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Risk of non-Hodgkin lymphoma and nitrate and nitrite from the diet in Connecticut women

Cancer Causes & Control volume 21, pages 889–896 (2010)Cite this article

Abstract

It has been estimated that 65,980 individuals were diagnosed with non-Hodgkin lymphoma (NHL) and 19,500 died from NHL in the United States in 2009. Although established risk factors such as immunodeficiency and viral infections may be responsible for a portion of the cases, the majority of NHL cases remain unexplained. Dietary nitrate and nitrite intake are exposures of particular interest for NHL risk as they are precursors in the endogenous formation of N-nitroso compounds, which cause lymphomas in animal studies. We investigated NHL risk overall and by histologic type in relation to dietary nitrate and nitrite intake in a population-based case–control study of 1,304 women in Connecticut. Nitrate and nitrite intake were assessed using a 120-item food frequency questionnaire. We found no association between risk of NHL overall and dietary nitrate and a slightly increased risk of NHL with higher dietary nitrite intake (highest vs. lowest intake quartile OR = 1.4; 95% CI: 0.9–2.2). When we evaluated intake by subtype, a significant positive trend was observed for follicular lymphoma and nitrate (p-trend = 0.04) and nitrite (p-trend < 0.01) with an over twofold risk in the highest nitrite intake quartile (OR = 2.3; 95% CI: 1.1–4.9). An increased risk in the highest quartile of nitrite intake was also observed for T-cell lymphoma (OR = 3.4; 95% CI: 1.0–11.9). Animal products containing nitrite were more strongly associated with risk of follicular lymphoma; whereas, both animal and plant sources of nitrite were associated with elevated ORs for T-cell lymphoma. Our results confirm a previous finding for nitrite intake and NHL risk and highlight the importance of evaluating histologic type. We conclude that these results should be replicated in a larger study with data on drinking water as well as dietary sources of nitrate intake.

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References

  1. Grulich AE, Vajdic CM (2005) The epidemiology of non-Hodgkin lymphoma. Pathology 37(6):409–419

    Article  PubMed  Google Scholar 

  2. Groves FD et al (2000) Cancer surveillance series: non-Hodgkin’s lymphoma incidence by histologic subtype in the United States from 1978 through 1995. J Natl Cancer Inst 92(15):1240–1251

    Article  CAS  PubMed  Google Scholar 

  3. The Non-Hodgkin’s Lymphoma Classification P (1997) A clinical evaluation of the International Lymphoma Study Group Classification of non-Hodgkin’s lymphoma, pp 3909–3918

  4. American Cancer Society (2009) Cancer facts and figures 2009. Atlanta, GA

  5. Gangolli SD et al (1994) Nitrate, nitrite and N-nitroso compounds. Eur J Pharmacol 292(1):1–38

    CAS  PubMed  Google Scholar 

  6. Bogovski P, Bogovski S (1981) Animal species in which N-nitroso compounds induce cancer. Int J Cancer 27:471–474

    Article  CAS  PubMed  Google Scholar 

  7. Lück E (1985) [Chemical preservation of food]. Zentralblatt für Bakteriologie, Mikrobiologie und Hygiene. 1. Abt. Originale B, Hygiene 180(2–3):311–318

  8. McKnight GM et al (1999) Dietary nitrate in man: friend or foe? Br J Nutr 81(5):349–358

    Article  CAS  PubMed  Google Scholar 

  9. Forman D (1989) Are nitrates a significant risk factor in human cancer? Cancer Surv 8(2):443–458

    CAS  PubMed  Google Scholar 

  10. Fraser P et al (1980) Nitrate and human cancer: a review of the evidence. Int J Epidemiol 9(1):3–11

    Article  CAS  PubMed  Google Scholar 

  11. Hansson LE et al (1994) Nutrients and gastric cancer risk. a population-based case–control study in Sweden. Int J Cancer 57(5):638–644

    Article  CAS  PubMed  Google Scholar 

  12. van Loon AJ et al (1997) Nitrate intake and gastric cancer risk: results from the Netherlands cohort study. Cancer Lett 114(1–2):259–261

    PubMed  Google Scholar 

  13. Weyer PJ et al (2001) Municipal drinking water nitrate level and cancer risk in older women: the Iowa Women’s Health Study. Epidemiology 12(3):327–338

    Article  CAS  PubMed  Google Scholar 

  14. Ward MH et al (2006) Risk of non-Hodgkin lymphoma and nitrate and nitrite from drinking water and diet. Epidemiology 17(4):375–382

    Article  PubMed  Google Scholar 

  15. Ward MH et al (1996) Drinking water nitrate and the risk of non-Hodgkin’s lymphoma. Epidemiology 7(5):465–471

    Article  CAS  PubMed  Google Scholar 

  16. Chiu BC, Dave BJ, Ward MH, Fought AJ, Hou L, Jain S, Gapstur S, Evens AM, Zahm SH, Blair A, Weisenburger DD (2008) Dietary factors and risk of t(14;18)-defined subgroups of non-Hodgkin lymphoma. Cancer Causes Control 19(8):859–867 [Epub 2008 Apr 2]

