Associations between sun exposure and environmental risk factors and non-Hodgkin lymphoma, by lymphoma subtype
| Exposure . | Controls,N† . | All NHL combined* . | DLBCL . | Follicular lymphoma . | Marginal zone lymphoma . | CLL/SLL . | P homo-geneity . | Lowest P value from pairwise analysis§ . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | ||||
| Sun in teens, h/wk | |||||||||||||
| < 7 | 46 | 62 | 1.0 (reference) | 23 | 1.0 (reference) | 18 | 1.0 (reference) | 4 | 1.0 (reference) | 5 | 1.0 (reference) | ||
| 7-< 14 | 68 | 89 | 1.0 (0.6, 1.7) | 26 | 0.8 (0.4, 1.6) | 24 | 1.0 (0.5, 2.0) | 7 | 1.1 (0.3, 4.1) | 4 | 0.5 (0.1, 2.2) | ||
| 14-< 28 | 155 | 185 | 0.8 (0.5, 1.3) | 67 | 0.8 (0.4, 1.4) | 44 | 0.7 (0.4, 1.3) | 13 | 0.8 (0.2, 2.6) | 13 | 0.7 (0.2, 2.2) | ||
| 28+ | 187 | 211 | 0.8 (0.5, 1.2) | 73 | 0.7 (0.4, 1.2) | 56 | 0.7 (0.4, 1.4) | 14 | 0.7 (0.2, 2.3) | 28 | 1.2 (0.4, 3.5) | ||
| P trend | .5 | .2 | .3 | .3 | .3 | .3 | CLL/SLL vs DLBCL, FL, MZ; P = .1 | ||||||
| Sun in past 10 y, h/wk | |||||||||||||
| < 7 | 159 | 216 | 1.0 (reference) | 71 | 1.0 (reference) | 58 | 1.0 (reference) | 14 | 1.0 (reference) | 18 | 1.0 (reference) | ||
| 7-< 14 | 126 | 145 | 0.8 (0.6, 1.2) | 43 | 0.7 (0.5, 1.2) | 43 | 0.9 (0.6, 1.4) | 12 | 1.0 (0.5, 2.4) | 12 | 0.8 (0.4, 1.7) | ||
| 14-< 28 | 123 | 131 | 0.7 (0.5, 1.0) | 44 | 0.7 (0.5, 1.2) | 29 | 0.6 (0.4, 1.0) | 9 | 0.7 (0.3, 1.8) | 18 | 1.1 (0.6, 2.4) | ||
| 28+ | 51 | 59 | 0.7 (0.4, 1.1) | 31 | 1.1 (0.6, 1.9) | 14 | 0.6 (0.3, 1.2) | 3 | 0.5 (0.1, 1.9) | 3 | 0.4 (0.1, 1.4) | ||
| P trend | .3 | .7 | .05 | .3 | .5 | .5 | FL vs DLBCL, MZ, CLL/SLL; P = .1 | ||||||
| Eye color | |||||||||||||
| Green/blue-green | 64 | 59 | 1.0 (reference) | 17 | 1.0 (reference) | 19 | 1.0 (reference) | 2 | 1.0 (reference) | 8 | 1.0 (reference) | ||
| Blue | 180 | 188 | 1.3 (0.8, 2.0) | 71 | 1.7 (0.9, 3.1) | 53 | 1.2 (0.7, 2.3) | 10 | 1.8 (0.4, 8.7) | 15 | 0.6 (0.2, 1.6) | ||
| Hazel | 84 | 96 | 1.4 (0.9, 2.2) | 28 | 1.4 (0.7, 2.8) | 29 | 1.4 (0.7, 2.7) | 9 | 3.7 (0.8, 18.0) | 13 | 1.3 (0.5, 3.2) | ||
| Light brown | 41 | 50 | 1.7 (0.9, 2.9) | 20 | 2.4 (1.1, 5.4) | 11 | 1.3 (0.5, 3.0) | 3 | 2.1 (0.3, 13.5) | 3 | 0.7 (0.2, 2.8) | ||
| Dark brown | 93 | 158 | 2.2 (1.4, 3.4) | 53 | 2.6 (1.3, 4.9) | 32 | 1.4 (0.7, 2.8) | 14 | 4.7 (1.0, 22.4) | 12 | 1.1 (0.4, 2.8) | ||
| P trend | .009 | .005 | .3 | .01 | .4 | .2 | DLBCL, MZ vs FL, CLL/SLL; P = .01 | ||||||
