Exposure to ultraviolet radiation and risk of Hodgkin lymphoma:  a pooled analysis

A Monnereau; SL Glaser; CW Schupp; K Ekstrom Smedby; S de Sanjose; Eleanor Victoria Kane; M Melbye; L Foretva; M Maynadie; A Staines; N Becker; A Nieters; P Brennan; P Boffetta; P Cocco; I Glimelius; J Clavel; H Hjalgrim; ET Chang

doi:doi:10.1182/blood-2013-04-497586

Exposure to ultraviolet radiation and risk of Hodgkin lymphoma: a pooled analysis

A Monnereau, SL Glaser, CW Schupp, K Ekstrom Smedby, S de Sanjose, Eleanor Victoria Kane, M Melbye, L Foretva, M Maynadie, A Staines, N Becker, A Nieters, P Brennan, P Boffetta, P Cocco, I Glimelius, J Clavel, H Hjalgrim, ET Chang

Health Sciences

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

Abstract

Ultraviolet radiation (UVR) exposure has been inversely associated with Hodgkin lymphoma (HL) risk but inconsistently, in few studies, and without attention to HL heterogeneity. We conducted a pooled analysis of HL risk focusing on type and timing of UVR exposure, and on disease subtypes by age, histology, and tumor-cell Epstein-Barr virus (EBV) status. Four case-control studies contributed 1,320 HL cases and 6,381 controls. We estimated lifetime, adulthood, and childhood UVR exposure and history of sunburn and sunlamp use. We used two-stage estimation with mixed-effects models and weighted pooled effect estimates by inverse marginal variances. We observed statistically significant inverse associations with HL risk for UVR exposures during childhood and adulthood, sunburn history, and sunlamp use, but found no significant dose-response relationships. Risks were significant only for EBV-positive HL (pooled odds ratio = 0.56, 95% confidence interval = 0.35, 0.91 for the highest overall UVR exposure category), with a significant linear trend for overall exposure (p=0.03). Pooled relative risk estimates were not heterogeneous across studies. Increased UVR exposure may protect against HL, particularly EBV-positive HL. Plausible mechanisms involving UVR induction of regulatory T cells or the cellular DNA damage response suggest opportunities for new prevention targets.

Original language	English
Pages (from-to)	3492-3499
Journal	Blood
Volume	122
Issue number	20
Early online date	9 Sept 2013
DOIs	https://doi.org/doi:10.1182/blood-2013-04-497586
Publication status	Published - 14 Nov 2013

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doi:10.1182/blood-2013-04-497586

http://www.bloodjournal.org/content/122/20/3492?sso-checked=true

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Monnereau, A., Glaser, SL., Schupp, CW., Ekstrom Smedby, K., de Sanjose, S., Kane, E. V., Melbye, M., Foretva, L., Maynadie, M., Staines, A., Becker, N., Nieters, A., Brennan, P., Boffetta, P., Cocco, P., Glimelius, I., Clavel, J., Hjalgrim, H., & Chang, ET. (2013). Exposure to ultraviolet radiation and risk of Hodgkin lymphoma: a pooled analysis. Blood, 122(20), 3492-3499. https://doi.org/doi:10.1182/blood-2013-04-497586

@article{6dc1c124894a4a3b856e51ab27d08e53,

title = "Exposure to ultraviolet radiation and risk of Hodgkin lymphoma: a pooled analysis",

abstract = "Ultraviolet radiation (UVR) exposure has been inversely associated with Hodgkin lymphoma (HL) risk but inconsistently, in few studies, and without attention to HL heterogeneity. We conducted a pooled analysis of HL risk focusing on type and timing of UVR exposure, and on disease subtypes by age, histology, and tumor-cell Epstein-Barr virus (EBV) status. Four case-control studies contributed 1,320 HL cases and 6,381 controls. We estimated lifetime, adulthood, and childhood UVR exposure and history of sunburn and sunlamp use. We used two-stage estimation with mixed-effects models and weighted pooled effect estimates by inverse marginal variances. We observed statistically significant inverse associations with HL risk for UVR exposures during childhood and adulthood, sunburn history, and sunlamp use, but found no significant dose-response relationships. Risks were significant only for EBV-positive HL (pooled odds ratio = 0.56, 95% confidence interval = 0.35, 0.91 for the highest overall UVR exposure category), with a significant linear trend for overall exposure (p=0.03). Pooled relative risk estimates were not heterogeneous across studies. Increased UVR exposure may protect against HL, particularly EBV-positive HL. Plausible mechanisms involving UVR induction of regulatory T cells or the cellular DNA damage response suggest opportunities for new prevention targets. ",

