Level of education and the risk of lymphoma in the European prospective investigation into cancer and nutrition

Hermann, S; Rohrmann, S; Linseisen, J; Nieters, A; Khan, A; Gallo, V; Overvad, K; Tjønneland, A; Raaschou-Nielsen, O; Bergmann, MM; Boeing, H; Becker, N; Kaaks, R; Bueno-de-Mesquita, HB; May, AM; Vermeulen, RC; Bingham, S; Khaw, KT; Key, TJ; Travis, RC; Trichopoulou, A; Georgila, C; Triantafylou, D; Celentano, E; Krogh, V; Masala, G; Tumino, R; Agudo, A; Altzibar, JM; Ardanaz, E; Martínez-García, C; Suárez, MV; Tormo, MJ; Braaten, T; Lund, E; Manjer, J; Zackrisson, S; Hallmans, G; Malmer, B; Boffetta, P; Brennan, P; Slimani, N; Vineis, P; Riboli, E; (2010) Level of education and the risk of lymphoma in the European prospective investigation into cancer and nutrition. Journal of cancer research and clinical oncology, 136 (1). pp. 71-7. ISSN 0171-5216 DOI: https://doi.org/10.1007/s00432-009-0638-9

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INTRODUCTION: Lymphomas belong to the few cancer sites with increasing incidence over past decades, and only a few risk factors have been established. We explored the association between education and the incidence of lymphoma in the prospective EPIC study.<br/> MATERIALS AND METHODS: Within 3,567,410 person-years of follow-up, 1,319 lymphoma cases [1,253 non-Hodgkin lymphomas (NHL) and 66 Hodgkin lymphomas (HL)] were identified. Cox proportional hazard regression was used to examine the association between highest educational level (primary school or less, technical/professional school, secondary school, university) and lymphoma risk.<br/> RESULTS: Overall, no consistent associations between educational level and lymphoma risk were observed; however, associations were found for sub-groups of the cohort. We observed a higher risk of B-NHL (HR = 1.31, 95% CI = 1.02–1.68; n = 583) in women with the highest education level (university) but not in men. Concerning sub-classes of B-NHL, a positive association between education and risk of B cell chronic lymphatic leukaemia (BCLL) was observed only in women. In both genders, the risk of diffuse large B cell lymphoma (DLBCL) was significantly lower for subjects with university degree (HR = 0.46, 95% CI = 0.27–0.79) versus lowest educational level. No association was found for HL.<br/> CONCLUSION: We could not confirm an overall consistent association of education and risk of HL or NHL in this large prospective study; although, education was positively related to the incidence of BCLL and B-NHL (in women) but inversely to incidence of DLBCL. Due to limited number of cases in sub-classes and the large number of comparisons, the possibility of chance findings can not be excluded.<br/>

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 19582474
Web of Science ID: 271981600009
URI: http://researchonline.lshtm.ac.uk/id/eprint/2580


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