Cigarette smoking and risk of Hodgkin lymphoma and its subtypes: a pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph)

M Kamper-Jorgensen; K Rostgaard; S.L.  Glaser; S H  Zahm; W Cozen; K E  Smedby; S  Sanjose; E T  Chang; T  Zheng; C LaVecchia; D Serraino; A Monnereau; Eleanor Victoria Kane; L Miligi; P Vineis; J J  Spinelli; J R  McLaughlin; P Pahwa; J A Dosman; M Vornanen; L Foretova; M Maynadie; A Staines; N  Becker; A Nieters; P Brennan; P Boffetta; P Cocco; H Hjalgrim

doi:10.1093/annonc/mdt218

Cigarette smoking and risk of Hodgkin lymphoma and its subtypes: a pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph)

M Kamper-Jorgensen, K Rostgaard, S.L. Glaser, S H Zahm, W Cozen, K E Smedby, S Sanjose, E T Chang, T Zheng, C LaVecchia, D Serraino, A Monnereau, Eleanor Victoria Kane, L Miligi, P Vineis, J J Spinelli, J R McLaughlin, P Pahwa, J A Dosman, M VornanenL Foretova, M Maynadie, A Staines, N Becker, A Nieters, P Brennan, P Boffetta, P Cocco, H Hjalgrim

Health Sciences

Research output: Contribution to journal › Literature review › peer-review

Abstract

Background: The etiology of Hodgkin lymphoma (HL) remains incompletely characterized. Studies of the association between smoking and HL have yielded ambiguous results, possibly due to differences between HL subtypes.
Patients and methods: Through the InterLymph Consortium, 12 case–control studies regarding cigarette smoking and HL were identified. Pooled analyses on the association between smoking and HL stratified by tumor histology and
Epstein–Barr virus (EBV) status were conducted using random effects models adjusted for confounders. Analyses included 3335 HL cases and 14 278 controls.
Results: Overall, 54.5% of cases and 57.4% of controls were ever cigarette smokers. Compared with never smokers, ever smokers had an odds ratio (OR) of HL of 1.10 [95% confidence interval (CI) 1.01–1.21]. This increased risk reflected
associations with mixed cellularity cHL (OR = 1.60, 95% CI 1.29–1.99) and EBV-positive cHL (OR = 1.81, 95% CI 1.27–2.56) among current smokers, whereas risk of nodular sclerosis (OR = 1.09, 95% CI 0.90–1.32) and EBV-negative HL
(OR = 1.02, 95% CI 0.72–1.44) was not increased.
Conclusion: These results support the notion of etiologic heterogeneity between HL subtypes, highlighting the need for HL stratification in future studies. Even if not relevant to all subtypes, our study emphasizes that cigarette smoking should
be added to the few modifiable HL risk factors identified.
Key words: Hodgkin lymphoma, case–control, cigarette smoking, epidemiology, Epstein–Barr virus, individual patient data meta-analysis

Original language	English
Article number	mdt218
Pages (from-to)	2245-2255
Journal	Annals of oncology
Volume	24
Issue number	9
DOIs	https://doi.org/10.1093/annonc/mdt218
Publication status	Published - 19 Jun 2013

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10.1093/annonc/mdt218

http://annonc.oxfordjournals.org/content/24/9/2245

Cite this

Kamper-Jorgensen, M., Rostgaard, K., Glaser, S. L., Zahm, S. H., Cozen, W., Smedby, K. E., Sanjose, S., Chang, E. T., Zheng, T., LaVecchia, C., Serraino, D., Monnereau, A., Kane, E. V., Miligi, L., Vineis, P., Spinelli, J. J., McLaughlin, J. R., Pahwa, P., Dosman, J. A., ... Hjalgrim, H. (2013). Cigarette smoking and risk of Hodgkin lymphoma and its subtypes: a pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph). Annals of oncology, 24(9), 2245-2255. Article mdt218. https://doi.org/10.1093/annonc/mdt218