author = "A Monnereau and SL Glaser and CW Schupp and {Ekstrom Smedby}, K and {de Sanjose}, S and Kane, {Eleanor Victoria} and M Melbye and L Foretva and M Maynadie and A Staines and N Becker and A Nieters and P Brennan and P Boffetta and P Cocco and I Glimelius and J Clavel and H Hjalgrim and ET Chang",

year = "2013",

month = nov,

day = "14",

doi = "doi:10.1182/blood-2013-04-497586",

language = "English",

volume = "122",

pages = "3492--3499",

journal = "Blood",

issn = "0006-4971",

publisher = "American Society of Hematology",

number = "20",

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Monnereau, A, Glaser, SL, Schupp, CW, Ekstrom Smedby, K, de Sanjose, S, Kane, EV, Melbye, M, Foretva, L, Maynadie, M, Staines, A, Becker, N, Nieters, A, Brennan, P, Boffetta, P, Cocco, P, Glimelius, I, Clavel, J, Hjalgrim, H & Chang, ET 2013, 'Exposure to ultraviolet radiation and risk of Hodgkin lymphoma: a pooled analysis', Blood, vol. 122, no. 20, pp. 3492-3499. https://doi.org/doi:10.1182/blood-2013-04-497586

TY - JOUR

T1 - Exposure to ultraviolet radiation and risk of Hodgkin lymphoma

T2 - a pooled analysis

AU - Monnereau, A

AU - Glaser, SL

AU - Schupp, CW

AU - Ekstrom Smedby, K

AU - de Sanjose, S

AU - Kane, Eleanor Victoria

AU - Melbye, M

AU - Foretva, L

AU - Maynadie, M

AU - Staines, A

AU - Becker, N

AU - Nieters, A

AU - Brennan, P

AU - Boffetta, P

AU - Cocco, P

AU - Glimelius, I

AU - Clavel, J

AU - Hjalgrim, H

AU - Chang, ET

PY - 2013/11/14

Y1 - 2013/11/14

N2 - Ultraviolet radiation (UVR) exposure has been inversely associated with Hodgkin lymphoma (HL) risk but inconsistently, in few studies, and without attention to HL heterogeneity. We conducted a pooled analysis of HL risk focusing on type and timing of UVR exposure, and on disease subtypes by age, histology, and tumor-cell Epstein-Barr virus (EBV) status. Four case-control studies contributed 1,320 HL cases and 6,381 controls. We estimated lifetime, adulthood, and childhood UVR exposure and history of sunburn and sunlamp use. We used two-stage estimation with mixed-effects models and weighted pooled effect estimates by inverse marginal variances. We observed statistically significant inverse associations with HL risk for UVR exposures during childhood and adulthood, sunburn history, and sunlamp use, but found no significant dose-response relationships. Risks were significant only for EBV-positive HL (pooled odds ratio = 0.56, 95% confidence interval = 0.35, 0.91 for the highest overall UVR exposure category), with a significant linear trend for overall exposure (p=0.03). Pooled relative risk estimates were not heterogeneous across studies. Increased UVR exposure may protect against HL, particularly EBV-positive HL. Plausible mechanisms involving UVR induction of regulatory T cells or the cellular DNA damage response suggest opportunities for new prevention targets.

AB - Ultraviolet radiation (UVR) exposure has been inversely associated with Hodgkin lymphoma (HL) risk but inconsistently, in few studies, and without attention to HL heterogeneity. We conducted a pooled analysis of HL risk focusing on type and timing of UVR exposure, and on disease subtypes by age, histology, and tumor-cell Epstein-Barr virus (EBV) status. Four case-control studies contributed 1,320 HL cases and 6,381 controls. We estimated lifetime, adulthood, and childhood UVR exposure and history of sunburn and sunlamp use. We used two-stage estimation with mixed-effects models and weighted pooled effect estimates by inverse marginal variances. We observed statistically significant inverse associations with HL risk for UVR exposures during childhood and adulthood, sunburn history, and sunlamp use, but found no significant dose-response relationships. Risks were significant only for EBV-positive HL (pooled odds ratio = 0.56, 95% confidence interval = 0.35, 0.91 for the highest overall UVR exposure category), with a significant linear trend for overall exposure (p=0.03). Pooled relative risk estimates were not heterogeneous across studies. Increased UVR exposure may protect against HL, particularly EBV-positive HL. Plausible mechanisms involving UVR induction of regulatory T cells or the cellular DNA damage response suggest opportunities for new prevention targets.

U2 - doi:10.1182/blood-2013-04-497586

DO - doi:10.1182/blood-2013-04-497586

M3 - Article

SN - 0006-4971

VL - 122

SP - 3492

EP - 3499

JO - Blood

JF - Blood

IS - 20

ER -