| Termite treatment before 1988 | |||||||||||||
| Not treated before 1988 | 717 | 852 | 1.0 (reference) | 261 | 1.0 (reference) | 218 | 1.0 (reference) | 59 | 1.0 (reference) | 96 | 1.0 (reference) | ||
| None or DK treated | 176 | 244 | 1.1 (0.9, 1.4) | 80 | 1.1 (0.8, 1.6) | 59 | 1.0 (0.7, 1.5) | 21 | 1.4 (0.8, 2.4) | 20 | 1.0 (0.6, 1.6) | ||
| 1+ homes treated before 1988 | 162 | 220 | 1.3 (1.0, 1.6) | 74 | 1.6 (1.1, 2.3) | 41 | 1.0 (0.7, 1.5) | 26 | 1.8 (1.0, 3.1) | 17 | 0.9 (0.5, 1.6) | .1 | DLBCL, MZ vs FL, CLL/SLL; P = .009 |
| Alpha-chlordane (dust), ng/g | |||||||||||||
| ND | 317 | 409 | 1.0 (reference) | 128 | 1.0 (reference) | 99 | 1.0 (reference) | 29 | 1.0 (reference) | 50 | 1.0 (reference) | ||
| 20.8–60.1 | 98 | 116 | 0.9 (0.7, 1.3) | 31 | 0.9 (0.5, 1.4) | 26 | 0.9 (0.6, 1.5) | 16 | 1.5 (0.8, 3.0) | 10 | 0.7 (0.3, 1.4) | ||
| 60.3–5870 | 98 | 157 | 1.3 (1.0, 1.9) | 50 | 1.5 (1.0, 2.3) | 34 | 1.3 (0.8, 2.1) | 16 | 1.5 (0.7, 3.1) | 9 | 0.6 (0.3, 1.3) | ||
| P trend | .1 | .1 | .4 | .2 | .1 | .1 | CLL/SLL vs DLBCL, FL, MZ; P = .04 | ||||||
| PCB180 (dust), ng/g | |||||||||||||
| < 20.8 | 395 | 499 | 1.0 (reference) | 162 | 1.0 (reference) | 115 | 1.0 (reference) | 41 | 1.0 (reference) | 52 | 1.0 (reference) | ||
| 20.8-44.3 | 60 | 92 | 1.3 (0.9, 1.9) | 27 | 1.2 (0.7, 2.0) | 20 | 1.3 (0.7, 2.2) | 6 | 1.2 (0.5, 3.1) | 11 | 1.3 (0.6, 2.8) | ||
| 44.4+ | 58 | 91 | 1.4 (1.0, 2.0) | 20 | 0.9 (0.5, 1.6) | 24 | 1.6 (1.0, 2.8) | 14 | 3.0 (1.5, 6.1) | 6 | 0.8 (0.3, 2.0) | ||
| P trend | .07 | .9 | .06 | .004 | .9 | .04 | MZ vs DLBCL, FL, CLL/SLL; P = .01 | ||||||
| Pre-1980 hair dye use | |||||||||||||
| Never | 98 | 101 | 1.0 (reference) | 34 | 1.0 (reference) | 24 | 1.0 (reference) | 13 | 1.0 (reference) | 10 | 1.0 (reference) | ||
| Permanent | 123 | 169 | 1.3 (0.9, 1.9) | 42 | 0.9 (0.5, 1.7) | 49 | 1.9 (1.0, 3.4) | 16 | 0.9 (0.4, 2.0) | 18 | 1.5 (0.6, 3.5) | .2 | FL vs DLBCL, MZ, CLL/SLL; P = .07 |
| Exposure . | Controls,N† . | All NHL combined* . | DLBCL . | Follicular lymphoma . | Marginal zone lymphoma . | CLL/SLL . | P homo-geneity . | Lowest P value from pairwise analysis§ . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | N† . | OR (95% CI)‡ . | ||||
| Sun in teens, h/wk | |||||||||||||
| < 7 | 46 | 62 | 1.0 (reference) | 23 | 1.0 (reference) | 18 | 1.0 (reference) | 4 | 1.0 (reference) | 5 | 1.0 (reference) | ||
