999 and 2002. Information on sun exposure during the spring, summer, fall and winter was collected from 387 cases and 535 controls by telephone interview. We found no association between seasonal sun exposure and risk of NHL. Vitamin D intake was also not associated with NHL risk, nor does it modify the sun-NHL association. In contrast, total hours of sun exposure was inversely associated with the risk of NHL (odds ratio (OR)=0.7 comparing >30h/week to <14h/week, 95% confidence interval (CI)=0.5-1.1). Sun exposure was associated with a lower risk of NHL among farmers (OR=0.8, 0.5-1.3 for 14-30h/week; OR=0.6, 0.3-0.9 for >30h/week; p-trend=0.02), but not among non-farmers. Total hours of sun exposure was also inversely associated with risk of diffuse large B-cell lymphoma and T-cell lymphoma. In conclusion, our data suggest that total hours of sun exposure is associated with a lower risk of NHL, and the inverse association is not modified by vitamin D intake, is stronger among farmer, and may vary by subtypes.

Objective: Few studies have explored the potential association between body mass index (BMI) and non-Hodgkin lymphoma (NHL) according to histologic subtypes, or have evaluated BMI at different periods in the subject's life, and the results of these studies have been inconsistent., Subjects: A population-based, case-control study of 387 patients with NHL and 535 controls conducted in Nebraska between 1999 and 2002., Methods: Information on usual adult weight, weight at the ages 20-29, 40-49, and 60-69 years, height, physical activity, and other lifestyle factors was collected by telephone interview. A self-administered semi-quantitative food frequency questionnaire was used to collect dietary intake. Risk was estimated by odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, total energy intake, physical activity, and other confounding factors., Results: Higher adult BMI was associated with risk of NHL (OR=1.4; 95% CI=0.9-2.0) comparing the obese group (BMI >or= 30.0 kg/m(2)) with the normal weight group (BMI=18.5-24.9 kg/m(2)). The risk was higher for those who were class 2 obese (BMI >or= 35.0 kg/m(2), OR=1.7; 95% CI=1.0-2.9). The positive association was similar among men and women. An excess risk of NHL was associated with high BMI at ages 40-49 years (OR=1.6; 95% CI=1.0-2.5), and to a lesser extent, at ages 20-29 years (OR=1.4; 95% CI=0.8-2.5). Obesity at ages 40-49 years was also associated with a higher risk of small lymphocytic lymphoma (OR=4.5; 95% CI=1.5-13.3), diffuse large B-cell NHL (OR=1.8; 95% CI=0.9-3.9) and follicular NHL (OR=1.8; 95% CI=0.9-3.5)., Conclusion: Obesity is associated with risk of NHL overall. Obesity at ages 40-49 years is also associated with a higher risk of NHL overall, and particularly small lymphocytic, follicular, and diffuse large B-cell NHL.

Some evidence suggests that smoking, a family history of hematopoietic cancer, and use of hair dyes are associated with t(14;18)-defined subsets of non-Hodgkin's lymphoma (NHL) in men. To further evaluate these associations and to expand them to women, the authors determined t(14;18)(q32;q21) status by fluorescence in situ hybridization in 172 of 175 tumor blocks from a population-based case-control study conducted in Nebraska during 1983-1986. Exposures in 65 t(14;18)-positive cases and 107 t(14;18)-negative cases were compared with those among 1,432 controls. Odds ratios and 95% confidence intervals were calculated using polytomous logistic regression. Among men, smoking was not associated with risk of t(14;18)-positive or -negative NHL. Among women who had ever smoked cigarettes, there was an association with risk of t(14;18)-negative NHL (odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.1, 3.3) but not t(14;18)-positive NHL (p-difference = 0.01). The risks for t(14;18)-negative NHL among women increased with longer duration (>30 years: OR = 2.1, 95% CI: 1.1, 4.1) and early initiation (age

Pesticides have been specifically associated with the t(14;18)(q32;q21) chromosomal translocation. To investigate whether the association between pesticides and risk of non-Hodgkin lymphoma (NHL) differs for molecular subtypes of NHL defined by t(14; 18) status, we obtained 175 tumor blocks from case subjects in a population-based case-control study conducted in Nebraska between 1983 and 1986. The t(14;18) was determined by interphase fluorescence in situ hybridization in 172 of 175 tumor blocks. We compared exposures to insecticides, herbicides, fungicides, and fumigants in 65 t(14;18)-positive and 107 t(14;18)-negative case subjects with those among 1432 control subjects. Multivariate polytomous logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Compared with farmers who never used pesticides, the risk of t(14;18)-positive NHL was significantly elevated among farmers who used animal insecticides (OR = 2.6; 95% CI, 1.0-6.9), crop insecticides (OR = 3.0; 95% CI, 1.1-8.2), herbicides (OR = 2.9; 95% CI, 1.1-7.9), and fumigants (OR = 5.0; 95% CI, 1.7-14.5). None of these pesticides were associated with t(14;18)-negative NHL. The risk of t(14;18)-positive NHL associated with insecticides and herbicides increased with longer duration of use. We conclude that insecticides, herbicides, and fumigants were associated with risk of t(14;18)-positive NHL but not t(14;18)-negative NHL. These results suggest that defining subsets of NHL according to t(14;18) status is a useful approach for etiologic research.

To investigate whether the association between agricultural pesticide use and the risk of non-Hodgkin's lymphoma (NHL) is modified by a family history of hematopoietic cancer, including leukemia, myeloma, and lymphoma, we analyzed pooled data on white men from three population-based, case-control studies of NHL conducted in Iowa/Minnesota, Kansas, and Nebraska. Information on the agricultural use of insecticides, fungicides, and herbicides; a family history of cancer; and other risk factors was obtained by interviewing 973 cases and 2,853 controls or, if deceased, their next-of-kin (37% of cases, 43% of controls). The NHL risk was estimated by odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for age, state of residence, type of respondent, and use of hair dye. Compared to men with no family history of cancer, the ORs (95% CIs) of NHL was 1.5 (1.3-1.8) for men with a family history of nonhematopoietic cancer, and 2.7 (1.9-3.7) for those with a history of hematopoietic cancer among first-degree relatives. This positive association was noted for each group of NHL defined according to the Working Formulation, and was most pronounced for small lymphocytic NHL. Among direct respondents, farmers who used pesticides and had a positive family history of cancer or hematopoietic cancer were not at elevated risk of NHL, compared to nonfarmers who had no family cancer history. However, among proxy respondents, ORs were elevated for farmers who had a positive family history of hematopoietic cancer and used animal insecticides (OR = 4.6; 1.9-11.2), crop insecticides (OR = 4.7; 1.6-13.4), or herbicides (OR = 4.9; 1.7-14.2), although the interaction of family history of cancer and agricultural pesticide use was not statistically significant. In summary, the joint effects of the family cancer history and pesticide use were limited to proxy respondents with wide CIs and, thus, provide little evidence that a family history of cancer modifies the association of agricultural exposures with NHL.