    Article  PubMed  Google Scholar 

  17. Zheng T et al (2004) Diet and nutrient intakes and risk of non-Hodgkin’s lymphoma in Connecticut women. Am J Epidemiol 159(5):454–466

    Article  PubMed  Google Scholar 

  18. Morton LM et al (2003) Cigarette smoking and risk of non-Hodgkin lymphoma subtypes among women. Br J Cancer 89(11):2087–2092

    Article  CAS  PubMed  Google Scholar 

  19. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma (1997) The non-Hodgkin’s Lymphoma Classification Project. Blood 89(11):3909–3918

    Google Scholar 

  20. Harris NL et al (1999) World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol 17(12):3835–3849

    CAS  PubMed  Google Scholar 

  21. Willett W, Lenart E (1998) Reproducibility and validity of food-frequency questionnaires, in nutritional epidemiology. Oxford University Press, New York, NY

    Google Scholar 

  22. Ward MH, Zahm SH, Weisenburger DD et al (1994) Dietary factors and non-Hodgkin’s lymphoma in Nebraska (United States). Cancer Causes Control 5:422–432

    Article  CAS  PubMed  Google Scholar 

  23. Ward MH, Cantor KP, Riley D et al (2003) Nitrate in public water supplies and risk of bladder cancer. Epidemiology 14:183–190

    Article  PubMed  Google Scholar 

  24. University of Minnesota Nutrition Coordinating Center NSDR (2007) Minneapolis’ MN: University of Minnesota Nutrition Coordinating Center. (http://wwwncc.umn.edu/products/nsrd.html)

  25. Mirvish S (1986) Effects of vitamins C and E on N-nitroso compound formation, carcinogenesis, and cancer. Cancer 58:1842–1850

    Article  CAS  PubMed  Google Scholar 

  26. Frankenfeld CL, Cerhan JR, Cozen W, Davis S, Schenk M, Morton LM, Hartge P, Ward MH (2008) Dietary flavonoid intake and non-Hodgkin lymphoma risk. Am J Clin Nutr 87(5):1439–1445

    CAS  PubMed  Google Scholar 

  27. Cutler GJ, Nettleton JA, Ross JA, Harnack LJ, Jacobs DR Jr, Scrafford CG, Barraj LM, Mink PJ, Robien K (2008) Dietary flavonoid intake and risk of cancer in postmenopausal women: the Iowa Women’s Health Study. Int J Cancer 123(3):664–671

    Article  CAS  PubMed  Google Scholar 

  28. Boeing H (1991) Epidemiological research in stomach cancer: progress over the last 10 years. J Cancer Res Clin Oncol 117:133–143

    Article  CAS  PubMed  Google Scholar 

  29. Forman D (1987) Dietary exposure to N-nitroso compounds and the risk of human cancer. Cancer Surv 6:719–738

    CAS  PubMed  Google Scholar 

  30. Ward MH, Cantor KP, Riley D et al (2003) Nitrate in public water supplies and risk of bladder cancer. Epidemiology 14:183–190

    Article  PubMed  Google Scholar 

  31. Chilvers C, Inskip H, Caygill C et al (1984) A survey of dietary nitrate in well-water users. Int J Epidemiol 13:324–331

    Article  CAS  PubMed  Google Scholar 

  32. Nolan BT, Hitt KJ (2006) Vulnerability of shallow groundwater and drinking-water wells to nitrate in the United States. Environ Sci Technol 40:7834–7840

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by grant CA62006 from the National Cancer Institute (NCI), the Intramural Research Program of the NCI, National Institutes of Health (NIH) and Fogarty training grant 1D43TW008323-01 from the NIH. This publication was made possible by CTSA Grant number UL1 RR024139 from the National Center for Research Resources (NCRR), a component of the NIH, and NHL roadmap for medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR.

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Affiliations

  1. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, EPS, Room 8111, 6120 Executive Boulevard, Rockville, MD, 20852-7244, USA

    Briseis A. Kilfoy & Mary H. Ward

  2. Yale School of Public Health, Yale University, New Haven, CT, USA

    Tongzhang Zheng, Theodore R. Holford, Brian Leaderer & Yawei Zhang

  3. International Prevention Research Institute, Lyon, France

    Peter Boyle

  4. Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, P.R. China

    Ping Zhao & Min Dai

Authors
  1. Briseis A. Kilfoy
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  2. Mary H. Ward
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  3. Tongzhang Zheng
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  4. Theodore R. Holford
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  5. Peter Boyle
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  6. Ping Zhao
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  7. Min Dai
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  8. Brian Leaderer
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  9. Yawei Zhang
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Correspondence to Briseis A. Kilfoy.

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Kilfoy, B.A., Ward, M.H., Zheng, T. et al. Risk of non-Hodgkin lymphoma and nitrate and nitrite from the diet in Connecticut women. Cancer Causes Control 21, 889–896 (2010). https://doi.org/10.1007/s10552-010-9517-6

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  • DOI: https://doi.org/10.1007/s10552-010-9517-6

Keywords

  • Non-Hodgkin lymphoma
  • Nitrate and nitrite
  • Diet