| 7-< 14 | 68 | 89 | 1.0 (0.6, 1.7) | 26 | 0.8 (0.4, 1.6) | 24 | 1.0 (0.5, 2.0) | 7 | 1.1 (0.3, 4.1) | 4 | 0.5 (0.1, 2.2) | ||
| 14-< 28 | 155 | 185 | 0.8 (0.5, 1.3) | 67 | 0.8 (0.4, 1.4) | 44 | 0.7 (0.4, 1.3) | 13 | 0.8 (0.2, 2.6) | 13 | 0.7 (0.2, 2.2) | ||
| 28+ | 187 | 211 | 0.8 (0.5, 1.2) | 73 | 0.7 (0.4, 1.2) | 56 | 0.7 (0.4, 1.4) | 14 | 0.7 (0.2, 2.3) | 28 | 1.2 (0.4, 3.5) | ||
| P trend | .5 | .2 | .3 | .3 | .3 | .3 | CLL/SLL vs DLBCL, FL, MZ; P = .1 | ||||||
| Sun in past 10 y, h/wk | |||||||||||||
| < 7 | 159 | 216 | 1.0 (reference) | 71 | 1.0 (reference) | 58 | 1.0 (reference) | 14 | 1.0 (reference) | 18 | 1.0 (reference) | ||
| 7-< 14 | 126 | 145 | 0.8 (0.6, 1.2) | 43 | 0.7 (0.5, 1.2) | 43 | 0.9 (0.6, 1.4) | 12 | 1.0 (0.5, 2.4) | 12 | 0.8 (0.4, 1.7) | ||
| 14-< 28 | 123 | 131 | 0.7 (0.5, 1.0) | 44 | 0.7 (0.5, 1.2) | 29 | 0.6 (0.4, 1.0) | 9 | 0.7 (0.3, 1.8) | 18 | 1.1 (0.6, 2.4) | ||
| 28+ | 51 | 59 | 0.7 (0.4, 1.1) | 31 | 1.1 (0.6, 1.9) | 14 | 0.6 (0.3, 1.2) | 3 | 0.5 (0.1, 1.9) | 3 | 0.4 (0.1, 1.4) | ||
| P trend | .3 | .7 | .05 | .3 | .5 | .5 | FL vs DLBCL, MZ, CLL/SLL; P = .1 | ||||||
| Eye color | |||||||||||||
| Green/blue-green | 64 | 59 | 1.0 (reference) | 17 | 1.0 (reference) | 19 | 1.0 (reference) | 2 | 1.0 (reference) | 8 | 1.0 (reference) | ||
| Blue | 180 | 188 | 1.3 (0.8, 2.0) | 71 | 1.7 (0.9, 3.1) | 53 | 1.2 (0.7, 2.3) | 10 | 1.8 (0.4, 8.7) | 15 | 0.6 (0.2, 1.6) | ||
| Hazel | 84 | 96 | 1.4 (0.9, 2.2) | 28 | 1.4 (0.7, 2.8) | 29 | 1.4 (0.7, 2.7) | 9 | 3.7 (0.8, 18.0) | 13 | 1.3 (0.5, 3.2) | ||
| Light brown | 41 | 50 | 1.7 (0.9, 2.9) | 20 | 2.4 (1.1, 5.4) | 11 | 1.3 (0.5, 3.0) | 3 | 2.1 (0.3, 13.5) | 3 | 0.7 (0.2, 2.8) | ||
| Dark brown | 93 | 158 | 2.2 (1.4, 3.4) | 53 | 2.6 (1.3, 4.9) | 32 | 1.4 (0.7, 2.8) | 14 | 4.7 (1.0, 22.4) | 12 | 1.1 (0.4, 2.8) | ||
| P trend | .009 | .005 | .3 | .01 | .4 | .2 | DLBCL, MZ vs FL, CLL/SLL; P = .01 | ||||||
| Termite treatment before 1988 | |||||||||||||
| Not treated before 1988 | 717 | 852 | 1.0 (reference) | 261 | 1.0 (reference) | 218 | 1.0 (reference) | 59 | 1.0 (reference) | 96 | 1.0 (reference) | ||
| None or DK treated | 176 | 244 | 1.1 (0.9, 1.4) | 80 | 1.1 (0.8, 1.6) | 59 | 1.0 (0.7, 1.5) | 21 | 1.4 (0.8, 2.4) | 20 | 1.0 (0.6, 1.6) | ||
| 1+ homes treated before 1988 | 162 | 220 | 1.3 (1.0, 1.6) | 74 | 1.6 (1.1, 2.3) | 41 | 1.0 (0.7, 1.5) | 26 | 1.8 (1.0, 3.1) | 17 | 0.9 (0.5, 1.6) | .1 | DLBCL, MZ vs FL, CLL/SLL; P = .009 |
