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Principal Investigator
Lindsay Morton
About this CDAS Project
PLCO (Learn more about this study)
Project ID
Initial CDAS Request Approval
Jul 1, 2006
Other Cancers - NHL and Tobacco/ Alcohol
Lymphoid malignancies represent a group of heterogeneous malignancies arising from lymphoid tissue throughout the body. Previous epidemiologic studies have suggested a relationship between cigarette smoking, alcohol consumption, body mass index (BMI) and non-Hodgkin lymphoma (NHL), which may vary by NHL subtype. However, the results from individual case-control studies of these hypotheses have been inconsistent, and few cohort studies have published results on these exposures. The investigators for this proposal recently completed an analysis of the potential roles of cigarette smoking and alcohol consumption in the etiology of NHL, using data from an international consortium of case-control studies (InterLymph). We pooled original data from nine case-control studies of NHL conducted in the United States, Europe, and Australia, resulting in a dataset with approximately 6500 cases and 8500 controls. Briefly, the pooled analysis showed increased risk estimates for follicular lymphoma, but not other NHL subtypes, associated with cigarette smoking, and significantly reduced NHL risk estimates associated with alcohol consumption, which did not depend on the type of alcoholic beverage consumed. The large sample size of this pooled analysis provided us with greater power than that of individual studies to explore the relationships between cigarette smoking, alcohol consumption, and NHL by NHL subtype. We have also recently completed an InterLymph pooled analysis of BMI and NHL risk, in which we found a suggestive increased risk for diffuse large B-cell lymphoma (DLBCL), but not other subtypes, associated with severe obesity. It is critical to confirm these findings using data from a prospective study design, due to the potential biases inherent in the case-control study design. Given the few published, prospectively-designed studies on the relationships of cigarette smoking, alcohol consumption, BMI to risk of all lymphoid neoplasms, we propose to analyze questionnaire data from the PLCO Trial to investigate whether these lifestyle factors are related lymphoid neoplasm risk. The PLCO study population is well-suited for this investigation because of its prospective nature, the identification of N~1400 confirmed cases of lymphoid neoplasms in the study population, and the baseline and supplementary questionnaire assessment of cigarette smoking, alcohol consumption, and BMI.

This proposal will investigate the following hypotheses: 1) Cigarette smoking increases risk for follicular lymphoma, but not other NHL subtypes; 2) Alcohol reduces risk for NHL; and 3) Obesity increases risk for DLBCL. We propose to analyze baseline and supplementary questionnaire data from the PLCO Trial. We plan to replicate the analyses conducted in our previous pooled analysis of case-control data, considering the intensity and duration of cigarette smoking, alcohol consumption, and BMI by lymphoid neoplasm subtype. The cost for this proposal will be minimal. We will identify scientists to collaborate in the design, data analysis, and interpretation of results from the Division of Cancer Prevention and from at least two PLCO Screening Centers who are also interested in the potential role of these lifestyle factors in the etiology of lymphoid neoplasms.


Patricia Hartge (National Cancer Institute)
Jesse Troy (George Washington University)

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