Abstract:
The aim of the present meta-analysis was to examine comprehensively the
association between smoking and lymphoma [Hodgkin lymphoma (HL) and
non-Hodgkin lymphoma (NHL)] in adults. Eligible studies were identified,
and pooled-effect estimates (odds ratios and relative risks) were
calculated for ever, current and former smoking, separately by lymphoma
subtype and gender. Metaregression analysis with percentage of male
patients, mean age, duration (years of smoking), intensity (pack-years
and cigarettes per day) and years since quitting was carried out. Out of
the 50 eligible articles, 41 used a case-control design (20 143 NHL
cases, 4340 HL cases and 61 517 controls), whereas nine used a cohort
design (5748 incident NHL cases, 334 HL cases, total cohort size
comprising 1 530 833 smokers). Ever smoking was associated with
increased risk for NHL [pooled-effect estimate = 1.05, 95% confidence
interval (CI): 1.00-1.09] mainly because of the association with T-NHL
(pooled-effect estimate = 1.23, 95% CI: 1.09-1.38). Ever smoking was
also associated with increased risk for HL (pooled-effect estimate =
1.15, 95% CI: 1.02-1.30); sizeable associations were observed regarding
both nodular sclerosis and mixed cellularity subtypes. Although male
study arms pointed to predominantly increased risk for HL,
metaregression did not confirm the male preponderance. Dose-response
patterns were particularly evident for HL. Cigarette smoking seems to be
associated with increased lymphoma risk, especially HL and T-NHL.
Further well-designed studies seem to be needed so as to investigate the
risk thoroughly, especially for T-NHL subentities, and the extent to
which confounding may interfere with gender-related disparities.
European Journal of Cancer Prevention 22:131-150 (c) 2013 Wolters Kluwer
Health vertical bar Lippincott Williams & Wilkins.
Authors:
Sergentanis, Theodoros N.
Kanavidis, Prodromos
Michelakos,
Theodoros
Petridou, Eleni Th
