Cancer Causes & Control

, Volume 27, Issue 9, pp 1059–1066 | Cite as

Smoking is a risk factor for development of adult T-cell leukemia/lymphoma in Japanese human T-cell leukemia virus type-1 carriers

  • Hisayoshi Kondo
  • Midori Soda
  • Norie Sawada
  • Manami Inoue
  • Yoshitaka Imaizumi
  • Yasushi Miyazaki
  • Masako Iwanaga
  • Yasuhito Tanaka
  • Masashi Mizokami
  • Shoichiro Tsugane
Original paper


Background and purpose

Adult T-cell leukemia/lymphoma (ATLL) is an aggressive hematological malignancy caused by human T-cell leukemia virus type-1 (HTLV-1); no effective methods have yet been identified to prevent development of ATLL in carriers of HTLV-1. This study investigated the association between cigarette smoking and the risk of ATLL development among Japanese carriers of HTLV-1.


This study examined the association between smoking and development of ATLL in a cohort of 1,332 Japanese HTLV-1 carriers aged 40–69 years free of ATLL at baseline from two different HTLV-1-endemic areas of Japan. Cox proportional hazards models adjusted for sex, geographic area, age at baseline, and alcohol drinking were used to estimate the effect of cigarette smoking on ATLL development.


Between 1993 and 2012, 25 new ATLL cases were identified among these subjects. The overall crude incidence rate for ATLL was 1.08 per 1,000 person-years among HTLV-1 carriers and was higher among male carriers than among female carriers (2.21 vs. 0.74). The risk of ATLL development increased significantly with increasing numbers of cigarettes smoked per day (hazard ratio for every increment of 20 cigarettes, 2.03; 95 % confidence interval (CI) 1.13–3.66 overall, 2.07 (95 % CI 1.13–3.73) in male carriers).


Cigarette smoking may influence ATLL development among HTLV-1 carriers in Japan.


ATLL Cigarette smoking HTLV-1 Japanese 



The authors thank the staff of each JPHC study area and the central office for their painstaking efforts to conduct the baseline survey and follow-up. We are indebted to the Ibaraki, Niigata, Osaka, Kochi, Nagasaki, and Okinawa Cancer Registries for providing their incidence data. This study was supported by the National Cancer Center Research and Development Fund (23-A-31[toku] and 26-A-2) (since 2011) and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010).

Compliance with ethical standards

Conflict of interest

The authors of this paper declare that they have no conflict of interest.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Hisayoshi Kondo
    • 1
  • Midori Soda
    • 2
  • Norie Sawada
    • 3
  • Manami Inoue
    • 3
    • 4
  • Yoshitaka Imaizumi
    • 5
  • Yasushi Miyazaki
    • 6
  • Masako Iwanaga
    • 7
  • Yasuhito Tanaka
    • 8
  • Masashi Mizokami
    • 9
  • Shoichiro Tsugane
    • 3
  1. 1.Biostatistics Section, Division of Scientific Data Registry, Atomic Bomb Disease InstituteNagasaki UniversityNagasakiJapan
  2. 2.Department of EpidemiologyRadiation Effects Research FoundationNagasakiJapan
  3. 3.Epidemiology and Prevention Group, Research Center for Cancer Prevention and ScreeningNational Cancer CenterTokyoJapan
  4. 4.Graduate School of MedicineThe University of TokyoTokyoJapan
  5. 5.Department of HematologyNagasaki University HospitalNagasakiJapan
  6. 6.Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease InstituteNagasaki UniversityNagasakiJapan
  7. 7.Department of Frontier Life Science, Unit of Basic Sciences, Graduate School of Biomedical SciencesNagasaki UniversityNagasakiJapan
  8. 8.Department of Virology and Liver UnitNagoya City University Graduate School of Medical SciencesNagoyaJapan
  9. 9.The Research Center for Hepatitis and ImmunologyNational Center for Global Health and MedicineIchikawaJapan

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