@article{a857f3e12aa64a4da9e3811218878b61,

title = "Cigarette smoking and risk of Hodgkin lymphoma and its subtypes: a pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph)",

abstract = "Background: The etiology of Hodgkin lymphoma (HL) remains incompletely characterized. Studies of the association between smoking and HL have yielded ambiguous results, possibly due to differences between HL subtypes.Patients and methods: Through the InterLymph Consortium, 12 case–control studies regarding cigarette smoking and HL were identified. Pooled analyses on the association between smoking and HL stratified by tumor histology andEpstein–Barr virus (EBV) status were conducted using random effects models adjusted for confounders. Analyses included 3335 HL cases and 14 278 controls.Results: Overall, 54.5% of cases and 57.4% of controls were ever cigarette smokers. Compared with never smokers, ever smokers had an odds ratio (OR) of HL of 1.10 [95% confidence interval (CI) 1.01–1.21]. This increased risk reflectedassociations with mixed cellularity cHL (OR = 1.60, 95% CI 1.29–1.99) and EBV-positive cHL (OR = 1.81, 95% CI 1.27–2.56) among current smokers, whereas risk of nodular sclerosis (OR = 1.09, 95% CI 0.90–1.32) and EBV-negative HL(OR = 1.02, 95% CI 0.72–1.44) was not increased.Conclusion: These results support the notion of etiologic heterogeneity between HL subtypes, highlighting the need for HL stratification in future studies. Even if not relevant to all subtypes, our study emphasizes that cigarette smoking shouldbe added to the few modifiable HL risk factors identified.Key words: Hodgkin lymphoma, case–control, cigarette smoking, epidemiology, Epstein–Barr virus, individual patient data meta-analysis",

author = "M Kamper-Jorgensen and K Rostgaard and S.L. Glaser and Zahm, {S H} and W Cozen and Smedby, {K E} and S Sanjose and Chang, {E T} and T Zheng and C LaVecchia and D Serraino and A Monnereau and Kane, {Eleanor Victoria} and L Miligi and P Vineis and Spinelli, {J J} and McLaughlin, {J R} and P Pahwa and Dosman, {J A} and M Vornanen and L Foretova and M Maynadie and A Staines and N Becker and A Nieters and P Brennan and P Boffetta and P Cocco and H Hjalgrim",

year = "2013",

month = jun,

day = "19",

doi = "10.1093/annonc/mdt218",

language = "English",

volume = "24",

pages = "2245--2255",

journal = "Annals of oncology",

issn = "0923-7534",

publisher = "Elsevier Ltd.",

number = "9",

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Kamper-Jorgensen, M, Rostgaard, K, Glaser, SL, Zahm, SH, Cozen, W, Smedby, KE, Sanjose, S, Chang, ET, Zheng, T, LaVecchia, C, Serraino, D, Monnereau, A, Kane, EV, Miligi, L, Vineis, P, Spinelli, JJ, McLaughlin, JR, Pahwa, P, Dosman, JA, Vornanen, M, Foretova, L, Maynadie, M, Staines, A, Becker, N, Nieters, A, Brennan, P, Boffetta, P, Cocco, P & Hjalgrim, H 2013, 'Cigarette smoking and risk of Hodgkin lymphoma and its subtypes: a pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph)', Annals of oncology, vol. 24, no. 9, mdt218, pp. 2245-2255. https://doi.org/10.1093/annonc/mdt218

TY - JOUR

T1 - Cigarette smoking and risk of Hodgkin lymphoma and its subtypes

T2 - a pooled analysis from the International Lymphoma Epidemiology Consortium (InterLymph)

AU - Kamper-Jorgensen, M

AU - Rostgaard, K

AU - Glaser, S.L.

