Introduction: Lymphomas belong to the few cancer sites with increasing incidence over past decades, and only a few risk factors have been established. We explored the association between education and the incidence of lymphoma in the prospective EPIC study. Materials and methods: Within 3,567,410 person-years of follow-up, 1,319 lymphoma cases [1,253 non-Hodgkin lymphomas (NHL) and 66 Hodgkin lymphomas (HL)] were identified. Cox proportional hazard regression was used to examine the association between highest educational level (primary school or less, technical/professional school, secondary school, university) and lymphoma risk. Results: Overall, no consistent associations between educational level and lymphoma risk were observed; however, associations were found for sub-groups of the cohort. We observed a higher risk of B-NHL (HR = 1.31, 95% CI = 1.02-1.68; n = 583) in women with the highest education level (university) but not in men. Concerning sub-classes of B-NHL, a positive association between education and risk of B cell chronic lymphatic leukaemia (BCLL) was observed only in women. In both genders, the risk of diffuse large B cell lymphoma (DLBCL) was significantly lower for subjects with university degree (HR = 0.46, 95% CI = 0.27-0.79) versus lowest educational level. No association was found for HL. Conclusion: We could not confirm an overall consistent association of education and risk of HL or NHL in this large prospective study; although, education was positively related to the incidence of BCLL and B-NHL (in women) but inversely to incidence of DLBCL. Due to limited number of cases in sub-classes and the large number of comparisons, the possibility of chance findings can not be excluded. © 2009 Springer-Verlag.
Level of education and the risk of lymphoma in the European prospective investigation into cancer and nutrition / Hermann, S.; Rohrmann, S.; Linseisen, J.; Nieters, A.; Khan, A.; Gallo, V.; Overvad, K.; Tjønneland, A.; Raaschou-Nielsen, O.; Bergmann, M.M.; Boeing, H.; Becker, N.; Kaaks, R.; Bas Bueno-De-Mesquita, H.; May, A.M.; Vermeulen, R.C.H.; Bingham, S.; Khaw, K.-T.; Key, T.J.; Travis, R.C.; Trichopoulou, A.; Georgila, C.; Triantafylou, D.; Celentano, E.; Krogh, V.; Masala, G.; Tumino, R.; Agudo, A.; Altzibar, J.M.; Ardanaz, E.; Martínez-García, C.; Suárez, M.V.A.; Tormo, M.J.; Braaten, T.; Lund, E.; Manjer, J.; Zackrisson, S.; Hallmans, G.; Malmer, B.; Boffetta, P.; Brennan, P.; Slimani, N.; Vineis, P.; Riboli, E.. - In: JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY. - ISSN 0171-5216. - STAMPA. - 136:1(2010), pp. 71-77. [10.1007/s00432-009-0638-9]
Level of education and the risk of lymphoma in the European prospective investigation into cancer and nutrition
KHAN, KAFEEL AHMED;Boffetta, P.;Slimani, N.;
2010
Abstract
Introduction: Lymphomas belong to the few cancer sites with increasing incidence over past decades, and only a few risk factors have been established. We explored the association between education and the incidence of lymphoma in the prospective EPIC study. Materials and methods: Within 3,567,410 person-years of follow-up, 1,319 lymphoma cases [1,253 non-Hodgkin lymphomas (NHL) and 66 Hodgkin lymphomas (HL)] were identified. Cox proportional hazard regression was used to examine the association between highest educational level (primary school or less, technical/professional school, secondary school, university) and lymphoma risk. Results: Overall, no consistent associations between educational level and lymphoma risk were observed; however, associations were found for sub-groups of the cohort. We observed a higher risk of B-NHL (HR = 1.31, 95% CI = 1.02-1.68; n = 583) in women with the highest education level (university) but not in men. Concerning sub-classes of B-NHL, a positive association between education and risk of B cell chronic lymphatic leukaemia (BCLL) was observed only in women. In both genders, the risk of diffuse large B cell lymphoma (DLBCL) was significantly lower for subjects with university degree (HR = 0.46, 95% CI = 0.27-0.79) versus lowest educational level. No association was found for HL. Conclusion: We could not confirm an overall consistent association of education and risk of HL or NHL in this large prospective study; although, education was positively related to the incidence of BCLL and B-NHL (in women) but inversely to incidence of DLBCL. Due to limited number of cases in sub-classes and the large number of comparisons, the possibility of chance findings can not be excluded. © 2009 Springer-Verlag.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
