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Anthropometrics, Physical Activity, Related Medical Conditions, and the Risk of Non-Hodgkin Lymphoma

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Abstract

Background: Recent reports suggest that obesity, or conditions associated with obesity, might be risk factors for non-Hodgkin lymphoma (NHL), a cancer with dramatically increasing incidence in western countries over the last several decades. Physical inactivity increases the risk of obesity and of type 2 diabetes, but there are few data on the association of physical activity with risk of NHL.

Methods: We evaluated these factors in a population-based case–control study conducted in Detroit, Iowa, Los Angeles, and Seattle from 1998 to 2000. Incident HIV-negative NHL cases aged 20–74 years were rapidly reported in each area (n = 1321). Controls were identified through random digit dialing and Medicare files, and were frequency matched to cases on sex, age, race, and study site (n = 1057). Risk factor data were collected by in-person interviews and self-administered questionnaires. Unconditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI), adjusted for age, sex, race and study center.

Results: High body mass index (OR = 1.73 for 35+ versus <25 kg/m2; 95% CI 1.15–2.59) and history of gallstones (OR = 1.95, 95% CI 1.11–3.40) were positively associated with diffuse NHL, but were not associated with follicular or all NHL combined. Height was positively associated with risk of all NHL combined (OR = 1.38 for >70 versus <65 inches; 95% CI 0.98–1.94), and positive associations were apparent for both diffuse and follicular NHL. Non-occupational physical activity was inversely associated with risk of all NHL combined (ORs with increasing level: 1, 0.75, 0.71, 0.55, 0.68; p-trend = 0.04) and for diffuse and follicular NHL. We observed no association of total energy intake, type 2 diabetes, or hypertension with risk of NHL. In a multivariable model to predict risk of diffuse NHL, BMI (OR = 2.15 for 35+ versus <25 kg/m2; 95% CI 1.09–4.25) and height (OR = 1.63 for 71+ versus <65 inches; 95% CI 0.75–3.57) were positively associated with risk while physical activity was weakly and inversely associated risk (ORs with increasing level: 1, 0.76, 0.72, 0.78, 0.82; p-trend = 0.9).

Conclusion: BMI and history of gallstones were positively associated with risk of diffuse NHL, supporting a role for obesity in this NHL subtype. Height was positively associated with NHL risk across subtypes, and suggests a role for early life nutrition in NHL risk. Non-occupational physical activity was only weakly and inversely associated with NHL risk after adjustment for obesity, height and alcohol use.

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Authors and Affiliations

  1. Mayo Clinic College of Medicine, Rochester, MN, USA

    James R. Cerhan

  2. The University of Iowa, Iowa City, IA, USA

    James R. Cerhan

  3. University of Southern California, Los Angeles, CA, USA

    Leslie Bernstein

  4. Karmanos Cancer Institute, Detroit, MI, USA

    Richard K Severson

  5. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Scott Davis

  6. National Cancer Institute, Bethesda, MD, USA

    Joanne S. Colt, Aaron Blair & Patricia Hartge

  7. Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    James R. Cerhan

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  1. James R. Cerhan
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Correspondence to James R. Cerhan.

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Cerhan, J.R., Bernstein, L., Severson, R.K. et al. Anthropometrics, Physical Activity, Related Medical Conditions, and the Risk of Non-Hodgkin Lymphoma. Cancer Causes Control 16, 1203–1214 (2005). https://doi.org/10.1007/s10552-005-0358-7

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