| Alpha-chlordane (dust), ng/g | |||||||||||||
| ND | 317 | 409 | 1.0 (reference) | 128 | 1.0 (reference) | 99 | 1.0 (reference) | 29 | 1.0 (reference) | 50 | 1.0 (reference) | ||
| 20.8–60.1 | 98 | 116 | 0.9 (0.7, 1.3) | 31 | 0.9 (0.5, 1.4) | 26 | 0.9 (0.6, 1.5) | 16 | 1.5 (0.8, 3.0) | 10 | 0.7 (0.3, 1.4) | ||
| 60.3–5870 | 98 | 157 | 1.3 (1.0, 1.9) | 50 | 1.5 (1.0, 2.3) | 34 | 1.3 (0.8, 2.1) | 16 | 1.5 (0.7, 3.1) | 9 | 0.6 (0.3, 1.3) | ||
| P trend | .1 | .1 | .4 | .2 | .1 | .1 | CLL/SLL vs DLBCL, FL, MZ; P = .04 | ||||||
| PCB180 (dust), ng/g | |||||||||||||
| < 20.8 | 395 | 499 | 1.0 (reference) | 162 | 1.0 (reference) | 115 | 1.0 (reference) | 41 | 1.0 (reference) | 52 | 1.0 (reference) | ||
| 20.8-44.3 | 60 | 92 | 1.3 (0.9, 1.9) | 27 | 1.2 (0.7, 2.0) | 20 | 1.3 (0.7, 2.2) | 6 | 1.2 (0.5, 3.1) | 11 | 1.3 (0.6, 2.8) | ||
| 44.4+ | 58 | 91 | 1.4 (1.0, 2.0) | 20 | 0.9 (0.5, 1.6) | 24 | 1.6 (1.0, 2.8) | 14 | 3.0 (1.5, 6.1) | 6 | 0.8 (0.3, 2.0) | ||
| P trend | .07 | .9 | .06 | .004 | .9 | .04 | MZ vs DLBCL, FL, CLL/SLL; P = .01 | ||||||
| Pre-1980 hair dye use | |||||||||||||
| Never | 98 | 101 | 1.0 (reference) | 34 | 1.0 (reference) | 24 | 1.0 (reference) | 13 | 1.0 (reference) | 10 | 1.0 (reference) | ||
| Permanent | 123 | 169 | 1.3 (0.9, 1.9) | 42 | 0.9 (0.5, 1.7) | 49 | 1.9 (1.0, 3.4) | 16 | 0.9 (0.4, 2.0) | 18 | 1.5 (0.6, 3.5) | .2 | FL vs DLBCL, MZ, CLL/SLL; P = .07 |
CLL/SLL indicates chronic lymphocytic leukemia/small lymphocytic lymphoma; DK, don't know; DLBCL, diffuse large B-cell lymphoma; FL, follicular lymphoma; MZ, marginal zone lymphoma; NHL, non-Hodgkin lymphoma; and PCB180, polychlorinated biphenyl congener 180.
Includes all NHL cases in the study, regardless of histologic subtype (N = 1320, excludes one DLBCL case resulting from missing data on education).
Counts may not sum to the total because of missing data. For some exposures (Table 1), a split-sample design was used so that only approximately 50% of participants were expected to provide information.
Odds ratios (95% CIs) estimated using polytomous logistic regression models, adjusted for age, sex, race, study center, and education.
To account for the seven comparisons within the pairwise analysis, we applied a Bonferroni correction and considered P < .007 to be statistically significant.