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Time spent in the sun and the risk of developing non-Hodgkin lymphoma: a Canadian cohort study

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Abstract

Purpose

The objective was to explore the relationship of sun behavior patterns with the risk of developing non-Hodgkin lymphoma (NHL).

Methods

Sun behavior information from Alberta’s Tomorrow Project, CARTaGENE, and Ontario Health Study were utilized. The relationship between time in the sun during summer months and risk of NHL was assessed using Cox proportional hazard models with age as the time scale and adjustment for confounders. Cohorts were analyzed separately and hazard ratios (HR) pooled with random effects meta-analysis. Joint effects of time in the sun and use of sun protection were examined. Patterns of exposure were explored via combinations of weekday and weekend time in the sun.

Results

During an average follow-up of 7.6 years, 205 NHL cases occurred among study participants (n = 79,803). Compared to < 30 min daily in the sun, we observed HRs of 0.84 (95% CI 0.55–1.28) for 30–59 min, 0.63 (95% CI 0.40–0.98) for 1–2 h, and 0.91 (95% CI 0.61–1.36) for > 2 h. There was suggestive evidence that > 2 h was protective against NHL with use of sun protection, but not without it. Compared to < 30 min daily, moderate exposure (30 min to 2 h on weekdays or weekend) was associated with a lower risk of NHL (HR 0.63, 95% CI 0.43–0.92), while intermittent (< 30 min on weekdays and > 2 h on weekends) and chronic (> 2 h daily) were not.

Conclusion

This study provides evidence of a protective effect of moderate time spent in the sun on NHL risk.

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Data availability

The data that support the findings of this study are available from Alberta’s Tomorrow Project, CARTaGENE, Ontario Health Study, and Cancer Care Ontario but restrictions apply to the availability of these data, which were used under license for the current study and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of Alberta’s Tomorrow Project, CARTaGENE, Ontario Health Study, and Cancer Care Ontario.

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Acknowledgements

Alberta’s Tomorrow Project is only possible because of the commitment of its research participants, its staff, and its funders: Alberta Health, Alberta Cancer Foundation, Canadian Partnership Against Cancer and Health Canada, and substantial in kind funding from Alberta Health Services. Cancer registry data were obtained through linkage with Surveillance & Reporting, Cancer Research & Analytics, Cancer Care Alberta. The views expressed herein represent the views of the author(s) and not of Alberta’s Tomorrow Project or any of its funders. The data used for this research were made available by the OHS with the financial support from the Canadian Partnership Against Cancer and Health Canada and the Ontario Institute for Cancer Research. The views expressed herein represent the views of the Authors and do not necessarily represent the views of Health Canada or the Government of Ontario. We thank the participants in the Ontario Health Study (OHS). Parts of this material are based on data and information provided by Ontario Health (Cancer Care Ontario) and include data received by Ontario Health (Cancer Care Ontario) from the Canadian Institute for Health Information (CIHI). The opinions, reviews, view, and conclusions reported in this publication are those of the authors and do not necessarily reflect those of Ontario Health (Cancer Care Ontario) or CIHI. No endorsement by Ontario Health (Cancer Care Ontario) or CIHI is intended or should be inferred. Finally, this research has also been conducted using data and information provided by CARTaGENE (https://cartagene.qc.ca/en). However, the analysis, conclusions, opinions, and statements expressed herein are those of the authors and not necessarily those of CARTaGENE.

Funding

This research is supported by a Canadian Institutes of Health Research Operating Grant: Secondary Data Analysis for Cancer Prevention and Control (#396856).

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Authors

Contributions

DEO contributed to conceptualization; formal analysis; funding acquisition; methodology; and writing of the original draft. TWRH contributed to formal analysis; methodology; and writing, reviewing, and editing of the manuscript. DRB contributed to conceptualization; funding acquisition; methodology; and writing, reviewing, and editing of the manuscript. CEP contributed to conceptualization; funding acquisition; methodology; and writing, reviewing, and editing of the manuscript. WDK contributed to conceptualization; funding acquisition; methodology; supervision; and writing, reviewing, and editing of the manuscript.

Corresponding author

Correspondence to Dylan E. O’Sullivan.

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Competing interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical approval

This study was approved by the Queen’s University Health Sciences & Affiliated Teaching Hospitals Research Ethics Board (HSREB).

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Informed consent was obtained from all individual participants included in Alberta’s Tomorrow Project, CARTaGENE, and the Ontario Health Study.

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The authors affirm that human research participants of Alberta’s Tomorrow Project, CARTaGENE, and the Ontario Health Study provided informed consent for publication.

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O’Sullivan, D.E., Hillier, T.W.R., Brenner, D.R. et al. Time spent in the sun and the risk of developing non-Hodgkin lymphoma: a Canadian cohort study. Cancer Causes Control 34, 791–799 (2023). https://doi.org/10.1007/s10552-023-01719-6

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