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Reproductive factors and lymphoid neoplasms in Europe: findings from the EpiLymph case–control study

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Abstract

Background

The study of lymphomagenesis has rarely focused on hormonal factors. Higher incidence rates are observed for many lymphoma subtypes in men compared with women suggesting an underlying association. Our goal was to investigate the association between reproductive factors and lymphomas.

Methods

The Epilymph study is a multicenter case–control study carried out in six European countries from 1998 to 2004. Female cases of mature T-cell neoplasms (n = 52), Hodgkin lymphoma (n = 147), and mature B-cell neoplasms (n = 795), including its common subtypes, and their respective controls (n = 1,141) frequency matched by age, gender, and center were considered.

Results

An odds reduction of 29% (95% CI −46 to −6%) was observed for mature T-cell neoplasms for each child increase among parous women and of 13% (95% CI −19 to −7%) for mature B-cell neoplasms; while no association was observed for Hodgkin lymphoma. By B-cell neoplasm subtypes, these associations were found for chronic lymphocytic leukemia/small lymphocytic lymphoma (−21%, 95% CI −31 to −9%) and diffuse large B-cell lymphoma (DLBCL; −14%; 95% CI −23 to −3%). Overall, no associations were observed with age at first and last pregnancy, and ever use of hormonal contraceptives and lymphoma. Higher odds ratios for a short-term use of hormonal contraceptives (<5 years), but not for a long-term use, were observed for mature B-cell neoplasms, DLBCL, and follicular lymphoma compared with never use.

Conclusion

These data support the hypothesis that increased parity confers a protective effect against lymphoma. Less clearly, our results also indicate that hormonal contraceptives could play a role.

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Abbreviations

OR:

Odds ratio

CI:

Confidence interval

NHL:

Non-Hodgkin lymphoma

CLL/SLL:

Chronic lymphocytic leukemia/small lymphocytic lymphoma

DLBCL:

Diffuse large B-cell lymphoma

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Acknowledgments

The authors thank Maria Brotons and Claudia Robles for their manuscript review, Laia Alemany, Laia Bruni and the reviewers of the manuscript for their helpful comments, Brigitte Tretare and Nicole Raverdy for their help in the recruitment and all those who took part in this study providing questionnaire data. This Epilymph work is partially supported by public grants from the European Commission 5th Framework Program (grant reference: QLK4-CT-2000-00422); from the European Commission 6th Framework Program (grant reference: FOOD-CT-2006-023103); from the Instituto de Salud Carlos III (Spanish Government) (grant references: FIS PI081555, RCESP C03/09, RTICESP C03/10, RTIC RD06/0020/0095 and CIBERESP); from the Marató de TV3 Foundation (grant reference: 051210); from the International Agency for Research on Cancer (IARC) (grant reference:5111); from the Fondation de France (grant references: 1999 008471; EpiLymph-France); from the Compagnia di San Paolo di Torino, Programma Oncologia 2001 (grant reference: EpiLymph-Italy); from the Italian Ministry of Education, University and Research (grant references: PRIN 2007, 2007WEJLZB); and from the German Federal Office for Radiation Protection (grant references: StSch4261 and StSch4420; EpiLymp-Germany).

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Authors and Affiliations

  1. Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Català d’ Oncologia, IDIBELL, Av. Gran Via de l’Hospitalet 199-203, 08908, L’ Hospitalet de Llobregat, Barcelona, Spain

    Laura Costas, Delphine Casabonne, Yolanda Benavente & Silvia de Sanjosé

  2. CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    Delphine Casabonne, Yolanda Benavente & Silvia de Sanjosé

  3. Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany

    Nikolaus Becker

  4. Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA

    Paolo Boffetta

  5. International Prevention Research Institute, Lyon, France

    Paolo Boffetta

  6. IARC, International Agency for Research on Cancer, Lyon, France

    Paul Brennan

  7. Department of Public Health, Occupational Health Section, University of Cagliari, Cagliari, Italy

    Pierluigi Cocco

  8. Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic

    Lenka Foretova

  9. Biological Hematology Unit; CRB Ferdinand Cabanne, Universitary Hospital of Dijon and EA4184, University of Burgundy, Dijon, France

    Marc Maynadié

  10. Public Health University College, Dublin, Ireland

    Anthony Staines

  11. Department of Health Sciences, Epidemiology and Genetics Unit, University of York, York, UK

    Eleanor Kane

  12. Centre of Chronic Immunodeficiency, Molecular Epidemiology, University Medical Center Freiburg, Freiburg, Germany

    Alexandra Nieters

Authors
  1. Laura Costas
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  2. Delphine Casabonne
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  7. Pierluigi Cocco
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  8. Lenka Foretova
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  12. Alexandra Nieters
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  13. Silvia de Sanjosé
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Corresponding author

Correspondence to Laura Costas.

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Costas, L., Casabonne, D., Benavente, Y. et al. Reproductive factors and lymphoid neoplasms in Europe: findings from the EpiLymph case–control study. Cancer Causes Control 23, 195–206 (2012). https://doi.org/10.1007/s10552-011-9869-6

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  • DOI: https://doi.org/10.1007/s10552-011-9869-6

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