AU - Zahm, S H

AU - Cozen, W

AU - Smedby, K E

AU - Sanjose, S

AU - Chang, E T

AU - Zheng, T

AU - LaVecchia, C

AU - Serraino, D

AU - Monnereau, A

AU - Kane, Eleanor Victoria

AU - Miligi, L

AU - Vineis, P

AU - Spinelli, J J

AU - McLaughlin, J R

AU - Pahwa, P

AU - Dosman, J A

AU - Vornanen, M

AU - Foretova, L

AU - Maynadie, M

AU - Staines, A

AU - Becker, N

AU - Nieters, A

AU - Brennan, P

AU - Boffetta, P

AU - Cocco, P

AU - Hjalgrim, H

PY - 2013/6/19

Y1 - 2013/6/19

N2 - Background: The etiology of Hodgkin lymphoma (HL) remains incompletely characterized. Studies of the association between smoking and HL have yielded ambiguous results, possibly due to differences between HL subtypes.Patients and methods: Through the InterLymph Consortium, 12 case–control studies regarding cigarette smoking and HL were identified. Pooled analyses on the association between smoking and HL stratified by tumor histology andEpstein–Barr virus (EBV) status were conducted using random effects models adjusted for confounders. Analyses included 3335 HL cases and 14 278 controls.Results: Overall, 54.5% of cases and 57.4% of controls were ever cigarette smokers. Compared with never smokers, ever smokers had an odds ratio (OR) of HL of 1.10 [95% confidence interval (CI) 1.01–1.21]. This increased risk reflectedassociations with mixed cellularity cHL (OR = 1.60, 95% CI 1.29–1.99) and EBV-positive cHL (OR = 1.81, 95% CI 1.27–2.56) among current smokers, whereas risk of nodular sclerosis (OR = 1.09, 95% CI 0.90–1.32) and EBV-negative HL(OR = 1.02, 95% CI 0.72–1.44) was not increased.Conclusion: These results support the notion of etiologic heterogeneity between HL subtypes, highlighting the need for HL stratification in future studies. Even if not relevant to all subtypes, our study emphasizes that cigarette smoking shouldbe added to the few modifiable HL risk factors identified.Key words: Hodgkin lymphoma, case–control, cigarette smoking, epidemiology, Epstein–Barr virus, individual patient data meta-analysis

AB - Background: The etiology of Hodgkin lymphoma (HL) remains incompletely characterized. Studies of the association between smoking and HL have yielded ambiguous results, possibly due to differences between HL subtypes.Patients and methods: Through the InterLymph Consortium, 12 case–control studies regarding cigarette smoking and HL were identified. Pooled analyses on the association between smoking and HL stratified by tumor histology andEpstein–Barr virus (EBV) status were conducted using random effects models adjusted for confounders. Analyses included 3335 HL cases and 14 278 controls.Results: Overall, 54.5% of cases and 57.4% of controls were ever cigarette smokers. Compared with never smokers, ever smokers had an odds ratio (OR) of HL of 1.10 [95% confidence interval (CI) 1.01–1.21]. This increased risk reflectedassociations with mixed cellularity cHL (OR = 1.60, 95% CI 1.29–1.99) and EBV-positive cHL (OR = 1.81, 95% CI 1.27–2.56) among current smokers, whereas risk of nodular sclerosis (OR = 1.09, 95% CI 0.90–1.32) and EBV-negative HL(OR = 1.02, 95% CI 0.72–1.44) was not increased.Conclusion: These results support the notion of etiologic heterogeneity between HL subtypes, highlighting the need for HL stratification in future studies. Even if not relevant to all subtypes, our study emphasizes that cigarette smoking shouldbe added to the few modifiable HL risk factors identified.Key words: Hodgkin lymphoma, case–control, cigarette smoking, epidemiology, Epstein–Barr virus, individual patient data meta-analysis

U2 - 10.1093/annonc/mdt218

DO - 10.1093/annonc/mdt218

M3 - Literature review

SN - 0923-7534

VL - 24

SP - 2245

EP - 2255

JO - Annals of oncology

JF - Annals of oncology

IS - 9

M1 - mdt218

ER -